Paphos, Cyprus
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Szczepanska E.,University of Silesia | Klocek M.,Diabetes Clinic | Kardas M.,University of Silesia | Dul L.,University of Silesia
Advances in Clinical and Experimental Medicine | Year: 2014

Background: Diabetes is one of many diseases in which prevention and treatment are essentially based on proper nutrition. Nutritional education should be a constant, integral and indispensable part of the therapeutic procedure in diabetes. Objectives. The aim of the study was an estimation of the nutritional habits of patients with type 2 diabetes before and after individual nutritional education and the answers to the question what influence this education had on the change of nutritional habits and the change of the anthropometric measurements of the patients. Material and Methods: 148 patients of diabetes outpatient clinics participated in our study, which contained, among others, anthropometric measurements and carrying out a questionnaire that tested dietary habits. An individual nutrition plan was established and the individual dietary education of the patients was carried out on the basis of the gathered data. The nutritional habits and the anthropometric measurements were verified again three months after the education. Results: The analysis of the results received revealed an occurrence of the differences between the incidence of proper nutritional habits and middle-values of body weight and waist size in the period before and after education. Before the education, an enormous amount of improper nutritional habits were found and the values of body weight and waist size were higher, while after the education the improvement of habits and a reduction in body weight and waist size were observed. Conclusions: The results of our study carried out before the education revealed the occurrence of many unfavorable nutritional habits. As a result of the education, nutritional habits improved, which were simultaneously reflected in an improvement of the anthropometric parameters. The results of the studies carried out proved the efficiency and profitable influence of dietary education on changes to the nutritional habits of respondents. © Copyright by Wroclaw Medical University.


Papaetis G.S.,Diabetes Clinic | Papaetis G.S.,National and Kapodistrian University of Athens | Orphanidou D.,National and Kapodistrian University of Athens | Panagiotou T.N.,National and Kapodistrian University of Athens
Current Drug Targets | Year: 2011

The prevalence of type 2 diabetes is evolving globally at an alarming rate. This fact is mainly the result of our global lifestyle "modernization" that has resulted in overweight and obesity. Dysfunction of peroxisome proliferators activated receptor-gamma (PPAR-γ) has been implicated in the development of insulin resistance, while a reduce expression of many PPAR-γ regulated genes has been observed in an obese diabetic state. Thiazolidinediones (TZDs) are potent exogenous agonists of PPAR-γ, which augment the effects of insulin to its cellular targets and mainly at the level of adipose tissue. Preclinical and clinical studies have demonstrated that apart from their glucose-lowering activity, these drugs also regulate the production of inflammatory mediators by cells that play a pivotal role in the pathogenesis of atherosclerosis. This paper summarizes the evolving changes observed in an enlarged adipose tissue and examines the activity of TZDs in their main cellular targets. It also discusses whether these cellular pleiotropic effects can result in a clinically meaningful outcome, in terms of cardiovascular benefit, in this population. © 2011 Bentham Science Publishers Ltd.


Papaetis G.S.,Diabetes Clinic | Papaetis G.S.,National and Kapodistrian University of Athens | Papakyriakou P.,Paphos General Hospital | Panagiotou T.N.,National and Kapodistrian University of Athens
Archives of Medical Science | Year: 2015

The prevalence of type 2 diabetes (T2D) is rapidly increasing. This is strongly related to the contemporary lifestyle changes that have resulted in increased rates of overweight individuals and obesity. Central (intra-abdominal) obesity is observed in the majority of patients with T2D. It is associated with insulin resistance, mainly at the level of skeletal muscle, adipose tissue and liver. The discovery of macrophage infiltration in the abdominal adipose tissue and the unbalanced production of adipocyte cytokines (adipokines) was an essential step towards novel research perspectives for a better understanding of the molecular mechanisms governing the development of insulin resistance. Furthermore, in an obese state, the increased cellular uptake of non-esterified fatty acids is exacerbated without any subsequent β-oxidation. This in turn contributes to the accumulation of intermediate lipid metabolites that cause defects in the insulin signaling pathway. This paper examines the possible cellular mechanisms that connect central obesity with defects in the insulin pathway. It discusses the discrepancies observed from studies organized in cell cultures, animal models and humans. Finally, it emphasizes the need for therapeutic strategies in order to achieve weight reduction in overweight and obese patients with T2D. Copyright © 2015 Termedia & Banach.


PubMed | University of Silesia and Diabetes Clinic
Type: Journal Article | Journal: Advances in clinical and experimental medicine : official organ Wroclaw Medical University | Year: 2014

Diabetes is one of many diseases in which prevention and treatment are essentially based on proper nutrition. Nutritional education should be a constant, integral and indispensable part of the therapeutic procedure in diabetes.The aim of the study was an estimation of the nutritional habits of patients with type 2 diabetes before and after individual nutritional education and the answers to the question what influence this education had on the change of nutritional habits and the change of the anthropometric measurements of the patients.148 patients of diabetes outpatient clinics participated in our study, which contained, among others, anthropometric measurements and carrying out a questionnaire that tested dietary habits. An individual nutrition plan was established and the individual dietary education of the patients was carried out on the basis of the gathered data. The nutritional habits and the anthropometric measurements were verified again three months after the education.The analysis of the results received revealed an occurrence of the differences between the incidence of proper nutritional habits and middle-values of body weight and waist size in the period before and after education. Before the education, an enormous amount of improper nutritional habits were found and the values of body weight and waist size were higher, while after the education the improvement of habits and a reduction in body weight and waist size were observed.The results of our study carried out before the education revealed the occurrence of many unfavorable nutritional habits. As a result of the education, nutritional habits improved, which were simultaneously reflected in an improvement of the anthropometric parameters. The results of the studies carried out proved the efficiency and profitable influence of dietary education on changes to the nutritional habits of respondents).


Wainstein J.,Diabetes Clinic | Wainstein J.,Tel Aviv University | Leibovitz E.,Wolfson Medical Center | Leibovitz E.,Tel Aviv University | And 3 more authors.
Israel Medical Association Journal | Year: 2011

Background: Control of diabetes is challenging, and frequent treatment changes are needed. Objective: To study the effect of the recommendation to start insulin glargine or insulin determir (long-acting insulin treatment, LAI) at discharge from hospital, on glucose control in the community setting. Methods: Included were type II diabetes patients who were referred to and received a consultation from the hospital diabetes clinic during their hosptialization, as part of a routine consultation for diabetes management. During the visit, all patients were recommended long-acting insulin-based treatment, as inpatient treatment and at discharge. Follow-up was done by the primary physician in the community or by a community-based diabetes clinic. Glycosylated hemoglobin, glucose levels and other laboratory tests were obtained from the community health records before hospitalization and 6-12 months later. Medical treatment was ascertained by reviewing the actual usage of prescriptions. Results: Eighty patients (58% males, mean age 64.1 ± 12.7 years) were included in the analysis. HbA1c levels were 10.1 ± 2.4% before admission, but improved significantly at follow-up (8.6 ± 2.2%, P < 0.001). Seventy-one percent of the patients were taking the LAI treatment and the rest were using non-LAI medications. Changes in diabetes control were similar between the LAI and non-LAI groups (HbA1c was reduced by 1.5 ± 3.2% and 1.9 ± 3.1% respectively). The rate of repeated admissions was also similar, averaging at 1.3 admissions for both groups, the minority of which were related to glucose control. Conclusions: Insulin glargine or determir-based treatment does not show any superiority over other anti-diabetes treatment. It is our opinion that this treatment should be used as tailored therapy and should not be recommended routinely to all patients.


Bachle C.C.,Heinrich Heine University Düsseldorf | Holl R.W.,University of Ulm | Strassburger K.,Heinrich Heine University Düsseldorf | Molz E.,University of Ulm | And 9 more authors.
Diabetic Medicine | Year: 2012

Aims To estimate direct costs of paediatric Type 1 diabetes care and associated factors in Germany for the year 2007 and to compare results with the costs for the year 2000. Methods Our study includes clinical data and charges for any diabetes-related health care service of 14185 continually treated subjects with paediatric diabetes aged <20years [52.5% male, mean age (SD) 12.1 (4.2)years], derived from a nationwide prospective patient documentation system (DPV). Health-care utilization was valued in monetary terms by using inpatient and outpatient medical fees and retail prices (perspective of the statutory health insurance). Associations between average total diabetes-related costs or various single cost categories per patient and age, sex, migration background, diabetes duration, and metabolic control were analysed by multiple regression procedures and by a two-part model for hospitalization costs. Total direct costs in the whole paediatric diabetes population in Germany were estimated. Mean costs per patient as well as total costs in the German paediatric diabetes population in 2007 were compared to 2000 costs (inflated to the year 2007). Results Mean direct diabetes-associated costs per subject were €3524 (inter-quartile range: 1831-4743). Main cost categories were hospitalization (32%), glucose self-monitoring (29%), insulin pump therapy (18%), and insulin (15%). Based on the present estimation, the total costs of paediatric diabetes care in Germany exceeded €110 million in 2007. Compared with estimates of the year 2000, average costs per patient had increased by 20% and total costs for German paediatric diabetes care by 47%. Conclusions Direct costs for paediatric Type 1 diabetes care increased between 2000 and 2007, probably partly because of new therapeutic strategies and an increase in diabetes prevalence. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.


Kianbakht S.,Tehran University of Medical Sciences | Kianbakht S.,Research Institute of Medicinal Plants | Abasi B.,Diabetes Clinic | Dabaghian F.H.,Tehran University of Medical Sciences
Forschende Komplementarmedizin | Year: 2013

Background: Type 2 diabetes mellitus is a common disease. Preliminary data indicate that Vaccinium arctostaphylos L. (Caucasian whortleberry) has a potential effect in glycemic control. Thus, the efficacy and safety of a standardized whortleberry fruit hydroalcoholic extract in the treatment of type 2 diabetic patients were studied. Methods: This randomized double-blind placebo-controlled clinical trial consisted of 37 patients aged 40-60 years with type 2 diabetes who were resistant to conventional oral anti-hyperglycemic drugs. The patients were treated with the whortleberry fruit hydroalcoholic extract (1 capsule = 350 mg, every 8 h for 2 months) in combination with anti-hyperglycemic drugs, and the effects on the blood levels of fasting glucose, 2-hour postprandial glucose, glycosylated hemoglobin (HbA1c), and liver/kidney function were tested, evaluated, and compared with a placebo group (n = 37). Results: The extract significantly lowered the blood levels of fasting glucose, 2-h postprandial glucose, and HbA1c (p = 0.007, p <0.001, and p = 0.005, respectively) without any significant effects on the liver/kidney function (p >0.05) compared with placebo at the end. No adverse effects were reported. Conclusion: Whortleberry may safely improve glycemic control in type 2 diabetic patients. © 2013 S. Karger AG, Basel.


Kianbakht S.,Tehran University of Medical Sciences | Kianbakht S.,Research Institute of Medicinal Plants | Abasi B.,Diabetes Clinic | Dabaghian F.H.,Tehran University of Medical Sciences
Forschende Komplementarmedizin | Year: 2013

Background: Type 2 diabetes mellitus is a common disease. Preliminary data indicate that Vaccinium arctostaphylos L. (Caucasian whortleberry) has a potential effect in glycemic control. Thus, the efficacy and safety of a standardized whortleberry fruit hydroalcoholic extract in the treatment of type 2 diabetic patients were studied. Methods: This randomized double-blind placebo-controlled clinical trial consisted of 37 patients aged 40-60 years with type 2 diabetes who were resistant to conventional oral anti-hyperglycemic drugs. The patients were treated with the whortleberry fruit hydroalcoholic extract (1 capsule = 350 mg, every 8 h for 2 months) in combination with anti-hyperglycemic drugs, and the effects on the blood levels of fasting glucose, 2-hour postprandial glucose, glycosylated hemoglobin (HbA1c), and liver/kidney function were tested, evaluated, and compared with a placebo group (n = 37). Results: The extract significantly lowered the blood levels of fasting glucose, 2-h postprandial glucose, and HbA1c (p = 0.007, p <0.001, and p = 0.005, respectively) without any significant effects on the liver/kidney function (p >0.05) compared with placebo at the end. No adverse effects were reported. Conclusion: Whortleberry may safely improve glycemic control in type 2 diabetic patients. Copyright © 2013 S. Karger AG, Basel.


We performed a non-inferiority trial comparing insulin detemir (Levemir) and biphasic insulin (NovoMix70) to standard care during Ramadan fast in insulin treated type 2 diabetes mellitus (T2DM) patients. This was an open label, controlled, multicentre, cluster randomised non-inferiority study. Insulin treated T2DM patients from 12 randomly selected primary clinics received Levemir and NovoMix 70 (intervention, n = 127) or standard care according to the American Diabetes Association recommendations (control, n = 118). Insulin dose (intervention) was 60% of the usual, of this 40% was dosed as Levemir at sunrise and 60% as NovoMix 70 before dinner. Insulin was titrated according to daily 4 point self-measured blood glucose (4P-SMBG) levels. The primary outcome was the difference in mean daily 4P-SMBG during days 23-30 of treatment. Mean age was 60.1 (SD 8.9) and 59.4 (SD 10.1) years in the intervention and control respectively. Mean HbA1c was 8.38% (68 mmol/mol) (SD 0.96) and 8.45% (69 mmol/mol) (SD 1.08). Mean BMI was 32.99 (SD 7.05) and 33.08 (SD 7.24), respectively. The intervention was non-inferior to standard care as assessed by mean 4P-SMBG during days 23-30 of treatment [155 (SD 30.76) mg% and 159 (SD 33.24) mg% respectively, p = 0.269]. Adverse event rate was significantly lower in the intervention group [0.04 (SD 0.06) vs. 0.07 (SD 0.11), p = 0.010]. In particular, hypoglycaemia event rate was lower in the intervention group [0.00 (SD 0.01) vs. 0.01 (SD 0.03), p 0.001]. To conclude, treatment with Levemir and NovoMix 70 was non-inferior to standard care in this heterogeneous group of patients and was associated with less adverse events.


PubMed | Diabetes Clinic and Institute of Medicinal Plants
Type: Journal Article | Journal: International journal of molecular and cellular medicine | Year: 2016

The efficacy and safety of

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