Biomedical subjects

Tsvetalina Tankova

Publications and source records attributed to Tsvetalina Tankova.

5 recordsLinked to original sources

PubMed2004

Education and quality of life in diabetic patients.

The aim of the present randomized, controlled study was to evaluate the effect of a 5-day teaching program for diabetic patients on their quality of life 1 and 2 years afterwards. Three hundred and nineteen insulin-treated patients, of mean age 38.2+/-14.1 years and mean duration of the disease 9.0+/-6.9 years were followed up at reeducation sessions 1 and 2 years after the program. A group of 241 insulin-treated patients were also followed up and served as a control group. At baseline and 1 and 2 years later, we have assessed patients' well-being, using a standard 22-item questionnaire. There was a significant increase in overall well-being of patients one (P <0.0001) and 2 years (P <0.001) after the program, due to reduction in depression and anxiety and increase in positive well-being after 1 year and decrease in depression and increase in positive well-being after 2 years as compared to the control group. There was an improvement in glycaemic control of the educated patients as compared to the control group (P <0.01). The results from the present study demonstrate that structured patient education improves patients' well-being 1 and 2 years after the teaching program.

Adult↗

PubMed2004

Alpha-lipoic acid in the treatment of autonomic diabetic neuropathy (controlled, randomized, open-label study).

AIM: to evaluate the effect of alpha-lipoic acid in autonomic diabetic neuropathy in a controlled, randomized, open-label study. MATERIAL AND METHODS: 46 patients with type 1 diabetes and different forms of autonomic neuropathy, of mean age 38.1 +/- 12.5 years and mean duration of diabetes 16.8 +/- 8.9 years were treated with alpha-lipoic acid for 10 days 600mg daily iv, thereafter one film tablet of 600mg daily for 50 days. 29 type 1 diabetic patients with autonomic diabetic neuropathy, of mean age 40.2 +/- 9.3 years and mean duration of diabetes 15.4 +/- 7.9 years served as a control group. We have followed-up patients' complaints, Ewing's tests, laboratory parameters of oxidative stress. RESULTS: There was a significant improvement after treatment in the score for severity of cardiovascular autonomic neuropathy--from 6.43 +/- 0.9 to 4.24 +/- 1.8 (p<0.001), while in the control group it worsened from 6.18 +/- 1.3 to 6.52 +/- 0.9 (p>0.1). We found improvement in the Valsalva manoeuvre after treatment - from 1.05 +/- 0.04 to 1.13 +/- 0.08 (p<0.001); in the deep-breathing test -from 3.4 +/- 2.8 to 10.4 +/- 5.7 (p<0.001); and in the lying-to-standing test--from 0.99 +/- 0.01 to 1.01 +/- 0.02 (p>0.1), while in the control group there was no improvement. There was a beneficial effect of treatment on the change of systolic blood pressure at the lying-to-standing test--from 22.7 +/- 11.5 to 9.8 +/- 7.9 (p<0.001), while in the control group the change was 20.5 +/- 11.1 mmHg and 19.7 +/- 12.9 mmHg (p>0.1), respectively. We found improvement in diabetic enteropathy in six patients; in the complaints of dizziness, instability upon standing in six patients; in neuropathic edema of the lower extremities in four patients and in erectile dysfunction in four patients after treatment, while in the control group no change was reported in the symptoms and signs of autonomic neuropathy by the end of the follow-up period. There were changes in the laboratory parameters of oxidative stress after therapy--total serum antioxidant capacity increased from 20.42 +/- 1.8 to 22.96 +/- 2.3 microgH2O2/ml/min (p<0.05), serum SOD activity - from 269.8 +/- 31.1 to 319.8 +/- 29.IU/l (p=0.02) and erythrocyte SOD--from 0.89 +/- 0.10 to 1.11 +/- 0.09 U/gHb (p=0.04). CONCLUSION: Our results demonstrate that alpha-lipoic acid (Thiogamma) appears to be an effective drug in the treatment of the different forms of autonomic diabetic neuropathy.

Adult↗

PubMed2003

The effect of repaglinide on insulin secretion and oxidative stress in type 2 diabetic patients.

The effect of repaglinide on insulin secretion and oxidative stress was evaluated in type 2 diabetic patients in a randomized, controlled, open-label trial. Forty-six patients were treated for 2 months with repaglinide, added to either diet (n=21) or metformin (n=25). A control group of 29 patients, matched for age, weight and glycaemic control, on either diet (n=13) or metformin (n=16) was also followed-up. Phases of insulin secretion (first-FPIS and second-SPIS) ware studied during IVGTT. Total serum antioxidant capacity and serum superoxide dismutase (SOD) activity were measured to assess oxidative stress. HbA(1c) decreased significantly in the repaglinide-treated group (P=0.01), the difference being significant compared with the control group (P=0.01). FPIS increased significantly after repaglinide (P<0.001). The area under the curve (AUC) for FPIS increased significantly (P<0.001), while the AUC for SPIS and for total insulin secretion did not change. Insulin secretion remained unchanged after 2 months in the control group. There was a significant increase after repaglinide in total serum antioxidant capacity (P<0.05) and serum SOD activity (P<0.0004); the difference compared to the control group being significant (P<0.002). Our results demonstrate the physiological effect of repaglinide on endogenous insulin secretion in a controlled, randomized, open-label study-there is a rise only in FPIS, which is the main beta-cell defect in type 2 diabetes mellitus. This improvement in glycaemic control was accompanied by a beneficial effect on oxidative stress in diabetes mellitus.

Carbamates↗

PubMed2003

Current indications for metformin therapy.

Metformin (dimethyl-biguanide) is an oral antidiabetic drug, which decreases hepatic glucose production (gluconeogenesis) and increases peripheral glucose uptake by muscles. Metformin is a first-line drug in the treatment of overweight and obese type 2 diabetic patients, offering a selective pathophysiological approach by its effect on insulin resistance. It has been shown in a number of studies to improve clinical outcomes in type 2 diabetic patients. It has been demonstrated in a number of studies that metformin has multiple biological effects - it has been shown to have platelet antiaggregating effects, to reduce the rate of formation of advanced glycation end products (AGEs) and to decrease the cellular oxidative reactions, thus demonstrating the antioxidant effects of the drug, which may largely explain its vascular protective effect. A number of studies have established the favorable effect of metformin on body weight, insulin resistance, hyperinsulinaemia, lipid parameters (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides), arterial hypertension, fibrinolysis, endothelial dysfunction. Thus metformin appears to have a broad set of pharmacological properties, making the drug potentially applicable even in nondiabetic situations such as obesity, extreme insulin resistance with acanthosis nigricans, polycystic ovary syndrome, etc. Metformin has been demonstrated in the Diabetes Prevention Program to be a drug with great potential in preventing the conversion of IGT to type 2 diabetes. Thus, metformin appears to be a drug with multiple therapeutic effects far beyond its effect on lowering blood glucose in diabetes mellitus.

Diabetes Mellitus, Type 1↗

PubMed2003

Metformin in the treatment of obesity in subjects with normal glucose tolerance.

The aim of the present study was to evaluate the effect of metformin on body weight, body fat mass, waist circumference, lipid parameters, insulin secretion and insulin resistance in obese subjects with normal glucose tolerance. 26 subjects (16 females and 10 males), mean age 37.3+/-9.7 years and mean BMI 32.3+/-9.1kg/m2 were treated with individual hypocaloric diet and metformin at a mean dose of 2.38+/-0.32g for six months. Insulin secretion was studied during OGTT; insulin resistance was assessed by the HOMA index. We have found a reduction of 3.24% in body weight, which was accompanied by a decrease in body fat mass (by 7.45%, p<0.01) and in waist circumference (p<0.01). Insulin resistance decreased by 14.5% (p=0.02) after metformin. There was a significant decrease in the AUC for the total (by 17.6%, from 6999+/-1453 to 5763+/-1511mU/L.120min, p<0.01) and stimulated insulin secretion (by 17.1%, from 4215+/-1011 to 3495+/-925mU/L.120min, p=0.01) during OGTT after six-month treatment with metformin. In conclusion, the results from the present study demonstrate that metformin contributes to a reduction in body weight, body fat mass and waist circumference, improves insulin sensitivity and decreases basal, total and stimulated insulin secretion in obese subjects. Thus metformin appears to be an effective and well-tolerated drug in the treatment of obesity in subjects with normal glucose tolerance.

Adult↗