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The presence of eruptive xanthomas is associated with lipid disorders, particularly hypertriglyceridaemia. Intensified hypertriglyceridaemia >10 mmol/l (880 mg%) is a major risk factor for acute pancreatitis. The presented case concerns a 40-year-old man with skin lesions in the form of eruptive xanthomas, accompanied by hypertriglyceridaemiae, complicated by acute pancreatitis, and diagnosed with type 2 diabetes with glycated haemoglobin 9.7 g/dl. Seeding of skin lesions appeared 2–3 months before hospitalization and was observed in the direction of molluscum contagiosum.
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Type 2 diabetes risk factors among the unemployed

100%
Unemployment is a significant social problem which has numerous negative health consequences. Findings of numerous researches provide  data on the range of the consequences of unemployment with risk of health deterioration being one of the most important. Unemployment remains an area of interest for the following fields of science: psychology, economics, sociology. More and more researches prove that there is a link between the increase of disease occurrence and death rate and long-term unemployment. Both in Poland and all over the world a steady increase in the incidence of type 2 diabetes is being observed. World Health Organization (WHO) estimates that, taking into consideration present dynamics of changes, in 2025 there will be 300 million people diagnosed with diabetes. That is why a diabetes epidemic is such a topical issue, and according to some epidemic data this epidemic is starting to reach Poland as well. Data provided by IDF (International Diabetes Federation) show that in Poland the percentage of diabetes patients is 9,1% of the whole population and it is a little higher than the European average (8,6%). It is predicted that by 2015 the percentage will rise to 11%. Identification of adverse health behaviors and introducing actions promoting health in a given population group can prove to be beneficial for the present condition of members of a given group as well as decrease the risk connected with the occurrence of diseases associated with the progress of civilization in the future. The aim of the article is to indicate type 2 diabetes risk factors among the unemployed in Poland.
Introduction. Physical training is considered an effective means of preventing and treating diseases of affluence such as T2DM. The key benefits of this therapy include improvements in physical performance and in metabolic processes. Aim of Study. The aim of this study was to investigate the impact of a 12-week long supervised combined strength and endurance training program on physical performance of T2DM patients with various complications. Material and Methods. The study was carried out on patients stratified into Groups (levels) 2 and 3 according to the criteria from the 2007 Danish program “Forløbsprogram for Type 2 Diabetes” (see Table 1). A total of 83 patients (29 women, 54 men) participated in the study, aged 65.5 ± 10.62 years. The subjects were offered 60 minutes of supervised group exercise, twice a week for 12 weeks. Each session consisted of a 5-min warm-up, 35-min strength exercise, and 10-min aerobic bicycling, with a load between 12 and 15 on the Borg Scale. Physical performance was measured using a 30-second sit-to-stand test (STS) and 6-minute-walk test (6MWT). Results. A significant improvement in STS was noted in Group 2 (mean = 1.6 ± 2.39; 95% CI 0.92-2.3) and in Group 3 (mean = 1.46 ± 2.14; 95% CI 0.74-2.17). Statistically significant (p <0.0001) 6MWT results were obtained in Group 2 (mean = 46.7 ± 54.08; (95% CI 30-63) and in Group 3 (mean = 46.2 ± 79.51; 95% CI 12-79). Participation in training sessions played a paramount role in improving the effectiveness of combined strength and endurance training. Conclusion. Participation in a 12-week exercise program increased physical performance in patients with type 2 diabetes, regardless of their complication status.
Prolonged postprandial hyperglycemia is a detrimental factor for type 2 diabetes and obesity. The benefit of green tea extract (GTE) consumption still requires confirmation. We report the effects of circulating green tea catechins on blood glucose and insulin levels. Oral glucose loading 1 h after GTE ingestion in humans led to higher blood glucose and insulin levels than in control subjects. Gallated catechins were required for these effects, although within the intestinal lumen they have been known to decrease glucose and cholesterol absorption. Treatment with epigallocatechin-3-gallate hindered 2-deoxyglucose uptake into liver, fat, pancreatic beta-cell, and skeletal muscle cell lines. The glucose intolerance was ameliorated by gallated catechin-deficient GTE or GTE mixed with polyethylene glycol, which was used as an inhibitor of intestinal absorption of gallated catechins. These findings may suggest that the gallated catechin when it is in the circulation elevates blood glucose level by blocking normal glucose uptake into the tissues, resulting in secondary hyperinsulinemia, whereas it decreases glucose entry into the circulation when they are inside the intestinal lumen. These findings encourage the development of non-absorbable derivatives of gallated catechins for preventative treatment of type 2 diabetes and obesity, which would specifically induce only the positive luminal effect.
Introduction. Diabetes as a non-infectious chronic metabolic disease is a problem of the contemporary world, including Poland. Behaviour therapy plays an important role in its treatment, i.e. proper diet and regular physical activity. Patient’s knowledge of nutrition principles is also an essential complement to the treatment, reducing the risk of late complications of diabetes. Objective. Assessment of the nutrition knowledge of patients with type 1 and type 2 diabetes. Materials and method. The study involved 300 randomly selected patients from Rzeszów and the surrounding area (135 patients with type 1 diabetes and 165 patients with type 2 diabetes) aged 8–78.The analysis was made using a survey questionnaire prepared by the authors of the study, conducted in the period July – December 2011. Results. The survey revealed that patients with type 1 diabetes have greater nutrition knowledge and knowledge about diabetes than patients with type 2 diabetes. On the other hand, they are less likely to comply with the recommendations of the diet prescribed by a doctor or a dietician. Conclusions. Patients with diabetes, regardless of age, type of diabetes, gender, or disease duration require continuous broadening of diabetes knowledge. Systematic training will teach patients proper eating habits related to their diet and lifestyle.
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Central regulation of food intake in ageing

72%
Energy homeostasis and fuel metabolism undergo significant modifications in the course of ageing. During the second half of life many humans increase their body mass and develop glucose intolerance that may lead to obesity and type 2 diabetes. However, many old people suffer from being underweight, and this "anorexia of elderly" may seriously compromise their health under certain circumstances. Experimental studies into the causes of ageing-related impairments of food intake regulation were performed mainly on rat, and to some extent, on non-human primates. It was found that the expression of NPY, the most potent orexigenic peptide, and of NPY receptors, is highly suppressed in the hypothalamus of old rats. Moreover, the increase of NPY mRNA after fasting was severely blunted in old as compared to young rats. Similar reductions, although of lower magnitude, were reported for other hypothalamic orexigenic compounds such as, AgRP and orexins. Interestingly, ageing does not significantly alter hypothalamic mRNA levels of important anorexigens such as CART and aMSH. The presented findings suggest that, at least in rodents, ageing is associated with the general down-regulation of hypothalamic peptides that stimulate food intake and unchanged expression of anorexigenic peptides. This situation may be responsible for the decreased appetite drive in senescent animals and loss of weight at the end-of-life period. If similar changes of the central control of food intake underly „anorexia of ageing“ observed in some elderly, it is possible that therapeutic intervention at this regulatory level may be possible in the future.
Background. Adiponectin is a protein specific to visceral adipose tissue where its concentrations are reduced in type 2 diabetes and obesity. Many factors also determine serum levels of adiponectin such as gender, BMI, as well as diet. Objective. To compare the effects of consuming certain key foodstuff products on serum adiponectin concentrations between diabetic patients and suitable controls. Material and methods. A survey and laboratory testing was performed on 72 patients of whom (n = 21) were diabetics, whilst the control group, (n = 51) non-diabetics. Eating habits were assessed and serum adiponectin was measured in all cases. Results. Diabetic patients had significantly lower adiponectin levels compared to the control group; respectively (23.5±21.1 μg/ml vs. 36.5±21.1 μg/ml; p=0.02). Furthermore, women had higher concentration than men; respectively (41.3 μg/ml± 20.1 μg/ml vs. 22.0 μg/ml± 14.8 μg/ml; p=0.000). A high consumption of foodstuffs such as vegetables, vegetable oils, coffee and tea positively correlated with adiponectin concentration in serum, whilst a negative correlation was seen with consumptions of mixed bread, fried and baked dishes, alcohol, nuts and seeds. Conclusions. Serum adiponectin levels are related to factors such as gender, (higher in women), BMI, (higher in persons with normal body weight) and whether diabetic, (lower in people with diabetes). Multiple correlations were observed between the consumption of foodstuff product groups and serum adiponectin concentration. It is thereby suggested, that adiponectin could have a significant role to play in the treatment and prevention of diabetes and obesity.
Melatonin plays several important physiological functions in mammals, such as immune enhancement and regulation of dark-light signal transduction. Melatonin is also known to be an endogenous free radical scavenger and an efficient antioxidant. It detoxifies a variety of free radicals and reactive oxygen intermediates, including the hydroxyl radical, singlet oxygen and nitric oxide. These radicals participate in many diseases, for example diabetes. This study determined the effect of melatonin on the antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and the level of glutathione (GSH) in human diabetic (C2 line) skin fibroblasts. Confluent monolayers of control (S2 line) and diabetic (C2 line) skin fibroblasts were incubated with different concentrations of melatonin: 10, 50, 100 and 1000 μmol/l at 37°C for 24 h. Next, the GSH level and SOD, CAT and GPx activities were measured colorimetrically. The activities of the antioxidant enzymes and the GSH level were lower in diabetic skin fibroblasts than in the control S2 line. Concentrations of melatonin of 100 and 1000 μmol/l caused a significant increase in the enzymes' activities and GSH level.
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Biliopancreatic diversion in Poland

58%
Biliopancreatic diversion (BPD) is a bariatric operation of proved efficacy especially in patients with metabolic comorbidities. The aim was to assess the results of BPD in relation to weight loss and coexisting lipid and glucose metabolism disturbances in the Polish population. Between October 2001 and December 2003 57 morbidly obese patients (24 male and 33 female) underwent BPD. Median age was 46 years (range: 17-58) and median body mass index (BMI) was 50.2 kg/m2 (range: 40.1-73 kg/m2). Type 2 diabetes mellitus was observed in 11 patients (19.3%), hypercholesterolaemia in 38 patients (66.7%) and hypertriglyceridaemia in 37 patients (64.9%). Median value of BMI decreased at three months to 40.0 kg/m2, at six months to 36.7 kg/m2, and after a year to 32.3 kg/m2. Diabetes was completely resolved in all patients. After six months, triglycerides and cholesterol levels were higher than normal only in one patient. Early specific complications that manifested as seroma and nosocomial pneumonia occurred in 5.3% and 3.5% patients, respectively. The following specific late complications were observed: ulceration of stomach stump (3.4%), anaemia (14.0%), hypoalbuminaemia (8.8%), deterioration of haemorrhoids (15.8). All of above complications were treated conservatively expect two haemorrhoidectomies. One patient died due to myocardial infarction eight months after BPD. Five cases of incisional hernias (8.8%) were found. BPD is an effective bariatric procedure also in the Polish population, resulting not only in weight loss but also in the improvement of lipid and glucose metabolism.
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