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Piťhová, P., Kvapil, M. The effect of adding glitazone or sulphonylurea
derivate in obese patients with type 2 diabetes mellitus treated by
metformine. Kazuistiky v diabetologii 6, č. 1: 11–15, 2008. |
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Type 2 diabetes mellitus represents a very heterogenic
group of diseases with a variably manifested impairment of insulin
sensitivity (insulin resistance) and/or an impairment of insulin
secretion (insulin deficiency). The treatment of patients resistant to
insulin is based primarily on lifestyle changes as well as
administration of metformine; depending on the grade of prevailing
impairment it is possible to improve the insulin sensitivity by adding
glitazone or to improve impaired insulin secretion by adding
sulphonylurea derivate. The clinical benefit of adding thiazolidinedione
or sulphonylurea secretagogue in 20 obese patients with type 2 diabetes
mellitus treated until then by metformine was assessed retrospectively.
Clinical parameters (weight, body mass index – BMI, blood pressure),
parameter of diabetic compensation (glycated hemoglobin HbA1c), lipid
spectrum (triacylglycerole levels; total, HDL and LDL cholesterol) and
liver function tests during metformine treatment and 1 year following
the addition of glitazone/sulphonylurea derivate to existing treatment
were assessed. A statistically significant improvement of metabolic
compensation in both groups and a decrease of total and LDL cholesterol
levels in glitazone group were achieved. A statistically significant
weight gain was seen in the group with added sulphonylurea derivate.
Other parameters were not influenced. Education of diabetic patients,
physical activity and weight reduction are the essential factors of the
treatment of type 2 diabetes mellitus.
Key words: insulin resistance, impairment of insulin secretion,
combined treatment of type 2 diabetes mellitus, metformine,
sulfonylurea, thiazolidinediones
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Hejnicová, K. The
influence of long acting insulin analogue on the reduction of
nocturnal hypoglycemic events. Kazuistiky v diabetologii 6, č. 1:
16–18, 2008. |
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The paper confirms the advantages of
administration of basal insulin analogue with extended action in
contrast to human medium-term acting insulin in a female patient
with type 2 diabetes mellitus who tends to nocturnal
hypoglycemias.
Key words: insulin detemir, type 2 diabetes mellitus,
nocturnal hypoglycemias
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Karásek, D., Doláková, J., Havlík, R., Musilová, K., Fryšák, Z. Insulinoma
manifested by epileptiform seizures. Kazuistiky v diabetologii 6, č. 1 –
Endokrinologie: 22–25, 2008. |
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Authors present a case of a patient with recurrent
attacks of unconsciousness with convulsions that were diagnosed as
epileptic seizures. Seizures were accompanied by hypoglycemia caused by
organic hyperinsulinism in pancreatic insulinoma. Following surgical
removal of the tumor the attacks of unconsciousness disappeared and
patient remains asymptomatic.
Key words: unconsciousness with convulsions, hypoglycemia,
organic hyperinsulinism, insulinoma
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Poločková, K. Neonatal hyperthyreosis. Kazuistiky v diabetologii 6, č. 1 –
Endokrinologie: 26–27, 2008. |
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The case history describes a neonatal hyperthyreosis
diagnosed by chance in a baby hospitalized for acute respiratory
infection demanding oxygenotherapy and intravenous bronchodilatation.
The condition was caused by a transfer of maternal thyroid stimulating
antibodies from the mother who had an undiagnosed and untreated
Graves-Basedow thyreotoxicosis.
Key words: neonatal hyperthyreosis, thyroid stimulating
antibodies, maternal transfer
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