1
|
Czarnik K, Sablik Z, Borkowska A, Drożdż J, Cypryk K. Impact of metabolic dysfunction-associated steatotic liver disease on markers of left ventricular function and mitral annular velocities in patients with type 1 diabetes: an exploratory study. Pol Arch Intern Med 2024; 134:16709. [PMID: 38506270 DOI: 10.20452/pamw.16709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
|
2
|
Cypryk K, Wender-Ozegowska E, Cyganek K, Sieradzki J, Skoczylas K, Chen X, Cordero TL, Shin J, Cohen O. Insulin pump therapy with and without continuous glucose monitoring in pregnant women with type 1 diabetes: a prospective observational Orchestra Foundation study in Poland. Acta Diabetol 2023; 60:553-561. [PMID: 36653533 PMCID: PMC10033617 DOI: 10.1007/s00592-022-02020-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/14/2022] [Indexed: 01/20/2023]
Abstract
AIMS The effects of continuous subcutaneous insulin infusion (CSII) therapy with or without continuous glucose monitoring (CGM) on neonatal outcomes and glycemic outcomes of pregnant women with type 1 diabetes (T1D), living in Poland, were assessed. METHODS This prospective observational study enrolled women with T1D (N = 481, aged 18-45 years) who were pregnant or planned pregnancy. All used CSII therapy and a subset used CGM with CSII (CSII + CGM). Neonatal outcomes (e.g., rate of large for gestational age [LGA] delivery [birth weight > 90th percentile]) and maternal glycemia (e.g., HbA1c and percentage of time at sensor glucose ranges) were evaluated. RESULTS Overall HbA1c at trimesters 1, 2, and 3 was 6.8 ± 1.1% (50.9 ± 12.3 mmol/mol, N = 354), 5.8 ± 0.7% (40.1 ± 8.0 mmol/mol, N = 318), and 5.9 ± 0.7% (41.4 ± 8.0 mmol/mol, N = 255), respectively. A HbA1c target of < 6.0% (42 mmol/mol) at each trimester was achieved by 20.9% (74/354), 65.1% (207/318), and 58.0% (148/255), respectively. For women using CSII + CGM versus CSII only, HbA1c levels at trimesters 1, 2, and 3 were 6.5 ± 0.9% versus 7.1 ± 1.3% (47.8 ± 9.7 mmol/mol versus 54.3 ± 14.0 mmol/mol, p < 0.0001), 5.7 ± 0.6% versus 6.0 ± 0.9% (38.9 ± 6.5 mmol/mol versus 41.6 ± 9.3 mmol/mol, p = 0.0122), and 5.8 ± 0.6% versus 6.1 ± 0.8% (40.3 ± 6.9 mmol/mol versus 42.9 ± 9.1 mmol/mol, p = 0.0117), respectively. For the overall, CSII only, and CSII + CGM groups, rates of LGA delivery were 22.7% (74/326), 24.6% (34/138), and 21.3% (40/188), respectively. CONCLUSIONS Observational assessment of women with T1D using CSII therapy demonstrated low HbA1c throughout pregnancy and low rates of LGA. The addition of CGM to CSII therapy compared to CSII therapy alone was associated with some improved maternal glycemic and neonatal outcomes. GOV IDENTIFIER NCT01779141 (January 2013).
Collapse
Affiliation(s)
- Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska Str. 251, 92-213, Lodz, Poland.
| | - Ewa Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poznań, Poland
| | - Katarzyna Cyganek
- Department of Metabolic Diseases, The University Hospital in Krakow, Krakow, Poland
- Collegium Medicum, Jagiellonian University of Krakow, Krakow, Poland
| | - Jacek Sieradzki
- Collegium Medicum, Jagiellonian University of Krakow, Krakow, Poland
| | | | | | | | | | | |
Collapse
|
3
|
Burzynska-Pedziwiatr I, Dudzik D, Sansone A, Malachowska B, Zieleniak A, Zurawska-Klis M, Ferreri C, Chatgilialoglu C, Cypryk K, Wozniak LA, Markuszewski MJ, Bukowiecka-Matusiak M. Targeted and untargeted metabolomic approach for GDM diagnosis. Front Mol Biosci 2023; 9:997436. [PMID: 36685282 PMCID: PMC9849575 DOI: 10.3389/fmolb.2022.997436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a disorder which manifests itself for the first time during pregnancy and is mainly connected with glucose metabolism. It is also known that fatty acid profile changes in erythrocyte membranes and plasma could be associated with obesity and insulin resistance. These factors can lead to the development of diabetes. In the reported study, we applied the untargeted analysis of plasma in GDM against standard glucose-tolerant (NGT) women to identify the differences in metabolomic profiles between those groups. We found higher levels of 2-hydroxybutyric and 3-hydroxybutyric acids. Both secondary metabolites are associated with impaired glucose metabolism. However, they are products of different metabolic pathways. Additionally, we applied lipidomic profiling using gas chromatography to examine the fatty acid composition of cholesteryl esters in the plasma of GDM patients. Among the 14 measured fatty acids characterizing the representative plasma lipidomic cluster, myristic, oleic, arachidonic, and α-linoleic acids revealed statistically significant changes. Concentrations of both myristic acid, one of the saturated fatty acids (SFAs), and oleic acid, which belong to monounsaturated fatty acids (MUFAs), tend to decrease in GDM patients. In the case of polyunsaturated fatty acids (PUFAs), some of them tend to increase (e.g., arachidonic), and some of them tend to decrease (e.g., α-linolenic). Based on our results, we postulate the importance of hydroxybutyric acid derivatives, cholesteryl ester composition, and the oleic acid diminution in the pathophysiology of GDM. There are some evidence suggests that the oleic acid can have the protective role in diabetes onset. However, metabolic alterations that lead to the onset of GDM are complex; therefore, further studies are needed to confirm our observations.
Collapse
Affiliation(s)
| | - Danuta Dudzik
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Anna Sansone
- Consiglio Nazionale delle Ricerche, Institute for the Organic Synthesis and Photoreactivity, Bologna, Italy
| | - Beata Malachowska
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland,Department of Nursing and Obstetrics, Medical University of Lodz, Lodz, Poland,Department of Clinic Nursing, Medical University of Lodz, Lodz, Poland,Department of Diabetology and Metabolic Diseases Lodz, Medical University of Lodz, Lodz, Poland
| | - Andrzej Zieleniak
- Laboratory of Metabolomic Studies, Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Monika Zurawska-Klis
- Department of Radiation Oncology, Einstein College of Medicine, Bronx, NY, United States
| | - Carla Ferreri
- Consiglio Nazionale delle Ricerche, Institute for the Organic Synthesis and Photoreactivity, Bologna, Italy
| | | | - Katarzyna Cypryk
- Department of Radiation Oncology, Einstein College of Medicine, Bronx, NY, United States
| | - Lucyna A. Wozniak
- Laboratory of Metabolomic Studies, Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Michal J. Markuszewski
- Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdansk, Gdansk, Poland
| | - Malgorzata Bukowiecka-Matusiak
- Laboratory of Metabolomic Studies, Department of Structural Biology, Medical University of Lodz, Lodz, Poland,*Correspondence: Malgorzata Bukowiecka-Matusiak,
| |
Collapse
|
4
|
Zieleniak A, Zurawska-Klis M, Cypryk K, Wozniak L, Wojcik M. Transcriptomic Dysregulation of Inflammation-Related Genes in Leukocytes of Patients with Gestational Diabetes Mellitus (GDM) during and after Pregnancy: Identifying Potential Biomarkers Relevant to Glycemic Abnormality. Int J Mol Sci 2022; 23:ijms232314677. [PMID: 36499008 PMCID: PMC9737950 DOI: 10.3390/ijms232314677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
Abstract
Although the immune system has been implicated in the pathophysiology of gestational diabetes mellitus (GDM) and postpartum abnormal glucose tolerance (AGT), little is known about the transcriptional response of inflammation-related genes linked to metabolic phenotypes of GDM women during and after pregnancy, which may be potential diagnostic classifiers for GDM and biomarkers for predicting AGT. To address these questions, gene expression of IL6, IL8, IL10, IL13, IL18, TNFA, and the nuclear factor κB (NFκB)/RELA transcription factor were quantified in leukocytes of 28 diabetic women at GDM diagnosis (GDM group) and 1-year postpartum (pGDM group: 10 women with AGT and 18 normoglycemic women), using a nested RT-PCR method. Control pregnancies with normal glucose tolerance (NGT group; n = 31) were closely matched for maternal age, gestational age, pre-pregnancy BMI, pregnancy weight, and gestational weight gain. Compared with the NGT group, IL8 was downregulated in the GDM group, and IL13 and RELA were upregulated in the pGDM group, whereas IL6, IL10, and IL18 were upregulated in the GDM and pGDM groups. The TNFA level did not change from pregnancy to postpartum. Associations of some cytokines with glycemic measures were detected in pregnancy (IL6 and RELA) and postpartum (IL10) (p < 0.05). Receiver operating characteristic (ROC) curves showed that IL6, IL8, and IL18, if employed alone, can discriminate GDM patients from NGT individuals at GDM diagnosis, with the area under the ROC curves (AUCs) of 0.844, (95% CI 0.736−0.953), 0.771 (95% CI 0.651−0.890), and 0.714 (95% CI 0.582−0.846), respectively. By the logistic regression method, we also identified a three-gene panel (IL8, IL13, and TNFA) for postpartum AGT prediction. This study demonstrates a different transcriptional response of the studied genes in clinically well-characterized women with GDM at GDM diagnosis and 1-year postpartum, and provides novel transcriptomic biomarkers for future efforts aimed at diagnosing GDM and identifying the high risk of postpartum AGT groups.
Collapse
Affiliation(s)
- Andrzej Zieleniak
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| | - Monika Zurawska-Klis
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 92-213 Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 92-213 Lodz, Poland
| | - Lucyna Wozniak
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| | - Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences, Medical University of Lodz, 90-752 Lodz, Poland
- Correspondence: ; Tel.: +48-426-393-238
| |
Collapse
|
5
|
Los-Stegienta A, Borkowska A, Cypryk K. Assessment of microvascular function using a novel technique Flow Mediated Skin Fluorescence (FMSF) in patients with diabetic kidney disease: A preliminary study. Microvasc Res 2022; 144:104417. [PMID: 35931125 DOI: 10.1016/j.mvr.2022.104417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Diabetic kidney disease (DKD) plays an important role in morbidity and mortality in patients with diabetes mellitus. The pathogenesis of this microangiopathy is mainly due to impaired vascular endothelial function. The Flow Mediated Skin Fluorescence (FMSF) method is an innovative, non-invasive tool for assessing the microcirculation function (especially microcirculatory response to hypoxia), also in patients with complications of diabetes mellitus (DM). MATERIAL AND METHODS The study was conducted at the Medical University of Lodz, Poland. Total of 84 volunteers including 30 patients with DKD, 33 patients with DM without complications, and 21 healthy subjects underwent microvascular function assessments using FMSF. This technique measures changes in the intensity of nicotinamide adenine dinucleotide (NADH) fluorescence from the skin on the forearm as a function of time, in response to blocking and releasing blood flow in the forearm. In this study we asses two key parameters: Reactive Hyperemia Response (RHR) and Hypoxia Sensitivity [log(HS)] to characterize vascular circulation in patients with DKD and their response to transient ischemia. RESULTS The patients with low reactive hyperemic response (the RHR parameter) had a significantly higher sCr than patients with moderate and high RHR value (p < 0.001, p < 0.05, respectively) and a significantly lower eGFR than the patients with moderate and high RHR parameter (p < 0.001, p < 0.01, respectively). The patients with very low and low log(HS) values had a significantly higher sCr than the patients with high log(HS) (p < 0.001, p < 0.01, respectively), and a significantly lower eGFR than the patients with high log(HS) parameter (p < 0.001, p < 0.01, respectively). The patients with very low log(HS) had a significantly higher sCr and a significantly lower eGFR than the patients with moderate (p < 0.05, p < 0.01, respectively). The mean value of the RHR parameter was significantly lower in DKD patients (18.31 ± 5.06 %) compared to both healthy subjects (34.37 ± 8.18 %, p < 0.001) and DM without complications subgroup (28.75 ± 7.12 %, p < 0.001). Similar trends were noted with the mean value of log(HS) parameter in DKD subgroup (1.03 ± 0.5) vs. healthy subjects (1.59 ± 0.53, p < 0.001), and vs. DM without complications subgroup (1.73 ± 0.52, p < 0.001). We observed a significant inverse correlation between the RHR parameter and serum creatinine (sCr) and a significant positive correlations with eGFR (R = -0.3; p < 0.05, R = 0.61; p < 0.001, respectively). We found also a significant negative correlations of the log(HS) measure with sCr and a significant positive correlations with eGFR (R = -0.33; p < 0.01, R = 0.55; p < 0.001, respectively). We observed also a significant inverse correlation between the RHR and log(HS) parameters and advanced glycation end products (AGEs) (R = -0.6; p < 0.001, R = -0.32; p < 0.01, respectively). The AGEs parameter was also a significantly higher in patients with low RHR parameter than in patients with moderate (p < 0.01) and high (p < 0.001). CONCLUSIONS The FMSF technique makes it possible to identify impairments of the microvascular function in patients with DKD. This study confirms that the simple two-parametric approach diagnostic tool perfectly characterizes the state of the microvascular system in diabetic patients with impaired renal function. These preliminary results require further validation in a larger patients cohort.
Collapse
Affiliation(s)
- Agnieszka Los-Stegienta
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland.
| | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland.
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland.
| |
Collapse
|
6
|
Mathiesen ER, Ali N, Alibegovic AC, Anastasiou E, Cypryk K, de Valk H, Dores J, Dunne F, Gall MA, Garcia SD, Hanaire HP, Husemoen LLN, Ivanišević M, Kempe HP, McCance DR, Damm P. Risk of Major Congenital Malformations or Perinatal or Neonatal Death With Insulin Detemir Versus Other Basal Insulins in Pregnant Women With Preexisting Diabetes: The Real-World EVOLVE Study. Diabetes Care 2021; 44:2069-2077. [PMID: 34330786 PMCID: PMC8740922 DOI: 10.2337/dc21-0472] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/24/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To compare the risk of severe adverse pregnancy complications in women with preexisting diabetes. RESEARCH DESIGN AND METHODS Multinational, prospective cohort study to assess the prevalence of newborns free from major congenital malformations or perinatal or neonatal death (primary end point) following treatment with insulin detemir (detemir) versus other basal insulins. RESULTS Of 1,457 women included, 727 received detemir and 730 received other basal insulins. The prevalence of newborns free from major congenital malformations or perinatal or neonatal death was similar between detemir (97.0%) and other basal insulins (95.5%) (crude risk difference 0.015 [95% CI -0.01, 0.04]; adjusted risk difference -0.003 [95% CI -0.03, 0.03]). The crude prevalence of one or more congenital malformations (major plus minor) was 9.4% vs. 12.6%, with a similar risk difference before (-0.032 [95% CI -0.064, 0.000]) and after (-0.036 [95% CI -0.081, 0.009]) adjustment for confounders. Crude data showed lower maternal HbA1c during the first trimester (6.5% vs. 6.7% [48 vs. 50 mmol/mol]; estimated mean difference -0.181 [95% CI -0.300, -0.062]) and the second trimester (6.1% vs. 6.3% [43 vs. 45 mmol/mol]; -0.139 [95% CI -0.232, -0.046]) and a lower prevalence of major hypoglycemia (6.0% vs. 9.0%; risk difference -0.030 [95% CI -0.058, -0.002]), preeclampsia (6.4% vs. 10.0%; -0.036 [95% CI -0.064, -0.007]), and stillbirth (0.4% vs. 1.8%; -0.013 [95% CI -0.024, -0.002]) with detemir compared with other basal insulins. However, differences were not significant postadjustment. CONCLUSIONS Insulin detemir was associated with a similar risk to other basal insulins of major congenital malformations, perinatal or neonatal death, hypoglycemia, preeclampsia, and stillbirth.
Collapse
Affiliation(s)
- Elisabeth R Mathiesen
- Department of Endocrinology, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark .,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Norsiah Ali
- Masjid Tanah Health Clinic, Malacca, Malaysia
| | | | - Eleni Anastasiou
- Department of Endocrinology-Diabetes Center, Princess Alexandra Hospital, Athens, Greece
| | - Katarzyna Cypryk
- Department of Internal Medicine and Diabetology, Medical University of Łódź, Łódź, Poland
| | - Harold de Valk
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jorge Dores
- Department of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Fidelma Dunne
- College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | | | | | - Hélène P Hanaire
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, University of Toulouse, Toulouse, France
| | | | - Marina Ivanišević
- Department of Obstetrics and Gynecology, State Referral Center for Diabetes in Pregnancy, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Hans-Peter Kempe
- Centre for Diabetes and Nutrition Ludwigshafen, Ludwigshafen, Germany
| | | | - Peter Damm
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
7
|
Mathiesen ER, Ali N, Anastasiou E, Cypryk K, de Valk HW, Dores JM, Dunne FP, Ekelund M, Durán García S, Hanaire H, Husemoen LLN, Ivanisevic M, Kempe HP, Nordsborg RB, McCance DR. Characteristics of pregnant women with diabetes using injectable glucose-lowering drugs in the EVOLVE study. J Matern Fetal Neonatal Med 2021; 35:7992-8000. [PMID: 34182866 DOI: 10.1080/14767058.2021.1940132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To examine clinical parameters, glycemic control, folic acid supplementation, and the presence of other chronic diseases during early pregnancy in the EVOLVE study population (women with pre-existing diabetes treated with injectable glucose-lowering drugs). METHODS Cross-sectional baseline evaluation of EVOLVE: an international, multicenter, non-interventional study investigating the safety of injectable glucose-lowering drugs in pregnant women with pre-existing type 1 (T1D) or type 2 diabetes (T2D). Data were collected at enrollment visit interviews before gestational week 16. RESULTS In total, 2383 women from 17 mainly European countries were enrolled in the study: 2122 with T1D and 261 with T2D; mean age was 31 and 33 years, and duration of diabetes was 15 and 6 years, respectively. For women with T1D or T2D, 63% and 75%, respectively, received basal and rapid-acting insulin, 36% and 3% rapid-acting insulin only, 0.7% and 14.0% basal insulin only, 0.2% and 5.4% premix insulin, 0.0% and 1.2% injectable glucagon-like peptide-1 receptor agonist treatment without insulin. In women with T1D or T2D, respectively, during early pregnancy, 59% and 62% had HbA1c <7.0% (53 mmol/mol); 16% and 36% reported not taking folic acid before or during early pregnancy. Overall, >40% of women had ≥1 chronic concomitant condition (predominantly thyroid disease or hypertension). Retinopathy was the most commonly reported diabetic complication. The most commonly reported previous pregnancy complication was miscarriage. CONCLUSIONS Baseline data from this large multinational population of women with pre-existing diabetes indicate that sub-optimal glycemic control, poor pregnancy planning, and chronic concomitant conditions were common in early pregnancy.
Collapse
Affiliation(s)
- Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Norsiah Ali
- Masjid Tanah Health Clinic, Malacca, Malaysia
| | - Eleni Anastasiou
- Department of Endocrinology-Diabetes Center, Alexandra Hospital, Athens, Greece
| | - Katarzyna Cypryk
- Department of Internal Medicine and Diabetology, Medical University of Łódź, Łódź, Poland
| | - Harold W de Valk
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jorge M Dores
- Department of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Fidelma P Dunne
- Department of Medicine, Galway Diabetes Research Centre, National University of Ireland Galway, Galway, Ireland
| | | | | | - Hélène Hanaire
- Department of Diabetology, Metabolic Diseases and Nutrition, University Hospital of Toulouse, University of Toulouse, Toulouse, France
| | | | - Marina Ivanisevic
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, Zagreb, Croatia
| | - Hans-Peter Kempe
- Centre for Diabetes and Nutrition Ludwigshafen, Ludwigshafen, Germany
| | | | | |
Collapse
|
8
|
Żurawska-Kliś M, Czarnik K, Szymczak S, Wójcik M, Cypryk K. 1-Hour postprandial glucose target of < 120 mg/dL is superior to < 140 mg/dL in the treatment for gestational diabetes mellitus in relation to pregnancy outcomes: A retrospective study. Acta Diabetol 2021; 58:665-668. [PMID: 33576889 PMCID: PMC8076122 DOI: 10.1007/s00592-020-01655-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/06/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Monika Żurawska-Kliś
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 251 Pomorska str., 92-213, Lodz, Poland.
| | - Klaudia Czarnik
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 251 Pomorska str., 92-213, Lodz, Poland
| | - Szymon Szymczak
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 251 Pomorska str., 92-213, Lodz, Poland
| | - Marzena Wójcik
- Department of Structural Biology, Medical University of Lodz, 7/9 Żeligowskiego str., 90-752, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, 251 Pomorska str., 92-213, Lodz, Poland
| |
Collapse
|
9
|
Los-Stegienta A, Katarzynska J, Borkowska A, Marcinek A, Cypryk K, Gebicki J. Differentiation of Diabetic Foot Ulcers Based on Stimulation of Myogenic Oscillations by Transient Ischemia. Vasc Health Risk Manag 2021; 17:145-152. [PMID: 33907408 PMCID: PMC8064676 DOI: 10.2147/vhrm.s307366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Diabetic foot ulceration is a chronic complication characterized by impaired wound healing. There is a great demand for a diagnostic tool that is able to monitor and predict wound healing. PATIENTS AND METHODS Oscillations in the microcirculation, known as flowmotion, can be monitored very distinctly and precisely using the Flow Mediated Skin Fluorescence (FMSF) technique. The flowmotion response to hypoxia was measured quantitatively in 42 patients with diabetic foot ulcers. RESULTS The flowmotion response to hypoxia parameters FM(R) and HS were used to differentiate the diabetic foot ulcers and correlate them with clinical status. In some cases, FMSF measurements were continued over the period of a year in order to monitor disease progress. The clinical status of the quarter of patients with the highest HS values (group A, HS = 50.2±18.3) was compared to the quarter with the lowest HS values (group B, HS = 4.3±1.7). The patients in the group B were identified as having low prognosis for healing and were characterized by higher incidences of hypertension, hyperlipidemia, prevalent CVD, neuropathy and nephropathy. CONCLUSION Impaired flowmotion responses to hypoxia induced by transient ischemia can be used for differentiation of diabetic foot ulcers and identification of cases with low prognosis for healing.
Collapse
Affiliation(s)
| | | | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| |
Collapse
|
10
|
Araszkiewicz A, Bandurska-Stankiewicz E, Borys S, Budzyński A, Cyganek K, Cypryk K, Czech A, Czupryniak L, Drzewoski J, Dzida G, Dziedzic T, Franek E, Gajewska D, Gawrecki A, Górska M, Grzeszczak W, Gumprecht J, Idzior-Waluś B, Jarosz-Chobot P, Kalarus Z, Karczewska-Kupczewska M, Klupa T, Koblik T, Kokoszka A, Korzon-Burakowska A, Kowalska I, Krętowski A, Majkowska L, Małecki M, Mamcarz A, Mirkiewicz-Sieradzka B, Młynarski W, Moczulski D. 2021 Guidelines on the management of patients with diabetes. A position of Diabetes Poland. Clinical Diabetology 2021. [DOI: 10.5603/dk.2021.0001] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
11
|
Rutkowska K, Cypryk K. Zastosowanie dapagliflozyny w terapii cukrzycy typu 1 u 36-letniej kobiety - opis przypadku. Clinical Diabetology 2021. [DOI: 10.5603/dk.a2021.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
12
|
Baryla I, Pluciennik E, Kośla K, Wojcik M, Zieleniak A, Zurawska-Klis M, Cypryk K, Wozniak LA, Bednarek AK. Identification of a novel association for the WWOX/HIF1A axis with gestational diabetes mellitus (GDM). PeerJ 2021; 9:e10604. [PMID: 33520443 PMCID: PMC7811782 DOI: 10.7717/peerj.10604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background Although the WW-domain-containing oxidoreductase (WWOX)/Hypoxia-inducible factor 1 (HIF1) pathway is a well-known regulator of cellular glucose and energy metabolism in pathophysiological processes, its role in gestational diabetes mellitus (GDM), remains elusive. We undertook this study to determine the effect of WWOX/HIF1A signaling on the expression of glucose metabolism genes in GDM patients. Methods Leukocytes were obtained from 135 pregnant women with (n = 98) or without (n = 37) GDM and, in turn, 3 months (n = 8) and 1 year (n = 12) postpartum. Quantitative RT-PCR was performed to determine gene expression profiles of the WWOX/HIF1A-related genes, including those involved in glucose transport (SLC2A1, SLC2A4), glycolytic pathway (HK2, PKM2, PFK, LDHA), Wnt pathway (DVL2, CTNNB1), and inflammatory response (NFKB1). Results GDM patients displayed a significant downregulation of WWOX with simultaneous upregulation of HIF1A which resulted in approximately six times reduction in WWOX/HIF1A ratio. As a consequence, HIF1A induced genes (SLC2A1, HK2, PFK, PKM) were found to be overexpressed in GDM compared to normal pregnancy and negative correlate with WWOX/HIF1A ratio. The postpartum WWOX expression was higher than during GDM, but its level was comparable to that observed in normal pregnancy. Conclusions The obtained results suggest a significant contribution of the WWOX gene to glucose metabolism in patients with gestational diabetes. Decreased WWOX expression in GDM compared to normal pregnancy, and in particular reduction of WWOX/HIF1A ratio, indicate that WWOX modulates HIF1α activity in normal tissues as described in the tumor. The effect of HIF1α excessive activation is to increase the expression of genes encoding proteins directly involved in the glycolysis which may lead to pathological changes in glucose metabolism observed in gestational diabetes.
Collapse
Affiliation(s)
- Izabela Baryla
- Department of Molecular Carcinogenesis, Medical University of Lodz, Lodz, Poland
| | - Elzbieta Pluciennik
- Department of Molecular Carcinogenesis, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Kośla
- Department of Molecular Carcinogenesis, Medical University of Lodz, Lodz, Poland
| | - Marzena Wojcik
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Zieleniak
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Monika Zurawska-Klis
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | | | - Andrzej K Bednarek
- Department of Molecular Carcinogenesis, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
13
|
Żurawska-Kliś M, Kosiński M, Kuchnicka A, Rurka M, Hałucha J, Wójcik M, Cypryk K. Continuous subcutaneous insulin infusion does not correspond with pregnancy outcomes despite better glycemic control as compared to multiple daily injections in type 1 diabetes - Significance of pregnancy planning and prepregnancy HbA1c. Diabetes Res Clin Pract 2021; 172:108628. [PMID: 33358970 DOI: 10.1016/j.diabres.2020.108628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to compare pregnancy outcomes with glycemic control, total increase in insulin requirement, and body weight gain in the women with Type 1 Diabetes Mellitus (T1DM) using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). MATERIAL AND METHODS This was a single center retrospective observational study involving 209 pregnant Caucasian women. Among the study participants, 95 subjects were treated with MDI and 114 patients were using CSII therapy. The primary outcomes were pregnancy results, while secondary ones were HbA1c, increase in daily dose of insulin (DDI), and body weight gain. RESULTS At baseline, the CSII users were older (P = 0.0373), they were diagnosed with T1DM at a younger age (P = 0.047), and more often planned pregnancy (P = 0.032). A majority of the women were classified as class D, according to the White classification. Among the CSII users, a significantly higher proportion of the subjects in class B was noted than in the MDI users, with no differences in the proportion of the remaining White classes. Prepregnancy HbA1c was insignificantly lower in the CSII group, however, a significantly higher proportion of the CSII users reached the target value of HbA1c (P = 0.008). A prepregnancy daily dose of insulin (both total and per kg of body weight), body weight, and body mass index (BMI) did not differ between the groups. The 1st and 2nd trimester HbA1c was lower among the CSII users (6.83 ± 1.38 vs 7.52 ± 2.11%, P = 0.01 and 6.17 ± 0.9 vs 6.57 ± 1.12%, P = 0.009, respectively), while the 3rd trimester HbA1c as well as the total change in HbA1c were comparable. Neither DDI and body weight in concecutive trimesters, nor their total gestational increase, differed between the groups. The rate of pregnancy loss, such as abortions, fetal and neonatal death did not differ between the groups. As regards composite pregnancy loss, prepregnancy HbA1c was 8.41%±2.81% among the MDI cohort vs 7.22%±1.31% in the CSII users (P = 0.517). No differences were found in the gestational age at delivery, the mode of delivery, neonatal birth weight, the rate of macrosomy, LGA or SGA. A higher Apgar score was noted among the CSII users (8.63 ± 1.63 vs 8.03 ± 2.49%, P = 0.047), however, the proportion of neonates with an Apgar score lower than 7 points was similar. In the women planning pregnancy, as compared to the subjects who did not, HbA1c was significantly lower in the 1st trimester, together with a significantly higher rate of the women achieving the target HbA1c value during planning as well as in the 1st trimester. In the group of women planning pregnancy, significantly lower 1st trimester HbA1c and composite outcome of pregnancy loss were observed in the CSII users vs the MDI treated women. Lack of pregnancy planning and a high HbA1c level in the 1st trimester were independent predictors of both LGA (OR = 4.99 [95%CI 1.12-21.0], P = 0.033 and OR = 3.02 [95%CI 1.19-7.65], P = 0.019, respectively) and macrosomia (OR = 8.43 [95%CI 1.36-51.93], P = 0.021 and OR = 5.47 [95%CI 1.77-16.87], P = 0.003, respectively). CONCLUSIONS The course of pregnancy and obstetric outcomes were not dependent on the mode of insulin delivery, but only on pregnancy planning and HbA1c in early pregnancy. Further studies are needed to explore more precise parameters describing both glycemic control in pregnant women as well as perinatal infant well-being.
Collapse
Affiliation(s)
- Monika Żurawska-Kliś
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland.
| | - Marcin Kosiński
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Andżelika Kuchnicka
- Student Science Club of the Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Milena Rurka
- Student Science Club of the Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Judyta Hałucha
- Student Science Club of the Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Marzena Wójcik
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| |
Collapse
|
14
|
Skibinska M, Zurawska-Klis M, Krekora M, Cypryk K. Metformin administration during pregnancy - current insight. Ginekol Pol 2021; 92:46-50. [PMID: 33576490 DOI: 10.5603/gp.a2020.0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/23/2020] [Accepted: 09/09/2020] [Indexed: 11/25/2022] Open
Abstract
The main mechanism of gestational diabetes mellitus (GDM) is insulin resistance, therefore using metformin as a medicine reducing insulin resistance appears to be promising. Currently, the majority of medical associations do not recommend using metformin during pregnancy as the first-line of therapy when the diet regimen is insufficient for glycaemic control. However, they do allow its administration if there is no possibility of insulin treatment. There is some evidence which suggests that using metformin during pregnancy is not related to an increased risk of obstetric complications during delivery and that its influence on the foetus can be beneficial. Since metformin crosses the placenta, the major argument for cautious use of this drug are the potential long-term effects of the treatment for the child and its development in later life. In this article, the authors attempt to discuss the use of metformin during pregnancy and the safety of the treatment in the light of current studies and recommendations.
Collapse
Affiliation(s)
- Milena Skibinska
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland. .,Department of Internal Diseases and Diabetology, Central Clinical Hospital of The Medical University, Lodz, Poland, Poland.
| | - Monika Zurawska-Klis
- Department of Internal Diseases and Diabetology, Central Clinical Hospital of The Medical University, Lodz, Poland, Poland
| | - Michal Krekora
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Central Clinical Hospital of The Medical University, Lodz, Poland, Poland
| |
Collapse
|
15
|
Gruchała A, Cypryk K, Schliess F, Bobeff K, Heise T, Gurdała M, Szadkowska A, Mianowska B. Pains and needs of patients with type 2 diabetes as targets for novel technologies. Clinical Diabetology 2020. [DOI: 10.5603/dk.2020.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
16
|
Katarzynska J, Borkowska A, Los A, Marcinek A, Cypryk K, Gebicki J. Flow-Mediated Skin Fluorescence (FMSF) Technique for Studying Vascular Complications in Type 2 Diabetes. J Diabetes Sci Technol 2020; 14:693-694. [PMID: 31855069 PMCID: PMC7576949 DOI: 10.1177/1932296819895544] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Agnieszka Los
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Poland
- Jerzy Gebicki, PhD, Institute of Applied Radiation Chemistry, Lodz University of Technology, Zeromskiego 116, Lodz 90-924, Poland. Emails: ;
| |
Collapse
|
17
|
Radzikowska U, Rinaldi AO, Çelebi Sözener Z, Karaguzel D, Wojcik M, Cypryk K, Akdis M, Akdis CA, Sokolowska M. The Influence of Dietary Fatty Acids on Immune Responses. Nutrients 2019; 11:E2990. [PMID: 31817726 PMCID: PMC6950146 DOI: 10.3390/nu11122990] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 12/16/2022] Open
Abstract
Diet-derived fatty acids (FAs) are essential sources of energy and fundamental structural components of cells. They also play important roles in the modulation of immune responses in health and disease. Saturated and unsaturated FAs influence the effector and regulatory functions of innate and adaptive immune cells by changing membrane composition and fluidity and by acting through specific receptors. Impaired balance of saturated/unsaturated FAs, as well as n-6/n-3 polyunsaturated FAs has significant consequences on immune system homeostasis, contributing to the development of many allergic, autoimmune, and metabolic diseases. In this paper, we discuss up-to-date knowledge and the clinical relevance of the influence of dietary FAs on the biology, homeostasis, and functions of epithelial cells, macrophages, dendritic cells, neutrophils, innate lymphoid cells, T cells and B cells. Additionally, we review the effects of dietary FAs on the pathogenesis of many diseases, including asthma, allergic rhinitis, food allergy, atopic dermatitis, rheumatoid arthritis, multiple sclerosis as well as type 1 and 2 diabetes.
Collapse
Affiliation(s)
- Urszula Radzikowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Arturo O Rinaldi
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| | - Zeynep Çelebi Sözener
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Department of Chest Disease, Division of Allergy and Clinical Immunology, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Dilara Karaguzel
- Department of Biology, Faculty of Science, Hacettepe University, 06800 Ankara, Turkey
| | - Marzena Wojcik
- Department of Structural Biology, Medical University of Lodz, 90-752 Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Medicine and Diabetology, Medical University of Lodz, 90-549 Lodz, Poland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| |
Collapse
|
18
|
Żurawska-Kliś M, Wójcik M, Zieleniak A, Kosiński M, Mazur B, Woźniak L, Cypryk K. Wpływ karmienia piersią na stężenia glukozy, odpowiedź insulinową i stężenia CRP u kobiet z przebytą GDM rozpoznaną według kryteriów WHO – prospektywna obserwacja 18-miesięczna. Clinical Diabetology 2019. [DOI: 10.5603/dk.2019.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
19
|
Schliess F, Heise T, Benesch C, Mianowska B, Stegbauer C, Broge B, Gillard P, Binkley G, Crône V, Carlier S, Delval C, Petkov A, Beck JP, Lodwig V, Gurdala M, Szecsenyi J, Rosenmöller M, Cypryk K, Mathieu C, Renard E, Heinemann L. Artificial Pancreas Systems for People With Type 2 Diabetes: Conception and Design of the European CLOSE Project. J Diabetes Sci Technol 2019; 13:261-267. [PMID: 30241444 PMCID: PMC6399797 DOI: 10.1177/1932296818803588] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the last 10 years tremendous progress has been made in the development of artificial pancreas (AP) systems for people with type 1 diabetes (T1D). The pan-European consortium CLOSE (Automated Glu cose Contro l at H ome for People with Chronic Disea se) is aiming to develop integrated AP solutions (APplus) tailored to the needs of people with type 2 diabetes (T2D). APplus comprises a product and service package complementing the AP system by obligatory training as well as home visits and telemedical consultations on demand. Outcome predictors and performance indicators shall help to identify people who could benefit most from AP usage and facilitate the measurement of AP impact in diabetes care. In a first step CLOSE will establish a scalable APplus model case working at the interface between patients, homecare service providers, and payers in France. CLOSE will then scale up APplus by pursuing geographic distribution, targeting additional audiences, and enhancing AP functionalities and interconnectedness. By being part of the European Institute of Innovation and Technology (EIT) Health public-private partnership, CLOSE is committed to the EIT "knowledge triangle" pursuing the integrated advancement of technology, education, and business creation. Putting stakeholders, education, and impact into the center of APplus advancement is considered key for achieving wide AP use in T2D care.
Collapse
Affiliation(s)
- Freimut Schliess
- Profil, Neuss, Germany
- Freimut Schliess, PhD, Profil GmbH, Hellersbergstrasse 9, 41460 Neuss, Germany.
| | | | | | - Beata Mianowska
- Department of Pediatrics, Oncology, Hematology and Diabetology Łódź, Medical University of Łódź, Poland
| | - Constance Stegbauer
- aQua-Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
| | - Björn Broge
- aQua-Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
| | - Pieter Gillard
- Clinical and Experimental Endocrinology, Catholic University of Leuven, Leuven, Belgium
| | - George Binkley
- IESE Business School, University of Navarra, Barcelona, Spain
| | | | | | | | | | | | | | | | - Joachim Szecsenyi
- aQua-Institute for Applied Quality Improvement and Research in Health Care, Goettingen, Germany
| | | | - Katarzyna Cypryk
- Department of Internal Medicine and Diabetology, Medical University of Łódź, Łódź, Poland
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, Catholic University of Leuven, Leuven, Belgium
| | - Eric Renard
- Montpellier University Hospital, Department of Endocrinology, Diabetes, Nutrition, and Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | | |
Collapse
|
20
|
Katarzynska J, Borkowska A, Czajkowski P, Los A, Szczerbinski L, Milewska-Kranc A, Marcinek A, Kretowski A, Cypryk K, Gebicki J. Flow Mediated Skin Fluorescence technique reveals remarkable effect of age on microcirculation and metabolic regulation in type 1 diabetes. Microvasc Res 2019; 124:19-24. [PMID: 30807771 DOI: 10.1016/j.mvr.2019.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 12/20/2022]
Abstract
STUDY DESCRIPTION Flow Mediated Skin Fluorescence (FMSF) is a novel technique for non-invasive evaluation of the microcirculation and metabolic regulation. This study describes the diagnostic potential of FMSF for type 1 diabetes (DM1). STUDY POPULATION All study participants, in both the control (n = 31) and DM1 (n = 40) groups, were between the ages of 30-49 y. The patients in the DM1 group had all been suffering from diabetes for at least 10 y. RESULTS The parameters HRindex, HRmax and MR inversely correlate with age and BMI. An unidentified compensatory effect was observed among the younger members of the DM1 group. The majority of DM1 patients with HRindex < 8% showed signs of dysfunctional metabolic regulation. CONCLUSION FMSF appears to be an extremely useful technique for monitoring diabetic patients over time, enabling early diagnosis of potentially dysfunctional microcirculation and metabolic regulation.
Collapse
Affiliation(s)
| | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | | | - Agnieszka Los
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Lukasz Szczerbinski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | | | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland; Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Adam Kretowski
- Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland; Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland; Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland.
| |
Collapse
|
21
|
Araszkiewicz A, Bandurska-Stankiewicz E, Budzyński A, Cypryk K, Czech A, Czupryniak L, Drzewoski J, Dzida G, Dziedzic T, Franek E, Gajewska D, Górska M, Grzeszczak W, Gumprecht J, Idzior-Waluś B, Jarosz-Chobot P, Kalarus Z, Klupa T, Koblik T, Kokoszka A, Korzon-Burakowska A, Kowalska I, Krętowski A, Majkowska L, Małecki M, Mamcarz A, Mirkiewicz-Sieradzka B, Młynarski W, Moczulski D, Myśliwiec M, Narkiewicz K, Noczyńska A, Piątkiewicz P, Rymaszewska J, Sieradzki J, Solnica B, Strączkowski M, Strojek K, Szadkowska A, Szelachowska M, Wender-Ożegowska E, Wierusz-Wysocka B, Wolnik B, Wyleżoł M, Wylęgała E, Zozulińska-Ziółkiewicz D. 2019 Guidelines on the management of diabetic patients. A position of Diabetes Poland. Clinical Diabetology 2019. [DOI: 10.5603/dk.2019.0001] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
22
|
|
23
|
Abstract
BACKGROUND The potential influence of pregnancy and parity on the risk of chronic diabetic complications is a matter of great concern and constant discussion. This aspect seems relevant and should be the subject of thorough discussion with the woman planning childbirth. INTRODUCTION Current data concerning the impact of pregnancy and parity covers primarily retinopathy and nephropathy, while the aspects of neuropathy and macrovascular complications are unsatisfactorily documented. Majority of studies focus on single complication only, while the number of papers assessing this problem in a complex setting is limited. The available body of evidence concerns mainly the short-term impact of pregnancy on diabetic chronic complications while the data concerning the longer perspective are scarce. Moreover, the results found in the available literature are conflicting. The aim of the study was to summarize all available data concerning the longer impact of parity on the chronic complications in the women with type 1 diabetes. METHODS PubMed database has been searched between October 2013 and September 2018 and all relevant papers were selected. This review summarizes data on the impact of pregnancy and parity on chronic complications in type 1 diabetic women. RESULTS Current data assessing this matter in a complex way are limited, and the available results are controversial. It seems however that pregnancy itself may rather influence pre-existing diabetic complication than affect risk of its development. Additionally, evidence suggests that any deleterious changes appearing during pregnancy are transient and tend to remit after delivery. CONCLUSION It seems that neither pregnancy nor parity affects the risk of diabetic chronic complications in the longer perspective.
Collapse
Affiliation(s)
- Monika Zurawska-Klis
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska Str. 251, 92-213 Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Pomorska Str. 251, 92-213 Lodz, Poland
| |
Collapse
|
24
|
Cypryk K, Małecki P. A review of cardiovascular outcome trials in type 2 diabetes. Endokrynol Pol 2018; 69:VM/OJS/J/55190. [PMID: 30209802 DOI: 10.5603/ep.2018.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/28/2018] [Accepted: 03/04/2018] [Indexed: 11/25/2022]
Abstract
Type 2 diabetes is a complex metabolic disorder associated with a high risk of cardiovascular complications. In December 2008, due to concerns about the cardiac safety of antihyperglycaemic therapies, the Food and Drug Administration (FDA) published a new guidance on special requirements for the demonstration of cardiovascular safety for these medications. In 2012, similar recommendations were made for antidiabetic drug manufacturers by the European Medicines Agency (EMA). Since then, both FDA and EMA recommendations have been applied in cardiovascular outcome trials (CVOTs) for several new antihyperglycaemic drugs. Unlike conventional trials, CVOTs are usually placebo controlled, non-inferiority trials that examine the cardiovascular safety of a drug compared to standard of care in large cohorts of patients with high cardiovascular risk or established cardiovascular disease. Patients in CVOTs are also monitored for a longer observation period than in typical randomised controlled trials to provide data on long-term cardiovascular risk. To date, nine CVOTs involving patients with type 2 diabetes have been completed, and at least 13 are still ongoing. These studies focus on a variety of antihyper-glycaemic drugs, including incretin-based agents, sodium-glucose cotransporter 2 inhibitor (SGLT-2) inhibitors, and insulin formulations. This article takes a critical look at these CVOTs and summarises the results of the completed trials.
Collapse
|
25
|
Mac-Marcjanek K, Zieleniak A, Zurawska-Klis M, Cypryk K, Wozniak L, Wojcik M. Expression Profile of Diabetes-Related Genes Associated with Leukocyte Sirtuin 1 Overexpression in Gestational Diabetes. Int J Mol Sci 2018; 19:ijms19123826. [PMID: 30513672 PMCID: PMC6321739 DOI: 10.3390/ijms19123826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/26/2018] [Accepted: 11/28/2018] [Indexed: 12/24/2022] Open
Abstract
Although compelling evidence indicates that Sirtuin 1 (SIRT1) plays a prominent role in type 2 diabetes, its relationship with gestational diabetes (GDM) remains elusive. This study was aimed at identifying diabetes-related genes and cellular pathways linked to changes of leukocyte SIRT1 expression at the time of GDM diagnosis. For this purpose, 122 GDM patients were screened for leukocyte SIRT1 expression, and two subgroups were distinguished, namely GDM/SIRT1(↑) (n = 30, p < 0.05) and GDM/SIRT1(↔) (n = 92, p > 0.05), with significant and insignificant changes in leukocyte SIRT1 expression compared to a normal glucose tolerant (NGT) group (n = 41), respectively. PCR array analysis identified 11 diabetes-related genes with at least a ± 2-fold difference in expression in GDM/SIRT1(↑) patients (n = 9) vs. NGT controls (n = 7); in addition, significant differences in the expression of four of the six investigated genes were confirmed between the entire GDM/SIRT1(↑) group and the whole NGT group (p < 0.05). Interestingly, of these four genes, only ACLY expression was found to significantly differ between GDM/SIRT1(↑) and GDM/SIRT1(↔). This study demonstrates that under hyperglycemic conditions, leukocyte SIRT1 overexpression is accompanied by an over-abundance of three transcripts and an under-abundance of another; these four govern related metabolism, inflammation, and transport functions, suggesting that such alterations might represent systemic biological adaptations with a unique ACLY under-expression in GDM/SIRT1(↑) women.
Collapse
Affiliation(s)
- Katarzyna Mac-Marcjanek
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Andrzej Zieleniak
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Monika Zurawska-Klis
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, 92-213 Lodz.
| | - Katarzyna Cypryk
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, 92-213 Lodz.
| | - Lucyna Wozniak
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland.
| |
Collapse
|
26
|
Łoś A, Wójcik-Odyniec J, Sobol-Pacyniak A, Cypryk K. Diabetic ketoacidosis as a reason for hospitalization in adult patients with any type of diabetes mellitus. Clinical Diabetology 2018. [DOI: 10.5603/dk.2018.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
27
|
Müller‐Wieland D, Kellerer M, Cypryk K, Skripova D, Rohwedder K, Johnsson E, Garcia‐Sanchez R, Kurlyandskaya R, Sjöström CD, Jacob S, Seufert J, Dronamraju N, Csomós K. Efficacy and safety of dapagliflozin or dapagliflozin plus saxagliptin versus glimepiride as add-on to metformin in patients with type 2 diabetes. Diabetes Obes Metab 2018; 20:2598-2607. [PMID: 29947099 PMCID: PMC6220756 DOI: 10.1111/dom.13437] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of dapagliflozin and dapagliflozin plus saxagliptin vs glimepiride as add-on to metformin in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This 52-week, multicentre, double-blind, active-controlled study (NCT02471404) randomized (1:1:1) patients (n = 939; HbA1c 7.5%-10.5%) on metformin monotherapy (≥1500 mg/day) to add-on dapagliflozin 10 mg, dapagliflozin 10 mg plus saxagliptin 5 mg, or glimepiride 1 to 6 mg (titrated). The primary efficacy end point was change in HbA1c from baseline to Week 52. RESULTS Baseline mean age, diabetes duration and HbA1c were 58.4 years, 7.0 years and 8.3%, respectively. Adjusted mean HbA1c change from baseline was -1.20% with dapagliflozin plus saxagliptin and -0.82% with dapagliflozin, vs -0.99% with glimepiride (mean dose at Week 52, 4.6 mg). Changes in body weight (-3.2 kg and -3.5 kg vs +1.8 kg) and systolic blood pressure (SBP; -6.4 mm Hg and -5.6 mm Hg vs -1.6 mm Hg) were significantly greater with dapagliflozin plus saxagliptin and dapagliflozin than with glimepiride. FPG decreased significantly with dapagliflozin plus saxagliptin compared with glimepiride (-2.1 mmol/L vs -1.5 mmol/L) and was similar with dapagliflozin (-1.6 mmol/L) compared with glimepiride. Confirmed incidence of hypoglycaemia was lower with dapagliflozin regimens than with glimepiride (0 and 1 vs 13 patients) and fewer patients required rescue. Genital infections were more frequent with dapagliflozin; other AE profiles were similar. CONCLUSIONS Dapagliflozin, saxagliptin and metformin improved glycaemic control compared with glimepiride plus metformin; add-on of dapagliflozin alone showed efficacy similar to that of glimepiride. Both dapagliflozin regimens decreased body weight and SBP, with a lower incidence of hypoglycaemia compared with glimepiride.
Collapse
Affiliation(s)
- Dirk Müller‐Wieland
- Department of Medicine IUniversity Hospital Rheinisch‐Westfälische Technische Hochschule AachenAachenGermany
| | | | - Katarzyna Cypryk
- Department of Internal Medicine and DiabetologyMedical University of LodzLodzPoland
| | - Dasa Skripova
- Outpatient Clinic of Diabetes and Metabolism, DIAMELTrencinSlovakia
| | | | | | | | | | | | - Stephan Jacob
- Cardio‐Metabolic InstituteVillingen‐SchwenningenGermany
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine IIMedical Center – University of Freiburg, Faculty of Medicine, University of FreiburgFreiburgGermany
| | | | | |
Collapse
|
28
|
Bukowiecka-Matusiak M, Burzynska-Pedziwiatr I, Sansone A, Malachowska B, Zurawska-Klis M, Ferreri C, Chatgilialoglu C, Ochedalski T, Cypryk K, Wozniak LA. Lipid profile changes in erythrocyte membranes of women with diagnosed GDM. PLoS One 2018; 13:e0203799. [PMID: 30216387 PMCID: PMC6138398 DOI: 10.1371/journal.pone.0203799] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a glucose intolerance that begins or is first recognized during pregnancy. It is currently a growing health problem worldwide affecting from 1% to 14% of all pregnant women depending on racial and ethnic group as well as the diagnostic and screening criteria. Our preliminary study aimed at investigating the erythrocyte membrane fatty acid profiles of pregnant women, in particular with diagnosed with gestational diabetes mellitus (GDM), and with normal glucose tolerant (NGT) pregnant women as a control group. The study group comprised 43 pregnant women, 32 of whom were diagnosed with GDM according to the WHO criteria, and 11 with normal glucose tolerance. The erythrocyte membrane phospholipids were obtained according to the Folch extraction procedure. Fatty acids (FA) were analyzed by gas chromatography (GC) as the corresponding fatty acid methyl esters (FAME). A cluster of 14 fatty acids identified contained >98% of the recognized peaks in the GC analysis. The analysis of fatty acids from erythrocytes revealed important differences between GDM and NGT women in the third trimester, and the results were correlated with biochemical data. Among the 14 measured FA representing the membrane lipidomic profile, the levels of three saturated FA (myristic, palmitic, stearic acids) tended to decrease in GDM patients, with the percentage content of stearic acid significantly changed. The relative content of monounsaturated fatty acids (MUFA) tended to increase, in particular the oleic acid and vaccenic acid contents were significantly increased in erythrocyte membranes of the GDM group in comparison with the NGT group. The GDM group demonstrated higher sapienic acid levels (+29%) but this change was not statistically significant. This study revealed association between an impaired cis-vaccenic acid concentration in erythrocytes membrane and GDM development. No significant changes of polyunsaturated fatty acids (PUFA) were observed in GDM and NGT erythrocytes. We postulate, basing on the differences between the GDM and NGT lipidomic profiles, that stearic and cis-vaccenic acids can be considered as dual biomarkers of specific SFA-MUFA conversion pathway, involving the coupling of delta-9 desaturase and elongase enzymes. Our results indicate that the SFA-MUFA families may be involved in the pathophysiology of metabolic diseases such as GDM, but the further studies are needed to confirm our hypothesis. In conclusion, the erythrocyte membranes of GDM women undergo remodeling resulting in abnormal fatty acid profiles, which are reflection of the long-term status of organism and can have great impact on both the mother and her offspring.
Collapse
Affiliation(s)
| | | | - Anna Sansone
- Consiglio Nazionale delle Ricerche, Institute for the Organic Synthesis and Photoreactivity, Bologna, Italy
| | - Beata Malachowska
- Medical University of Lodz, Department of Biostatistics and Translational Medicine, Lodz, Poland
| | - Monika Zurawska-Klis
- Medical University of Lodz, Department of Nursing and Obstetrics, Department of Clinic Nursing, Department of Diabetology and Metabolic Diseases Lodz, Poland
| | - Carla Ferreri
- Consiglio Nazionale delle Ricerche, Institute for the Organic Synthesis and Photoreactivity, Bologna, Italy
| | | | - Tomasz Ochedalski
- Medical University of Lodz, Department of Comparative Endocrinology, Lodz, Poland
| | - Katarzyna Cypryk
- Medical University of Lodz, Department of Nursing and Obstetrics, Department of Clinic Nursing, Department of Diabetology and Metabolic Diseases Lodz, Poland
| | | |
Collapse
|
29
|
Cypryk K, Grycewicz J, Swierzewska P, Kosinski M, Lewinski A, Zurawska-Klis M. Parity does not affect diabetes complications in women with type 1 diabetes. Ann Agric Environ Med 2018; 25:114-119. [PMID: 29575865 DOI: 10.5604/12321966.1230738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The problem concerning the impact of pregnancy on diabetic complications is a matter for discussion as there is some evidence suggesting that pregnancy may trigger development or progression of diabetic chronic complications. However, currently available data concerning this issue is still controversial. OBJECTIVE The aim of the study was to evaluate the impact of obstetric history on the development of chronic microangiopatic and macroangiopatic complications in type 1 diabetic women. MATERIAL AND METHODS The retrospective study comprised 226 white Caucasian type 1 diabetic women, including 190 parous and 36 nulliparous women. Anthropometric data, information concerning the course of the disease, including metabolic control and chronic complications, together with obstetric history, were registered. RESULTS Parous women were older (p<0.001), but did not differ significantly regarding metabolic control in the course of the disease (p>0.05) and diabetes duration (p>0.05) from nulliparous subjects. There were no significant differences in the incidence (p>0.05) nor onset (p>0.05) of chronic diabetes complications between the groups. The number of deliveries did not correlate with either the incidence nor the onset of chronic complications. Longer DM duration at the moment of first delivery was related to the higher incidence of retinopathy (p<0.01), nephropathy (p<0.05) and neuropathy (p<0.001). CONCLUSIONS The incidence of chronic diabetic complications does not differ between parous women and the subjects that were never pregnant, and is not related to the number of pregnancies.
Collapse
Affiliation(s)
- Katarzyna Cypryk
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland
| | - Joanna Grycewicz
- Regional Centre of Occupational Medicine, Prevention and Treatment Centre in Lodz, Poland
| | - Patrycja Swierzewska
- Outpatient Department of Diabetology in the Polish Mother's Memorial Hospital/Research Institute in Lodz, Poland
| | - Marcin Kosinski
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland
| | - Andrzej Lewinski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland
| | - Monika Zurawska-Klis
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland.
| |
Collapse
|
30
|
Wojcik M, Krawczyk M, Wojcik P, Cypryk K, Wozniak LA. Melatonin as a Pleiotropic Molecule with Therapeutic Potential for Type 2 Diabetes and Cancer. Curr Med Chem 2017; 24:3829-3850. [PMID: 28721827 DOI: 10.2174/0929867324666170718110606] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/16/2017] [Accepted: 07/14/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND The incidence of both type 2 diabetes (T2DM) and cancer is increasing worldwide, making these diseases a global health problem along with increasing healthcare expenditures. The current therapeutic approaches for treating these multifactorial diseases are far from satisfactory. As increasing evidence shows beneficial effects of melatonin (MLT) on typical pathological changes occurring during the development of T2DM and cancer, the present review focuses on molecular aspects of antidiabetic and anticancer activities of MLT and, moreover, discusses several future directions of research regarding MLT application as potential therapeutic agent. METHODS Critical literature analysis in PubMed central combined with personal expertise. RESULTS Numerous in vitro and in vivo studies have revealed that MLT possesses a number of antidiabetic health benefits by diminishing hyperglycemia, insulin resistance, oxidative stress, and inflammation through modulating various intracellular signaling pathways or other targets involved in the pathophysiology of this disease. Mounting evidence also indicates that MLT exhibits multi-targeted anticancer effects in numerous human malignancies, mainly resulting from its ability to modulate several signal transduction pathways associated with cell survival, proliferation, and apoptosis. Furthermore, beneficial synergistic action of MLT with chemotherapy and radiotherapy has also been observed. Importantly, no adverse outcomes have been found from the clinical use of MLT, which highlights its therapeutic usefulness, either alone or in combination with other conventional therapies, in cancer treatment. CONCLUSION The findings described in this review suggest that MLT may confer potential benefits to human health, particularly in respect to T2DM and cancer.
Collapse
Affiliation(s)
- Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, Lodz, Poland
| | - Michal Krawczyk
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, Lodz, Poland
| | - Pawel Wojcik
- Department of Horticultural Crop Management and Nutrition, Research Institute of Horticulture, Skierniewice, Poland
| | - Katarzyna Cypryk
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, Lodz, Poland
| | - Lucyna Alicja Wozniak
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
31
|
Mac-Marcjanek K, Zieleniak A, Woźniak L, Źurawska-Kliś M, Cypryk K, Okła P, Wójcik M. Porównanie ekspresji IL6 w leukocytach pacjentek z cukrzycą ciążową (GDM) diagnozowanych zgodnie z kryteriami Polskiego Towarzystwa Diabetologicznego z 2011 i 2014 roku. Endokrynologia Polska 2017; 68:317-325. [DOI: 10.5603/ep.a2017.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/14/2016] [Accepted: 06/30/2016] [Indexed: 11/25/2022]
|
32
|
Pertynska-Marczewska M, Cypryk K. The possible impact of advanced glycation end products on pregnancy outcome in women with diabetes mellitus type 1. MINERVA ENDOCRINOL 2016; 42:271-279. [PMID: 27304070 DOI: 10.23736/s0391-1977.16.02477-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Diabetes mellitus (DM) is a group of metabolic disorders of carbohydrate metabolism in which glucose is underutilized, resulting in hyperglycemia. Reproductive impairment in poorly controlled diabetes mellitus type 1 (T1DM) results from a combined effect of insulin deficiency and hyperglycemia that disrupt the functioning of metabolic signals participating in the regulation of the reproductive system. Good metabolic control as a result of intensive insulin therapy has a great impact on the fertility and childbearing possibilities in the T1DM females. Advanced glycation end products (AGEs) are formed by nonenzymatic modification of proteins, lipids, and nucleic acids by glucose. The formation and accumulation of AGEs are known to progress at an accelerated rate in diabetes. AGEs either act on the pro-inflammatory cell surface receptors called RAGE or bind to the circulating anti-inflammatory sRAGE that prevents activation of cell-surface RAGE by AGEs and other proinflammatory ligands. Pregnancy has been found to induce a significant increase in RAGE protein levels in both myometrium and omental vasculature. This review will focus on the role of AGEs and RAGE in pregnancy complicated by DM type 1 as well as ways to reduce the rate of congenital malformations in the offspring of diabetic type 1 women.
Collapse
Affiliation(s)
| | - Katarzyna Cypryk
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
33
|
Wójcik M, Chmielewska-Kassassir M, Grzywnowicz K, Woźniak L, Cypryk K. The relationship between adipose tissue-derived hormones and gestational diabetes mellitus (GDM). Endokrynol Pol 2015; 65:134-42. [PMID: 24802737 DOI: 10.5603/ep.2014.0019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 11/25/2022]
Abstract
Gestational diabetes mellitus (GDM) is defined as a glucose intolerance of varying severity with onset or first recognition during pregnancy. The prevalence of GDM is growing rapidly worldwide, resulting in numerous and serious complications for both mother and foetus. Two major metabolic disorders, insulin resistance and β cells dysfunction, are currently linked to the pathogenesis of GDM, although the cellular mechanisms involved in the development of GDM are not yet completely understood. Increasing evidence from clinical and experimental studies indicates that adipose tissue dysfunction, characterised by abnormal production of adipokines, is an essential factor linked to insulin resistance and GDM. To date, several adipose tissue-derived hormones have been identified, including leptin, adiponectin, resistin, visfatin, apelin, retinol-binding protein 4 (RBP-4), vaspin, and omentin. The relationship of leptin and adiponectin to insulin resistance in GDM is relatively well documented, but the molecular mechanisms by which these hormones affect insulin resistance are not yet fully known. The other aforementioned adipokines appear to be also important players in the pathophysiology of GDM, although their precise function in this complex process remains to be established. The aim of this article is to review the literature concerning the relationship between the above-mentioned adipokines and GDM, and to clarify their role in the pathophysiology of GDM.
Collapse
|
34
|
|
35
|
Wojcik M, Zieleniak A, Zurawska-Klis M, Cypryk K, Wozniak LA. Increased expression of immune-related genes in leukocytes of patients with diagnosed gestational diabetes mellitus (GDM). Exp Biol Med (Maywood) 2015; 241:457-65. [PMID: 26568332 DOI: 10.1177/1535370215615699] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/14/2015] [Indexed: 12/16/2022] Open
Abstract
Compelling evidence indicates that the immune system is linked to metabolism in gestational diabetes mellitus (GDM), but factors participating in these processes still are awaiting identification. Inducible nitric oxide synthase, encoded by the NOS2 gene, and surfactant protein D, encoded by the SFTPD gene, have been implicated in diabetes. We investigated NOS2 and SFTPD mRNA levels in leukocytes obtained from 125 pregnant women with (n = 87) or without (control group; n = 38) GDM, and, in turn, correlated their expression with clinical parameters of subjects. Leukocytes were isolated from the blood of pregnant women and NOS2 and SFTPD expression in these cells was determined by quantitative real time PCR (qRT-PCR). Univariate correlation analyses were performed to assess an association between leukocyte NOS2 and SFTPD expression and clinical characteristics of patients. qRT-PCR experiments disclosed significantly increased leukocyte NOS2 and SFTPD mRNA levels in hyperglycemic GDM patients (P < 0.05). In the entire study group, there were significant positive associations of leukocyte NOS2 and SFTPD mRNAs with C-reactive protein. Additionally, transcript level of SFTPD also correlated positively with fasting glycemia and insulin resistance. This study demonstrates that an impaired glucose metabolism in GDM may be predominant predictor of leukocyte NOS2 and SFTPD overexpression in diabetic patients. Furthermore, alterations in the expression of these genes are associated with glucose metabolism dysfunction and/or inflammation during pregnancy. In addition, these findings support the utilization of leukocytes as good experimental model to study a relationship between immune-related genes and metabolic changes in women with GDM, as well as to assess the potential mechanisms underlying these alterations.
Collapse
Affiliation(s)
- Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland
| | - Andrzej Zieleniak
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland
| | - Monika Zurawska-Klis
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, 92-213 Lodz, Poland Diabetological Medical Center "OmniMed", 93-338 Lodz, Poland
| | - Katarzyna Cypryk
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, 92-213 Lodz, Poland Diabetological Medical Center "OmniMed", 93-338 Lodz, Poland
| | - Lucyna Alicja Wozniak
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, 90-752 Lodz, Poland
| |
Collapse
|
36
|
Wójcik M, Mac-Marcjanek K, Woźniak LA, Nadel I, Lewiński A, Cypryk K. The association of leukocyte phosphatidylinositol 3-kinase delta overexpression with gestational diabetes mellitus (GDM). Endokrynol Pol 2015; 65:17-24. [PMID: 24549598 DOI: 10.5603/ep.2014.0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/19/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION An increasing body of evidence has linked diabetes to inflammation. The phosphatidylinositol 3-kinase delta (PI3-K delta), a member of the PI3K class IA family, has been implicated in the regulation of inflammation since it is predominantly expressed in leukocytes. To date, no information has been available on the relationship of leukocyte PI3-K delta with gestational diabetes mellitus (GDM). Therefore, the aim of this study was to investigate changes in leukocyte PIK3CD mRNA expression in GDM women and, in turn, to correlate them with anthropometric and metabolic parameters of patients. Additionally, an association between leukocyte mRNA expression of PIK3CD and Sirtuin 1 (SIRT1) was determined. MATERIAL AND METHODS Blood samples from women with normal glucose tolerance (NGT; n = 43) and GDM (n = 132) at 24-33 weeks of gestation were collected. After isolating leukocytes from the blood, quantitative real time PCR (qRT-PCR) was performed to determine PIK3CD gene expression in these cells. Univariate regression analyses were used to assess an association of leukocyte PIK3CD mRNA level with clinical characteristics of patients as well as with leukocyte SIRT1 mRNA expression. RESULTS Leukocyte PIK3CD mRNA was increased by 1.98-fold in the GDM v. NGT subjects and inversely correlated with low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) in diabetic pregnancy. There were also significant positive correlations of leukocyte PIK3CD mRNA with plasma glucose concentration at 2h of 75 g oral glucose tolerance test (OGTT) and SIRT1 mRNA in the whole study population (both P < 0.05). CONCLUSIONS GDM is accompanied by leukocyte PIK3CD overexpression associated with reduced plasma LDL-C and TC levels, as well as with hyperglycaemia and elevated leukocyte SIRT1 mRNA.
Collapse
|
37
|
Cypryk K, Bartyzel L, Zurawska-Klis M, Mlynarski W, Szadkowska A, Wilczynski J, Nowakowska D, Wozniak LA, Fendler W. Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Shows that Fetal Heart Rate Correlates with Maternal Glycemia. Diabetes Technol Ther 2015; 17:619-24. [PMID: 25927286 DOI: 10.1089/dia.2014.0255] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Much evidence has shown that pregnancies in women with preexisting diabetes are affected by an increased risk of maternal and fetal adverse outcomes, probably linked to poor glycemic control. Despite great progress in medical care, the rate of stillbirths remains much higher in diabetes patients than in the general population. Recent technological advances in the field of glucose monitoring and noninvasive fetal heart rate monitoring made it possible to observe the fetal-maternal dependencies in a continuous manner. SUBJECTS AND METHODS Fourteen type 1 diabetes patients were involved into the study and fitted with a blinded continuous glucose monitoring (CGM) recorder. Fetal electrocardiogram data were recorded using the Monica AN24™ device (Monica Healthcare Ltd., Nottingham, United Kingdom), the recordings of which were matched with CGM data. Statistical analysis was performed using a generalized mixed-effect logistic regression to account for individual factors. RESULTS The mean number of paired data points per patient was 254±106, representing an observation period of 21.2±8.8 h. Mean glycemia equaled 5.64±0.68 mmol/L, and mean fetal heart rate was 135±6 beats/min. Higher glycemia correlated with fetal heart rate (R=0.32; P<0.0001) and was associated with higher odds of the fetus developing small accelerations (odds ratio=1.05; 95% confidence interval, 1.00-1.10; P=0.04). CONCLUSIONS Elevated maternal glycemia of mothers with diabetes is associated with accelerations of fetal heart rate.
Collapse
Affiliation(s)
- Katarzyna Cypryk
- 1 Department of Diabetology and Metabolic Diseases, Medical University of Lodz , Poland
| | - Lukasz Bartyzel
- 1 Department of Diabetology and Metabolic Diseases, Medical University of Lodz , Poland
| | - Monika Zurawska-Klis
- 1 Department of Diabetology and Metabolic Diseases, Medical University of Lodz , Poland
| | - Wojciech Mlynarski
- 2 Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz , Poland
| | - Agnieszka Szadkowska
- 2 Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz , Poland
| | - Jan Wilczynski
- 3 Feto-Maternal and Gynecology Department, Research Institute, Polish Mother's Memorial Hospital , Lodz, Poland
| | - Dorota Nowakowska
- 3 Feto-Maternal and Gynecology Department, Research Institute, Polish Mother's Memorial Hospital , Lodz, Poland
| | - Lucyna A Wozniak
- 4 Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz , Lodz, Poland
| | - Wojciech Fendler
- 2 Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz , Poland
| |
Collapse
|
38
|
Wójcik M, Mac-Marcjanek K, Nadel I, Woźniak L, Cypryk K. Gestational diabetes mellitus is associated with increased leukocyte peroxisome proliferator-activated receptor γ expression. Arch Med Sci 2015; 11:779-87. [PMID: 26322090 PMCID: PMC4548020 DOI: 10.5114/aoms.2015.47692] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/29/2014] [Accepted: 03/06/2014] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Peroxisome proliferator-activated receptor γ (PPARγ) is a ligand-activated transcription factor of the nuclear receptor superfamily that is involved in lipid and carbohydrate metabolism as well as inflammation; thereby it participates in metabolic diseases including diabetes. Although PPARγ expression has been observed in different tissues of diabetic patients, its level in leukocytes from subjects affected by gestational diabetes mellitus (GDM) has not yet been reported. This study aimed to investigate leukocyte PPARG expression in GDM patients at 24-33 weeks of gestation and, in turn, to correlate these alterations with anthropometric and metabolic parameters of patients. MATERIAL AND METHODS Leukocytes were isolated from the blood of normal glucose tolerant (NGT; n = 34) and GDM (n = 77) pregnant women between 24 and 33 weeks of gestation. Leukocyte PPARG mRNA expression was determined by semi-quantitative polymerase chain reaction. Univariate correlation analysis was performed to investigate associations between PPARG expression and clinical characteristics of patients. RESULTS Leukocyte PPARG mRNA level was significantly higher in GDM than NGT women (p < 0.05). In the whole study group, PPARG expression positively correlated with plasma glucose concentrations at 1 h (r = 0.222, p = 0.049) and 2 h (r = 0.315, p = 0.020) of 75 g oral glucose tolerance test (OGTT), and negatively correlated with plasma HDL cholesterol concentration (r = -0.351, p = 0.010). CONCLUSIONS The correlation between leukocyte PPARG overexpression and hyperglycaemia suggests that PPARG mRNA expression in these cells might be up-regulated in high-glucose conditions in GDM patients at 24-33 weeks of gestation.
Collapse
Affiliation(s)
- Marzena Wójcik
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | | | - Iwona Nadel
- Polish Mother's Memorial Hospital, Research Institute, Lodz, Poland
| | - Lucyna Woźniak
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Cypryk
- Polish Mother's Memorial Hospital, Research Institute, Lodz, Poland
- Diabetology and Metabolic Diseases Department, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
39
|
Żurawska-Kliś M, Lesman J, Pietrzak I, Mianowska B, Szadkowska A, Cypryk K. The impact of having siblings - analysis of "hygiene theory" of chronic diseases in patients with type 1 diabetes in population of the Łódz region Hygiene theory and type 1 diabetes. Pediatr Endocrinol Diabetes Metab 2015; 20:95-100. [PMID: 26615045 DOI: 10.18544/pedm-20.03.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION In the recent years there has been a significant increase in the incidence of the type 1 diabetes mellitus. Therefore, numerous studies are underway to evaluate the possible factors underlying this trend. Some studies suggest that better sanitary conditions and lack of contact with microorganisms might be important, thus increasing the risk of disease in firstborns. Moreover, siblings could play an important role in the transmission of pathogens, which, by stimulating the immune system, may prevent the development of atopic and autoimmune diseases including such as type 1 diabetes. Current data, however, are still inconclusive. PURPOSE The aim of the study was to evaluate the effect of having siblings on the incidence of type 1 diabetes among children and adults. MATERIALS AND METHODS A group of 469 patients with type 1 diabetes was selected. The study population was composed of 245 adults and 224 youth patients. Information from Outpatient Diabetologic Departments database was gathered. Data such as age at the diagnosis of diabetes, sex of siblings, number and birth order were analyzed. RESULTS In the studied population, 4.5% were only children, and 30.3% patients came from large families. In the group of type 1 diabetic patients 39.7% were firstborns and this proportion was comparable to the group of healthy subject. The highest proportion of firstborns was noted in the group that was diagnosed after 18 years of age (45,1%) compared to the group that was diagnosed between 10 and 14 (29,1%) (p<0.05). Type 1 diabetic patients that were not firstborns much more often had older siblings of the opposite sex than the same sex. CONCLUSIONS he firstborns in the population of type 1 diabetes from the Łódz region did not outnumber the healthy subjects. Significantly higher proportion of firstborns in the group that was diagnosed after 18 years of age compared to the group that was diagnosed between 10 an 14 years was noted.
Collapse
Affiliation(s)
| | - Jędrzej Lesman
- Uniwersytet Medyczny w Łodzi, student V Roku Wydziału Lekarskiego
| | - Iwona Pietrzak
- Klinika Pediatrii, Onkologii, Hematologii i Diabetologii, Uniwersytet Medyczny w Łodzi
| | - Beata Mianowska
- Klinika Pediatrii, Onkologii, Hematologii i Diabetologii, Uniwersytet Medyczny w Łodzi
| | - Agnieszka Szadkowska
- Klinika Pediatrii, Onkologii, Hematologii i Diabetologii, Uniwersytet Medyczny w Łodzi
| | - Katarzyna Cypryk
- Klinika Diabetologii i Chorób Przemiany Materii, Uniwersytet Medyczny w Łodzi
| |
Collapse
|
40
|
Swierzewska P, Kosiński M, Wójcik M, Dworacka M, Cypryk K. Family, anthropometric and biochemical factors affecting birth weight of infants born to GDM women. Ginekol Pol 2015; 86:499-503. [DOI: 10.17772/gp/652] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
41
|
Czupryniak L, Barkai L, Bolgarska S, Bronisz A, Broz J, Cypryk K, Honka M, Janez A, Krnic M, Lalic N, Martinka E, Rahelic D, Roman G, Tankova T, Várkonyi T, Wolnik B, Zherdova N. Self-monitoring of blood glucose in diabetes: from evidence to clinical reality in Central and Eastern Europe--recommendations from the international Central-Eastern European expert group. Diabetes Technol Ther 2014; 16:460-75. [PMID: 24716890 PMCID: PMC4074758 DOI: 10.1089/dia.2013.0302] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Self-monitoring of blood glucose (SMBG) is universally considered to be an integral part of type 1 diabetes management and crucial for optimizing the safety and efficacy of complex insulin regimens. This extends to type 2 diabetes patients on intensive insulin therapy, and there is also a growing body of evidence suggesting that structured SMBG is beneficial for all type 2 diabetes patients, regardless of therapy. However, access to SMBG can be limited in many countries in Central and Eastern Europe. A consensus group of diabetes experts from 10 countries in this region (with overlapping historical, political, and social environments)--Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Serbia, Slovakia, Slovenia, and Ukraine--was formed to discuss the role of SMBG across the spectrum of patients with diabetes. The group considered SMBG to be an essential tool that should be accessible to all patients with diabetes, including those with non-insulin-treated type 2 diabetes. The current article summarizes the evidence put forward by the consensus group and provides their recommendations for the appropriate use of SMBG as part of individualized patient management. The ultimate goal of these evidence-based recommendations is to help patients and providers in Central and Eastern Europe to make optimal use of SMBG in order to maximize the efficacy and safety of glucose-lowering therapies, to prevent complications, and to empower the patient to play a more active role in the management of their diabetes.
Collapse
Affiliation(s)
- Leszek Czupryniak
- Internal Medicine and Diabetology Department, Medical University of Lodz, Lodz, Poland
| | - László Barkai
- Postgraduate Institute of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
- Department of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
| | - Svetlana Bolgarska
- Department of Diabetology, National Medical Academy of Post-Graduate Education, Institute of Endocrinology and Metabolism of National Academy of Medical Science, Kiev, Ukraine
| | - Agata Bronisz
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University in Toruń, Toruń, Poland
- Ludwik Rydygier Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Jan Broz
- Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Faculty Hospital Motol, Prague, Czech Republic
| | - Katarzyna Cypryk
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| | - Marek Honka
- Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Faculty Hospital Motol, Prague, Czech Republic
| | - Andrej Janez
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, Ljubljana, Slovenia
| | | | - Nebojsa Lalic
- Department for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Emil Martinka
- National Institute for Endocrinology and Diabetology, Lubochna, Slovakia
| | - Dario Rahelic
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dubrava University Hospital, Zagreb, Croatia
| | - Gabriela Roman
- Iuliu Hatieganu University of Medicine & Pharmacy, Clinical Center of Diabetes, Nutrition, Metabolic Diseases, Cluj-Napoca, Romania
| | | | - Tamás Várkonyi
- First Department of Internal Medicine, University of Szeged, Szeged, Hungary
| | - Bogumił Wolnik
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland
| | - Nadia Zherdova
- Department of Diabetology, National Medical Academy of Post-Graduate Education, Institute of Endocrinology and Metabolism of National Academy of Medical Science, Kiev, Ukraine
| |
Collapse
|
42
|
Wojcik M, Zieleniak A, Mac-Marcjanek K, Wozniak LA, Cypryk K. The elevated gene expression level of the A(2B) adenosine receptor is associated with hyperglycemia in women with gestational diabetes mellitus. Diabetes Metab Res Rev 2014; 30:42-53. [PMID: 23956030 DOI: 10.1002/dmrr.2446] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 05/13/2013] [Accepted: 08/01/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adenosine receptors denoted by A1 , A2A , A2B , and A3 and encoded by ADORA1, ADORA2A, ADORA2B, and ADORA3 genes, respectively, are adenosine-activated G-protein-coupled receptors that play an important role in obesity and type 2 diabetes mellitus. However, little is known about their significance in gestational diabetes mellitus (GDM). The purpose of this study was to investigate whether there are changes in leukocyte AR expression in GDM patients and whether these alterations are linked to well-known diabetic genes. METHODS Leukocytes were isolated from the blood of normal glucose tolerant (NGT; n = 35) and GDM (n = 82) pregnant women, and expression of ARs was determined by a semi-quantitative polymerase chain reaction (PCR). Univariate correlation analysis was performed to investigate associations between expression of ARs and anthropometric and metabolic parameters of patients. Furthermore, the identification of diabetic genes linked to significantly differentiated leukocyte adenosine receptors expression in GDM women was also carried out with the use of the human diabetes RT(2) profiler PCR arrays. RESULTS ADORA2B mRNA expression was significantly higher in GDM versus NGT pregnant women (p < 0.05), and positively correlated with the glucose level at 1-h 75-g oral glucose tolerance test (OGTT; r = 0.21, p = 0.044). Nineteen diabetic genes linked to leukocyte ADORA2B overexpression associated with hyperglycemia in GDM women were also identified. CONCLUSIONS Maternal leukocyte ADORA2B overexpression is associated with hyperglycemia in GDM subjects, and it is accompanied by complex alterations in the expression of diabetes-related genes involved in insulin action, carbohydrate and lipid metabolism, oxidative stress, and inflammation.
Collapse
Affiliation(s)
- Marzena Wojcik
- Department of Structural Biology, Faculty of Biomedical Sciences and Postgraduate Education, Medical University of Lodz, Zeligowskiego 7/9 St., 90-752, Lodz, Poland
| | | | | | | | | |
Collapse
|
43
|
Kosinski M, Knop F, Vedtofte L, Grycewiczv J, Swierzewska P, Cypryk K, Vilsbøll T. Postpartum reversibility of impaired incretin effect in gestational diabetes mellitus. ACTA ACUST UNITED AC 2013; 186:104-7. [DOI: 10.1016/j.regpep.2013.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/25/2013] [Accepted: 08/08/2013] [Indexed: 01/23/2023]
|
44
|
Reaney M, Cypryk K, Tentolouris N, Jecht M, Cleall S, Petzinger U, Koivisto V. Resource utilisation and clinical data before and after switching between short-acting human insulin and rapid-acting insulin analogues in patients with type 2 diabetes: the SWING study. Diabetes Res Clin Pract 2012; 97:231-41. [PMID: 22483577 DOI: 10.1016/j.diabres.2012.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 12/21/2011] [Accepted: 02/23/2012] [Indexed: 11/18/2022]
Abstract
AIM SWING was a prospective, observational study conducted in nine European countries primarily to assess direct treatment costs when switching from short-acting human insulins to rapid-acting insulin analogues (H-A) or vice versa (A-H) in patients with type 2 diabetes. METHODS Data were collected at a baseline visit (time of switch) and at approximately 3, 6 and 12 months post-switch. RESULTS In total, 2389 patients switched from H-A (n=2203) or A-H (n=186); another 603 were enrolled but ineligible. Mean (SD) direct diabetes-related costs (pro-rated to account for variable visit schedules) were €548.7 (865.8) 6 months prior to switch, €625.6 (1474.9) at 0-6 months and €568.6 (590.7) 6-12 months following switch for H-A, and €544.5 (421.0), €481.0 (301.5) and €461.6 (335.0) for A-H, respectively. Mean (SD) HbA(1c) decreased over 12 months by 1.08 (1.53)% units H-A and 1.17 (1.45)% units A-H. A small decline in hypoglycaemia occurred over time, but there were no clinically meaningful changes in mean PROs. CONCLUSIONS There were small changes in mean direct diabetes-related costs (following adjustment for time interval) in patients switching in either direction. Improvements in mean HbA(1c) and incidence of hypoglycaemia cannot necessarily be attributed to therapeutic switch.
Collapse
|
45
|
Zieleniak A, Cypryk K, Wozniak LA, Bieńkiewicz M, Wójcik M. Adenosine receptors expression is elevated in leukocytes of gestational diabetes mellitus (GDM) subjects--a preliminary study. Endokrynol Pol 2012; 63:110-114. [PMID: 22538749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Adenosine receptors (ARs), belonging to the G-protein-coupled receptors (GPCRs), are present in the majority of human cells and tissues. Depending on their biochemical and pharmacologic properties, four subtypes of ARs (i.e. A₁, A(2A), A(2B), and A₃) have been distinguished. Currently, these receptors are attractive molecular targets for pharmacological interventions in various diseases, including diabetes. The literature published to date has shown an altered expression of ARs in several types of cells under diabetic conditions. However, there has been no publication devoted to the investigation of ARs expression in leukocytes of subjects with gestational diabetes mellitus (GDM). Therefore, this study was aimed to determine the expression level of AR subtypes in leukocytes of GDM patients and its relationship to anthropometric and biochemical parameters. MATERIAL AND METHODS Gene expression of four AR subtypes in leukocytes of both healthy (n = 34) and GDM (n = 67) subjects in the third trimester of pregnancy (from 24 to 33 weeks) was investigated. Multiple regression analyses were used to assess the association between the expression level of ARs and both anthropometric and biochemical parameters. RESULTS Statistically significant (p < 0.05) higher levels of A(2A) and A(2B) mRNAs were observed in leukocytes of the GDM subjects compared to the control group. There was a positive correlation of A(2B) mRNA level with glucose concentration at 120 min of oral glucose tolerance test (OGTT) (r = 0.24, p = 0.041). CONCLUSIONS Overexpression of A2BAR in leukocytes of the GDM subjects and, additionally, the existence of a relationship between its elevated expression level in these cells and abnormal values of glucose concentration at 120 min of OGTT for GDM, suggest that this subtype might be involved in the pathogenesis of GDM.
Collapse
Affiliation(s)
- Andrzej Zieleniak
- Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | | | | | | | | |
Collapse
|
46
|
Lewandowski K, Nadel I, Lewinski A, Bienkiewicz M, Tan B, Randeva HS, Cypryk K. Positive correlation between serum omentin and thrombospondin-1 in gestational diabetes despite lack of correlation with insulin resistance indices. Ginekol Pol 2010; 81:907-912. [PMID: 21391440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
UNLABELLED Gestational Diabetes (GDM) is characterized by insulin resistance and a pro-inflammatory state, both factors possible related to adipokine expression. SUBJECTS AND METHODS The study included 20 women with GDM, diagnosed according to the WHO criteria, and 23 matched for age and BMI women with normal glucose tolerance. Omentin and TSP-1 were measured by ELISA assays. Insulin resistance was assessed by HOMA and Insulin Resistance Index (IRI). RESULTS There were no significant differences in omentin and TSP-1 levels between subjects with GDM and controls (48.0 +/- 12.0 ng/ml versus 50.2 +/- 7.9 ng/ml and 2150 +/- 1661 ng/ml versus 1569 +/- 1160 ng/ml, p = 0.64 and p = 0.29, for omentin and TSP-1 in GDM and control subjects, respectively). There was no significant correlation between either omentin or TSP-1 with HOMA or IRI, however there was a significant positive correlation between thrombospondin-1 and omentin (r = 0.49, p = 0.010). There was also a positive correlation between serum omentin and glucose levels at 60 and 90 minutes of OGTT, however, in the control group only (p < 0.05). CONCLUSIONS Concentrations of omentin and thrombospondin-1 seem to be inter-related in pregnancy however there are no differences in serum levels between women with normal glucose tolerance and those with glucose intolerance. These observations suggest that regulation of concentrations of these adipokines in pregnancy might be mediated though different mechanisms than in non-pregnant subjects.
Collapse
Affiliation(s)
- Krzysztof Lewandowski
- Department of Endocrinology & Metabolic Diseases, Medical University of Lodz, Poland
| | | | | | | | | | | | | |
Collapse
|
47
|
Grycewicz J, Ścibór Z, Ćwikła JB, Lewiński A, Cypryk K. Recurrent hypoglycaemia in a type 2 diabetes patient - diagnostic difficulties. Arch Med Sci 2010; 6:126-9. [PMID: 22371733 PMCID: PMC3278956 DOI: 10.5114/aoms.2010.13520] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Revised: 03/20/2009] [Accepted: 04/19/2009] [Indexed: 11/17/2022] Open
Abstract
Hypoglycaemia is the most frequent acute complication of diabetes, regardless of the type of diabetes and the treatment method. Hormonally active tumours of the pancreas, insulinomas, which belong to digestive tract neuroendocrine tumours, constitute one of the less frequent causes of hypoglycaemia. This paper presents a case of a 60-year-old type 2 diabetes patient with recurrent hypoglycaemic events, in whom an insulin-secreting hepatic neuroendocrine tumour was diagnosed. We suggest performing a diagnostic workup taking into consideration insulinoma in patients with diabetes who experience frequent otherwise inexplicable hypoglycaemic events, particularly when they recur despite decreased dose or discontinuation of hypoglycaemic agents.
Collapse
Affiliation(s)
- Joanna Grycewicz
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital – Research Institute (RI PMMH), Lodz, Poland
| | - Zdzistawa Ścibór
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital – Research Institute (RI PMMH), Lodz, Poland
| | - Jarosław B. Ćwikła
- Department of Radiology and Diagnostic Imaging, Postgraduate Medical Centre and Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital – Research Institute (RI PMMH), Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland
| | - Katarzyna Cypryk
- Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital – Research Institute (RI PMMH), Lodz, Poland
| |
Collapse
|
48
|
Koziarska-Rościszewska M, Panasiuk M, Cypryk K. Prevalence of metabolic syndrome and its' components in the young adult-students of universities in Lodz, Poland. Pediatr Endocrinol Diabetes Metab 2010; 16:277-283. [PMID: 21447269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION AND AIM OF THE STUDY Early identification of people at cardiovascular diseases (CVD) risk is crucial for the effective management. The aim of the study was to assess the prevalence of metabolic syndrome (MS) and its' components in young adults. MATERIAL AND METHODS The study (2006-2007) was conducted on the group of 1019 students: 709 women (W), 310 men (M), aged 18-38 years (mean 24.6) attending a primary care practice. A clinical interview was provided and anthropometric measurements and laboratory investigation were done. Body mass index (BMI), waist-hip ratio (WHR) and insulin-resistance (IR) were calculated. RESULTS Mean BMI was 24.4 kg/m2 in men and 21,29 kg/m2 in women. Overweight (BMI=25-30 kg/m2) was diagnosed in 17.66% and obesity (BMI>30 kg/ m2) in 3.02% of the study population. The prevalence of hypertension (HA) according to ATPIII/IDF (BP >= 130/85 mmHg) was revealed in 4.61%; acc. WHO (BP >= 140/90 mmHg) in 2.06%. There were no women with HA in the examined population. Fasting plasma glucose >100 mg/dL occurred in 0.78%. Hypercholesterolaemia was found in 12.56%; high levels of LDL and TG in 2.06% and 7.69% respectively and low HDL level in 6.64%. Metabolic syndrome acc. WHO criteria was diagnosed in 2.65%; acc. ATP III in 0.59% and acc. IDF in 0.98% of the study population. All MS components, except hyperglycaemia, occurred statistically more frequently in men than in women (p <0.05). CONCLUSIONS Our study shows a relatively high incidence of overweight, obesity and lipid disturbances, whereas other CVD risk factors are of a relatively lower percentage in young adults in Poland. The results confirm the higher incidence of MS and its components in men than in women. Revealing individuals at risk on the earliest stages allows to cope with the incorrect metabolic processes and, as a result, optimizing prevention activities based on primary care practice. Obesity is the greatest challenge for the public health.
Collapse
|
49
|
Pertyńska-Marczewska M, Głowacka E, Grodzicka A, Sobczak M, Cypryk K, Wilczyński JR, Wilczyński J. Profile of peripheral blood neutrophil cytokines in diabetes type 1 pregnant women and its correlation with selected parameters in the newborns. Am J Reprod Immunol 2009; 63:150-60. [PMID: 20039861 DOI: 10.1111/j.1600-0897.2009.00775.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PROBLEM Interleukin (IL)-12, IL-10, tumor necrosis factor-alpha (TNF-alpha), IL-6 and IL-8 alter as pregnancy progresses, implying continuous immune regulation associated with the maintenance of pregnancy. We aimed to evaluate the peripheral blood neutrophil-derived production of these cytokines in the course of pregnancy complicated by type 1 diabetes. METHOD of study These parameters were measured in samples from healthy non-pregnant (C), diabetic non-pregnant (D), healthy pregnant (P) and pregnant diabetic (PD) women. RESULTS Neutrophil-derived secretion of TNF-alpha and IL-12 increased along with progression of pregnancy in PD and P groups. The concentration of IL-10 from lipopolysaccharide (LPS)-stimulated neutrophils increased during the course of uncomplicated pregnancy but decreased in diabetic pregnancy. Concentration of IL-8 decreased with the advancing gestational age in P and PD groups. LPS-stimulated neutrophil-derived IL-6 concentration increased only in PD patients. CONCLUSION Our results show that diabetes creates pro-inflammatory environment thus potentially influencing the outcome of pregnancy. We conclude that neutrophil-derived cytokine production could contribute to the complications seen in pregnant women with type 1 diabetes.
Collapse
Affiliation(s)
- Magdalena Pertyńska-Marczewska
- Department of Fetal-Maternal Medicine and Gynaecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | | | | | | | | | | | | |
Collapse
|
50
|
Pertyńska-Marczewska M, Głowacka E, Sobczak M, Cypryk K, Wilczyński J. ORIGINAL ARTICLE: Glycation Endproducts, Soluble Receptor for Advanced Glycation Endproducts and Cytokines in Diabetic and Non-diabetic Pregnancies. Am J Reprod Immunol 2009; 61:175-82. [DOI: 10.1111/j.1600-0897.2008.00679.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|