[Evaluation of blood pressure changes by 24-hours ambulatory blood pressure monitoring (ABPM) in young, normotensive patients with diabetes mellitus type I]. / Ocena zmian cisnienia tetniczego metoda 24-godzinnego ambulatoryjnego monitorowania cisnienia (ABPM) u mlodych, normotensyjnych chorych na cukrzyce typu 1.

UNLABELLED: The aim of this study was to evaluate usefulness of ambulatory blood pressure monitoring (ABPM) to examine circadian patterns of blood pressure (BP) alterations in young, normotensive patients with type I diabetes mellitus (DM1). MATERIAL AND METHODS: We studied 43 patients with DM1 aged 18-28 years, with 9-23 years of DM1, without long-term complications. Control group consisted of 32 healthy persons, matched to the DM1 group. 24h ABPM was performed by a Spacelab 90207 device to obtain daytime (7 AM to 11 PM, readings at 20-min interval) and nighttime (11 PM to 7 AM, readings at 30-min interval) measurements in both groups. RESULTS: During the daytime systolic BP (sBP) and diastolic BP (dBP) were not significantly different from the control group. We noted nighttime sBP and dBP higher in DM1 group: sBE 119.7+/-12.6 mmHg vs. 103.817.1; p = 0.001 l dBP 65.5+/-6.2 vs. 61.5+/-3.1; p = 0.001. The loss of fall in BP ('non-dippers') was more prevalent in DM1 group: 49% vs. 9%; p = 0.003. Pulse pressure (PP) was significantly higher in DM1 patients: 50.9+/-6.9 mmHg vs. 44.8+/-5.6 mmHg; p = 0.0001. CONCLUSIONS: ABPM is a useful method in detecting early BP alterations in young normotensive patients with diabetes mellitus type 4 1. Increased PP and suppressed diurnal BP variations could represent a increased risk of cardiovascular complications in young patients with diabetes mellitus type 1.

[Usefulness of continuous glucose monitoring system in detection of hypoglycaemic episodes in patients with diabetes in course of chronic pancreatitis]. / Przydatnosc systemu ciaglego monitorowania glikemii w wykrywaniu niedocukrzen u chorych na cukrzycf powstala w przebiegu przewleklego zapalenia trzustki.

BACKGROUND: Recently introduced method of glucose monitoring--Continuous Glucose Monitoring System (CGMS, Medtronic MiniMed) now offers new possibilities of assessing metabolic control of diabetes as it records blood glucose values 288 times per day. CGMS is particularly helpful in pancreatogenic diabetes, which is associated with essentially poor metabolic control and higher number of hypoglycemic events. AIM: The study aimed at assessing number of hypoglycemic episodes, including symptom-free hypoglycemic episodes detected with CGMS and glucose meter (GM). TURESTIGALED GROUP AND METHODS: The study comprised 60 diabetic out-patients, treated with insulin in age mean 53.8 +/- 5.1 years, with chronic pancreatitis lasting mean 10.6 +/- 4.6 years and diabetes mellitus-- 4.9 +/- 2.4 years. Serum glucose concentration values were measured with the use of CGMS. Ten measurements of capillary blood glucose concentration with GM were performed daily during the period of CGMS use. Observation period of hypoglycemic episodes lasted 3 days. Hypoglycemic event was detected when glucose value decreased below 60 mg/dl. The number of hypoglycemic episodes, including symptom-free hypoglycemic episodes detected with CGMS and GM was compared. RESULTS: Number of hypoglycemic events detected with CGMS was five times higher than in GM measurements (p < 0.001). Episodes of symptom--free hypoglycemia were noted in CGMS six times higher than in GM measurements (p < 0.001). Hypoglycemia was found in twice as many patients when diagnosed upon CGMS results as when found upon GM results (p < 0.01). Episodes of symptom-free hypoglycemia were detected in six times as many patients when diagnosed upon CGMS as when analysed upon GM measurements (p < 0.001). CONCLUSION: CGMS offers more complete data on low blood glucose incidents, including symptom-free hypoglycemia, than intensive blood glucose monitoring with the use of glucose meter.

[Accuracy of blood glucose concentration values outcome performed at various skin sites with personal glucose meters]. / Wiarygodnosc wartosci stezen glukozy we krwi uzyskanych z róznych okolic ciala za pomoca indywidualnych mierników glikemii.

AIM: The aim of this study was the comparison of capillary blood glucose values performed at different skin sites with various glucose meters. PATIENTS AND METHODS: 50 type 2 - diabetic patients were enrolled into the study. At the first part of study - in stable glucose phase, measurements were performed with four various glucose meters at four skin sites: finger, forearm, abdomen, big toe. At the second part of the study all the subjects underwent one hyperglycemic challenge (after intravenous 40% glucose load) and hypoglycemic challenge (after intravenous 6 I.U.dose of short-acting human insulin). All of those capillary glucose values were compared between the venous blood and the interstitial glucose values. RESULTS: No significant differences in performed glucose values were observed between the four types of glucose meters (p>0.05). Only the glucose values at finger were similar to the venous and the interstitial glucose levels in stable glycaemic and rapid glucose change phase as well (p>0.05). CONCLUSION: 1. Glucose meters are precise and reliable tool for capillary glucose measurement. 2. Capillary glucose measurements can differ depend on various skin sites. 3. Capillary glucose measurements at finger are reliable and comparable with the suitable venous and the interstitial glucose levels.