Serum Levels of Incretin Hormones - GLP-1 and GIP in Patients with Type 1 Diabetes Mellitus.

BACKGROUND: The glucagon-like peptide-1 (GLP-1) and the glucose- dependent Insulinotropic peptide (GIP) are natural incretin hormones, which are secreted respectively by the L- and K-cells of the intestinal mucosa in response to the physiological gastrointestinal glucose absorption. In patients with type 2 diabetes mellitus, the incretin effect is reduced, whereas the results in type 1 diabetes mellitus (T1DM) are heterogeneous, in some patients normal incretin response is observed. AIM: Comparative analysis of the basal serum levels of the incretin hormones GLP-1 and GIP in patients with type 1 DM and in individuals without carbohydrate disorders. MATERIALS AND METHODS: The study included 27 patients with diagnosed T1DM and a control group of 39 individuals without carbohydrate disorders. All participants in the study were subjected to the following clinical measurements and laboratory tests - height, weight, bioimpedance analysis of body composition, fasting blood sugar (BS 0'), postprandial blood sugar (PPBS), glycated haemoglobin (HbA1c) in T1DM patients, total cholesterol (TC), HDL cholesterol (HDL chol), triglycerides (TG), transaminase (AST and ALT), basal serum levels of GLP-1 and GIP. RESULTS: The serum levels of GIP in the patients with type T1DM were significantly higher, compared to the individuals without carbohydrate disorders (P<0.05), while there was no statistically significant difference in the GLP-1 levels. CONCLUSION: The significantly higher GIP levels and the similar GLP-1 levels in our patients with type 1 DM, compared to the individuals without carbohydrate disorders, support the hypothesis of intact incretin effect in this type of diabetes mellitus Key Words: Glucagon-like peptide-1, Glucose-dependent insulinotropic peptide, Type 1 diabetes mellitus.

Chronic Treatment with Opiate Agonists in Bulgaria - Assessing the Quality of Life Using SF 36 v. 2.

INTRODUCTION: Drug addictions to psychoactive substances are disorders with a complex bio-psycho-social genesis, which are characterized with chronic relapses. Substance addiction causes multifactorial damage to the normal functioning of individuals and requires a multicenter approach for the treatment process. AIM: The aim of the study was to assess the quality of life of patients undergoing chronic treatment with the opiate agonist methadone using a standardized questionnaire method in Bulgarian. MATERIAL AND METHODS: The study included patients aged 18 to 40 years undergoing chronic treatment with methadone for at least six months. The study included 100 subjects. Seventy-six patients were from 5 clinical programs in Bulgaria; twenty- four clinically healthy age-matched subjects with no history of drug abuse, psychiatric and somatic diseases were the control group. RESULTS: We found significant differences between patients and controls in all components of the survey (P<0.05). The patients had lower scores than the control group in the SF-36 in terms of all eight components and both the physical and mental component summaries of the SF-36-survey. Patients compared between the groups by dose, duration of treatment with methadone and period of heroin abuse before initiating treatment did not show significant differences. There were no significant differences between patients with and without hepatitis C virus. CONCLUSIONS: Opiate addiction is a state associated with poor quality of life. The duration of treatment, the methadone dose, period of heroin abuse before initiating treatment and illness of hepatitis C virus does not correlate with lower results.