Less common forms of diabetes in young population.

Types diabetes other than type 1 are generally considered rare in children and adolescents. The incidence of type 2 diabetes has increased dramatically over the past decade in some ethnic groups. The increased incidence of this type of diabetes mellitus has corresponded tem-porally to unprecedented increases in body weight and obesity prevalence in adolescents in various ethnic populations.

Type 1 diabetes - What's new in prevention and therapeutic strategies?

Type 1 diabetes (T1D) is an autoimmune disorder, and insulin deficiency is the result of b-cell dysfunction. Treatment of type 1 diabetes requires constant parenteral insulin administration, which can be very burdensome for the patient. Meticulous use of insulin therapy does not protect the patient against complications.

β-cell self-destruction and extremely complicated and still unknown etiopathogenesis of type 1 diabetes.

Type 1 diabetes is based on apoptosis, which leads to b-cell death. Factors triggering apoptosis processes are very diverse and currently not fully explained. The main role is attributed to genetic and environmental factors.

Polycystic ovary syndrome (PCOS) and the accompanying disorders of glucose homeostasis among girls at the time of puberty.

Polycystic ovary syndrome (PCOS) usually arises during puberty and is marked by insulin resistance, hyperinsulinemia, and hyperandrogenism. The principle is that the diagnosis of PCOS must be based on the presence of at least two of the following three criteria: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries. The diagnosis of PCOS in adolescents is particularly difficult due to developmental problems in this group.

Pharmacological Treatment in Diabetes Mellitus Type 1 - Insulin and What Else?

The basis of treatment in autoimmune diabetes is insulin therapy; however, many clinical cases have proven that this method does not solve all problems. Trials of causal treatment including blocking the autoimmune processes and insulin-producing cells transplants were carried out. Those methods require more research to be concerned as efficient and safe ways of treatment in type 1 diabetes.

[The clinical utility of C-peptide measurement in diabetology].

C-peptide is produced in equal amounts to insulin and is the best measure of endogenous insulin secretion in patients with diabetes. Measurement of insulin secretion using C-peptide can be helpful in clinical practice: differences in insulin secretion are fundamental to different requirements in the treatment of diabetes. An important clinical role of C-peptide is differentiating between type 1 and type 2 diabetes.

[Type LADA diabetes--interrogation points].

Type LADA diabetes is a form of autoimmune-mediated diabetes in adults. The progression of beta-cell failure is slower than in childhood type 1 diabetes. Patients with LADA present with more preserved beta cell function than those with classic type l diabetes.

Role of ghrelin and leptin in the regulation of carbohydrate metabolism. Part II. Leptin.

Leptin is produced by mature adipocytes. Its amount correlates positively with the mass of the adipose tissue. Leptin plays a crucial role in maintaining body weight and glucose homeostasis.

Role of ghrelin and leptin in the regulation of carbohydrate metabolism. Part I. Ghrelin.

Ghrelin is a polypeptide that is excreted by the secretory cells of the gastric and intestinal mucosa, the arcuate nucleus of the hypothalamus as well as by the epsilon cells (ε) located in the pancreatic islets. It plays an important role in maintaining the energy balance of the organism and influences the endocrine function of the pancreas and glucose metabolism. It takes part in the regulation of glucose homeostasis through the modulation of insulin secretion and insulin sensitivity.

[Glucagon and glucagon-like peptides the role in control glucose homeostasis. Part I].

Glucose homeostasis is controlled primarily by the opposing actions of insulin and glucagon, hormones that are secreted by the islets of Langerhans from β-cells and α-cells and Δ-cells, their role in glucose homeostasis still needs identifying. Insulin secretion is increased in response to elevated blood glucose to maintain normoglycemia by stimulating glucose transport in muscles and adipocytes and reducing glucose production by inhibiting gluconeogenesis in the liver. Whereas glucagon secretion is suppressed by hyperglycemia, it is stimulated during hypoglycemia, promoting hepatic glucose production and ultimately raising blood glucose levels.

The role of leptin in the regulation of carbohydrate metabolism.

The hormone leptin is secreted from white adipocytes, and serum levels of leptin correlate with adipose tissue mass. Leptin was first described as acting on the satiety centre in the hypothalamus through specific receptors (ob-R) to restrict food intake and enhance energy expenditure. Leptin plays a crucial role in the maintenance of body weight and glucose homeostasis hrough central and peripheral pathways, including regulation of insulin secretion by pancreatic b cells.

Metabolic memory - the implications for diabetic complications.

Many important biochemical mechanisms are activated in the presence of high levels of glucose, which occur in diabetes. Large randomised studies have established that early intensive glycaemic control reduces the risk of diabetic complications. This phenomenon has recently been dubbed 'metabolic memory'.

[Could oral antidiabetic agents be useful in the management of different types of diabetes and syndromes of insulin resistance in children and adolescents?].

Various pharmacological approaches can be used to improve glucose homeostasis. These pharmacological treatments may be used individually for certain types of patients, or may be combined to provide a more ideal glycaemic control. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent.

The perspectives of adjunctive drugs usage in the treatment of glucose metabolism disturbances in adolescent patients.

Tightening of the diabetes control criteria in the last few years induces searches for adjunctive drugs to reinforce the basic treatment typical for the specific type of the disease. These agents are meant to stimulate insulin secretion, increase insulin sensitivity or inhibit the antagonists of the hormone. Up till now that kind of studies included adults, mainly with type 2 diabetes.

[Used of oral antidiabetic agents in pediatric patients - own observations].

Our present investigation demonstrates that in adolescents with various impaired glucose homeostasis oral antidiabetic agents can be used to improve glucose metabolism. Metformin is widely used in pediatric patients and is considered to be the most effective oral agent. Metformin is beneficial in improving glucose tolerance and insulin sensitivity, in lowering insulinemia, and in reducing elevated androgen levels.

Neuropathy and type 1 diabetes mellitus.

Diabetic neuropathy is the most common type of neuropathies. It affects patients with both type 1 and type 2 diabetes, but it progresses more rapidly and its manifestations are more severe in type 1 diabetes. Although there has been a significant progress in the understanding of the clinical aspects of these conditions, many questions remain unanswered.

[Coexistance of autoimmunological diseases with type 1 diabetes mellitus in young patients based on literature and own experience].

Patients with autoimmune type 1 diabetes mellitus have often, besides immune diabetic markers, also other organ-specific antibodies. In many diabetic patients autoimmune thyroid diseases, i.e.

[Role of amylin in glucose homeostasis and its perspective use in diabetes management].

In response to hyperglycemia, beta-cells release insulin and C-peptide, as well as islet amyloid pancreatic polypeptide - amylin. In diabetgic patients beta-cell destruction does not only result in deficiency of insulin, but also a deficiency of C-peptide and amylin. Amylin is clearly involved in glucose homeostasis through the inhibition of gastric emptying and postprandial hepatic glucose production, eventually reducing postprandial glucose excursions.

[New developments in the treatment and monitoring of type 1 diabetes mellitus].

In recent years, insulin analogues are the benefits of the use in functional intensive insulin therapy for the treatment of diabetes. Shortacting insulin (lispro, aspart and glulisine) and long-acting insulin (glargine and detemir) have been developed for the management of diabetes. Short-acting insulin analogues are an alternative to regular human insulin before meals.

Cardiovascular system disease in youth patients with various forms of glucose metabolism impairment - diagnosis and treatment.

For many years chronic complications of diabetes in adolescent patients were linked mainly to microangiopathy. New, more and more accurate, diagnostic methods, making noninvasive diagnosis of very early lesions in the vascular wall possible, allowed to find out that microangiopathic lesions may be present even in very young patients. Maintenance of increased blood glucose levels initiates a number of mechanisms which lead to damage of blood vessels and nerves.

[The occurrence and analysis of chosen risk factors of DKA among children with new onset of DMT1].

Introduction: DKA is still the potentially life-threatening complication of DMT1 especially in children and in newly diagnosed subjects. The aim of the study was the assessment of the DKA frequency and the analysis of chosen risk factors in children with the new onset of DMT1.

Material And Methods: The group of 186 children with the onset of DM hospitalised in the years 2004-2005 was followed up.

Treatment of type 1 diabetes mellitus revealed below 7 years of age in the Diabetes Center of Silesia, Poland.

Introduction: Frequency of type 1 diabetes mellitus diagnosis in young children increases. Within this group, such factors as limited cooperation, little acceptance of multiple injections and other typical patterns of behavior can strongly influence the insulin management outcome.

Aim Of The Study: The objective of the study was to provide information regarding metabolic control in young diabetes patients.

Alterations of blood glucose homeostasis in critically ill children - hyperglycemia.

Hyperglycemia is common in critically ill children. It does not appear to be associated with a particular diagnostic category but is significantly associated with the severity of illness. Severe hyperglycemia may be associated with complications, this in turn could result in end-organ dysfunction.