The еffects of low mineral content water on microbiota, metabolic, and oxidative stress parameters in patients with type 2 diabetes mellitus.

Although scientific evidence has shown that natural mineral waters have potential beneficial metabolic effects, there is still very scarce data on their influence on type 2 diabetes mellitus (T2DM). The study was designed to investigate the effects of low mineral water from the "Sneznik-1/79″ source in Serbia on microbiota, metabolic, and oxidative stress parameters in patients with T2DM. In total, 60 patients with confirmed T2DM were included in the study, and they consumed "Sneznik-1/79″ water for 28 days. To examine the positive effects of "Sneznik-1/79″ water, we compared the results before and after the four weeks of "Sneznik-1/79″ water intake. Standard biochemical analyses were carried out, such as glucose level, lipid profile, and stool tests. The blood samples were collected to evaluate the effects of "Sneznik-1/79″ water on the redox status. At the end of the monitoring period, the total cholesterol concentration significantly dropped compared to the initial value. A significant improvement in intestinal peristalsis was observed, which was reflected in the fact that after four weeks, all patients established regular, daily bowel movements. Moreover, consumption of "Sneznik-1/79″ water eliminated the appearance of dysbiosis in 50% of patients. Additionally, the antioxidant capacity was improved by increasing the concentration of superoxide dismutase and reduced glutathione. The result of our study pointed out that the intake of "Sneznik-1/79″ water could be a promising adjuvant therapy for improving intestinal peristalsis as well as reducing the appearance of dysbiosis in T2DM patients.

Prevalence of intestinal parasites in dogs from public shelters in Serbia.

Data on endoparasitic infections in dogs from dog shelters in Southeastern Europe are limited; thus, this study aimed to add to the existing knowledge on this topic by reporting on the prevalence of intestinal parasites in dogs from public dog shelters in the Republic of Serbia. In 2017 and 2018, individual and pooled fecal samples, were collected from 1267 dogs from six shelters. All samples were qualitatively examined for parasites using flotation tests. Seven taxa of intestinal parasites were identified: Cystoisospora spp., ascarids: Toxocara canis and Toxascaris leonina, hookworms, Trichuris vulpis, taeniids and Dipylidium caninum. The overall prevalence of intestinal parasites was 58. 3 % (78. 1 % in young dogs and 53.1 % in adult dogs). The parasites detected in both young (<1 year old) and adult dogs (>1 year old) were Cystoisospora spp. (20 % and 4.9 %), T. canis (33.5 % and 14.7 %), T. leonina (7.7 % and 2.3 %), and hookworms (16.9 % and 15 %), respectively. However, T. vulpis (9.6 %), taeniids (1.3 %), and D. caninum (5.4 %) were detected only in adult dogs. In the Belgrade shelter, young dogs had a higher prevalence of endoparasitic infections (18.9 %, 49/260) than adult dogs (14.8 %, 149/1007). In the Subotica, Jagodina and Nis shelters, young dogs had significantly higher (p < 0.001 and p < 0.05, respectively) prevalence of endoparasitic infections (10 %, 12.3 % and 14.6 %) than adult dogs (5.3 %, 8 % and 7.2 %). These results will be useful for establishing health care programs in dog shelters and implementing effective strategies for the control of intestinal parasites.

The impact of low mineral content water on cardiac function in diabetic rats: focus on oxidative stress.

The aim of this study was to estimate the effects of natural low mineral water from the source "Sneznik-1/79" in Serbia on glycemia as well as heart function in rats with diabetes mellitus type 2 (T2DM), with the special emphasis on the role of the oxidative stress. Twenty Wistar albino rats (males, 4 weeks old at the beginning of the study, body weight 180 ± 20 g) were included in the study. Rats were divided randomly into 2 groups (10 animals per group): T2DM: rats with diabetes mellitus type 2 with free access to tap water; T2DM + SW: rats with diabetes mellitus type with free access to natural mineral water from "Sneznik-1/79". Glucose level, ex vivo cardiac function as well as systemic and cardiac redox state were assessed. At the end of the study protocol, glucose level was lower in diabetic rats who consumed mineral water. Moreover cardiac function wasn't affected by mineral water intake, however, significant antioxidant effects were observed. Our study suggests that 4-week consumption of low mineral water from the spring "Sneznik-1/79" has important role in regulation of glycemia and altering redox state in favor of elevated antioxidant capacity without affecting heart function. Based on our findings we may assume that low mineral water from the spring "Sneznik-1/79" has the potential to be used either as preventive strategy or as additional therapeutic strategy in management of T2DM.

The Impact of Structured Self-Monitoring of Blood Glucose Combined With Intensive Education on HbA1c Levels, Hospitalizations, and Quality-of-Life Parameters in Insulin-Treated Patients With Diabetes at Primary Care in Serbia: The Multicenter SPA-EDU Study.

BACKGROUND: We assessed the effect of structured self-monitoring of blood glucose (SMBG), in combination with intensive education, on metabolic control, SMBG frequency, hospitalizations, cardiovascular risk factors, and quality-of-life parameters in patients with insulin-treated diabetes in primary health care settings in Serbia. METHODS: This 6-month, observational, noninterventional study, followed 346 insulin-treated diabetes patients (type 1 diabetes [T1D], n = 57; type 2 diabetes [T2D], n = 289) from 28 primary care centers. Patients attended a 10-day course at the specialized educational center and were followed monthly by their primary care physicians. Patients used a simple paper tool to document 3-day, 7-point glucose profiles prior to each monthly clinic visit. Physicians reviewed the completed forms at each visit and used a standardized education program to provide remedial training. Changes in HbA1c levels, SMBG frequency, metabolic risk factors, and Diabetes Distress Scale (DDS) were assessed. RESULTS: Mean (± SD) HbA1c within the full cohort was significantly improved from baseline at 6 months (8.85 ± 1.17% vs 7.91 ± 1.24%, P < .01). Significant increases in average SMBG frequency per week were seen at 6 months versus baseline (14.6/week vs 4.3/week, P < .001). The mean (± SE) number of hospitalizations due to metabolic conditions was significantly lower during the 6-month study compared to the 6-month period prior to the study (0.14 ± 0.04 vs 0.59 ± 0.09). DDS scores decreased from 39.6 ± 13.9 to 33.9 ± 14.5, P < .01. CONCLUSION: The use of structured SMBG combined with intensive education was associated with clinically significant reductions in HbA1c, increased SMBG frequency, and improved quality of life.

Prevalence and risk factors for prolonged QT interval and QT dispersion in patients with type 2 diabetes.

AIMS: Prolonged QT interval is associated with cardiac arrhythmias and sudden death. The present study determined the prevalence of prolonged QT interval and QT dispersion and defined their clinical and metabolic predictors in patients with type 2 diabetes. METHODS: Cross-sectional study included 501 patients with type 2 diabetes. A standard 12-lead electrocardiogram was recorded. QT corrected for heart rate (QTc) >440 ms and QT dispersion (QTd) >80 ms were considered abnormally prolonged. QTc ≥ 500 ms was considered a high-risk QTc prolongation. Demographic, clinical and laboratory data were collected. Independent risk factors for prolonged QTc and QTd were assessed using logistic regression analysis. RESULTS: Prevalence of QTc > 440 ms and QTd > 80 ms were 44.1 and 3.6 %, respectively. Prevalence of high-risk QTc (≥500 ms) was 2 % only. Independent risk factors for QTc prolongation >440 ms were mean blood glucose (ß = 2.192, p < 0.001), treatment with sulphonylurea (ß = 5.198, p = 0.027), female gender (ß = 8.844, p < 0.001), and coronary heart disease (ß = 8.636, p = 0.001). Independent risk factors for QTc ≥ 500 ms were coronary heart disease (ß = 4.134, p < 0.001) and mean blood glucose level (ß = 1.735, p < 0.001). The independent risk factor for prolonged QTd was only coronary heart disease (ß = 5.354, p < 0.001). CONCLUSIONS: Although the prevalence of prolonged QTc > 440 ms is significant, the prevalence of high-risk QTc (≥500 ms) and QTd > 80 ms is very low in patients with type 2 diabetes. Hyperglycaemia and coronary heart disease are strong predictors of high-risk QTc.

The analysis of factors associated with improved glycemic control in patients with insulin-requiring type 2 diabetes mellitus after treatment.

AIM: To observe the effect of standardized ten-day diabetes prevention and control program on glycemic control, and to analyze factors contributing significantly to improvement of glycemic control after the program/intervention. METHODS: A cross-sectional nested case-control study on 91 adult patients with insulin-requiring type 2 diabetes mellitus who underwent a standardized ten-day diabetes program in the Specialized Hospital "Merkur" in Vrnjacka Banja, Serbia, from June the 1st to August 1st 2010 was performed. All necessary data were obtained from patients' medical files archived in this institution. Cases (n=32) and controls (n=32) were matched for age and sex. RESULTS: Diabetes program led to a significant decrease in mean daily blood glucose (p=0.039), achieved at the expense of the reduction of postprandial hyperglycemia (p=0.013). Male patients, patients with mean daily glycemia above the acceptable range before the intervention, and patients who were receiving combined therapy (insulin plus oral antidiabetics) before the intervention, were significantly more likely to achieve such positive outcome (ORadjusted = 344.48, 12.83, and 25.44 respectively, with 95%CIs that not included 1). CONCLUSION: Standardized ten-day diabetes educational and rehabilitation program in the Specialized Hospital "Merkur" could be efficient in improving glycemic control, especially for male patients whose glucoregulation was poor despite the combined therapy with insulin and oral antidiabetic agents. Further investigation on determinants of efficiency of this program are necessary to understand better how to facilitate and support improvements in diabetes control at the population level.