Summary The diabetes is а chronic non-infectious disease that touches people from the birth to the old age. Children and young people mostly suffer from diabetes type 1. Тhe morbidity in this disease is increasing not only in Lithuania but also in the whole world. In 1980, 30 million people in the world suffered from the diabetes, while in 2000 there were already 100 million such people. As the number of children suffering from the diabetes is increasing, it is very important to understand what influence to their psycho-social development is caused bу this disease, how the relationship between the child and his or her family changes, and how the relationship between the diabetics, their family and the environment develops. When а child falls ill with the diabetes, the family faces many questions, and the life splits into two parts: before the disease and after its diagnosing. А child who suffers from diabetes of type 1 has to make insulin injections during аll his or her life, to check the quantity of glucose in the blood, to observe nutrition recommendations. The family whose child falls ill with an incurable disease experiences the process of loss. The duration of its stages and its succession depends of the psychosocial state of the family. The treatment of children's diabetes is also complicated due to psychological peculiarities of the age of children. Children of different ages can perform different tasks and to undertake different duties. Eventually, а child will bе... [to full text]

Šio darbo tikslas buvo ištirti VšĮ Šiaulių apskrities ligoninės Akušerijos – Ginekologijos klinikos nėščių moterų GD diagnostinius rodiklius; surinkti duomenis apie jų rizikos veiksnius ir atlikti analizę. Uždaviniai: 1) ištirti gliukozės koncentraciją kraujo serume nėštumo pradžioje, atlikti GTM 24 – 28 nėštumo savaitę; 2) po gimdymo pakartotinai atlikti GTM galutinei diagnozei patvirtinti; 3) surinkti duomenis apie nėščiųjų GD rizikos veiksnius ir juos įvertinti; 4) ištirti naujagimių gliukozės koncentraciją kapiliariniame kraujyje; 5) surinkti duomenis apie naujagimių komplikacijas ir juos įvertinti. Tiriamos nėščiosios suskirstytos į 3 grupes: rizikos, GD ir kontrolinę. Darbe daugiausia dėmesio skirta diagnostiniams rodikliams ir rizikos veiksnių analizei. Gliukozės koncentracija serume ir kraujyje yra nustatoma gliukozės analizatoriumi EBIO compact fermentiniu būdu. Buvo nustatytas gliukozės koncentracija kiekvienai moteriai nėštumo pradžioje, o rizikos ir GD grupių moterims dar atliktas ir GTM 24 – 28 nėštumo savaitę. Paskyrus gydytojui – neontologui naujagimiams buvo atlikti gliukozės koncentracijos kapiliariniame kraujyje tyrimai. Po gimdymo, kurios atvyko į laboratoriją, buvo atliktas pakartotinas GTM dėl galutinės diagnozės. Gliukozurija šlapime nustatoma juosteliniu (automatiniu) būdu, pagal principą: mėginys → juostelė, padengta specialiais reagentais → sureaguoja → spalvos pokyčiai. Aparato veikimo principas yra refleksinis fotometrinis. Šlapimo... [toliau žr. visą tekstą] / The aim of this work was to investigate pregnant women‘s gestational diabetes mellitus (GDM) diagnostic indicators in Siauliai county hospital Obstetrics - Gynecology clinic; to collect the data about their risk factors and do the analysis. The tasks: 1) to investigate the concentration of glucose in blood serum in the beginning of pregnancy, to do oral glucose tolerance test (OGTT) the 24th -28th week of pregnancy; 2) to repeat OGTT after childbirth to confirm the final diagnosis; 3) to collect the data about pregnant women‘s GDM diagnostic indicators and evaluate them; 4) to investigate the concentration of glucose in capillary blood of a newborn; 5) to collect the data about the complications of newborns and evaluate them. The collected data was grouped into 3 groups: risk, GDM and control. In the work the biggest attention was given to diagnostic indicators and the analysis of risk factors. The concentration of glucose in serum and blood is identified by analyzer EBIO compactin enzyme way. The concentration of glucose was identified for every woman in the beginning of pregnancy and for women in risk and GDM groups was done OGTT the 24th -28th week of pregnancy. By a doctor neonatologist’s prescription the analysis of the concentration of glucose in capillary blood of a newborn was done. For women, who came to the laboratory after childbirth was repeated OGTT for the final diagnosis. Glucosuria in urine is identified in an automatic way, according to the principle: sample... [to full text]

Darbo tikslas – ištirti ir įvertinti sergančiųjų II tipo cukriniu diabetu gliukozės koncentraciją kapiliariniame ir veniniame kraujyje, kai kuriuos kraujo biocheminius rodiklius, kūno masės indeksą, išanalizuoti cukrinio diabeto rizikos veiksnius bei jų tarpusavio sąveiką. Tyrimo medžiaga ir metodai. Buvo ištirti 31 pacientai, sergantys II tipo CD, besigydantys Viešojoje Įstaigoje Aukštadvario Pirminiame Sveikatos Priežiūros Centre. Sergančių II tipo cukriniu diabetu gliukozės koncentracijos, glikozilinto hemoglobino (HbA1c) tyrimai atlikti biocheminiais analizatoriais, įvertintos kūno masės indekso reikšmės. Rezultatai. Įvertinę sergančiųjų II tipo CD gliukozės koncentracijų kapiliariniame ir veniniame kraujyje vidurkių reikšmes, statistikai reikšmingo skirtumo nenustatėme: kraujo plazmoje vidurkis – 8,70 mmol/l, kapiliariniame kraujyje – 8,90 mmol/l. Kapiliariniame kraujyje gliukozės koncentracija buvo šiek tiek didesnė. Vidutinė bendro cholesterolio koncentracija buvo nežymiai didesnė nei norma (rekomenduojama reikšmė < 5,2 mmol/l). MTL cholesterolio koncentracijos vidurkis neviršijo rekomenduojamos normos (rekomenduojama reikšmė < 3,4 mmol/l).Tiriamiesiems nustatyta nedidelė aterosklerozės rizika. DTL cholesterolio koncentracija buvo didesnė nei rekomenduojama norma (rekomenduojama reikšmė vyrams – &#8805; 1,03 mmol/l, moterims – &#8805; 1,29 mmol/l). Pusei tirtų vyrų ir 40 % moterų nustatėme padidėjusią aterosklerozės riziką. Triacilglicerolių koncentracija buvo nedaug... [toliau žr. visą tekstą] / Aim of the study: to measure venous and capillary blood glucose concentrations, certain biochemical markers and body mass index in patients with type 2 diabetes mellitus, to analyse risk factors for diabetes and their interaction. Materials and methods: We investigated 31 patients with type 2 diabetes, who attend Aukstadvaris Primary Health Care centre. Concentration of blood glucose and glycolysated haemoglobin (HbA1c) values were determined using biochemical analysers, and body mass index was calculated. Results: There was no statistically significant difference in the mean venous and capillary blood glucose concentration. The mean value was 8.7 mmol/l in the venous plasma and 8.9 mmol/l in the capillary blood. Glucose concentration was slightly higher in the capillary blood. The mean concentration of total cholesterol was slightly higher than normal (recommended value – less than 5.2 mmol/l). Concentration of the LDL cholesterol did not exceed the recommended value of less than 3.4 mmol/l. The patients investigated were determined to be at low risk for developing atherosclerosis. Concentration of HDL cholesterol was higher than recommended (normal value for men &#8805; 1.03 mmol/l, for women – &#8805; 1.29 mmol/l). Half of investigated men and 40 % of investigated women were deemed to have an increased risk of atherosclerosis. The concentration of blood triglycerides was only slightly higher than recommended normal value (recommended value – less than 1.7 mmol/l). 32 % of... [to full text]

Aim of the study. To assess the organization possibilities and evaluate the quality of diabetes education in outpatient clinic. Methods. The anonymous questionnaire survey was performed among adult diabetic patients in Kaunas Dainava outpatient clinic in october-December, 2005. 500 questionnaire were given to the patients, the responce rate was 354 patients (70.8 %). The data was analysed by application of statistical package SPSS 12.0 for Windows. The associations between the variables were measured using the Chi-squared (χ²) test. Results. The positive evaluation of diabetes education in Kaunas Dainava outpatient clinic was given by 73.7 % of patients. 98.3 % believed that diabetes education is necessary. 77.9 % knew about diabetes, 80.8 % - were aware of fasting glycaemia criteria, 95.3 % - glycaemia in untreated patients. 82.2 % understood the importance of diet and it‘s ingredients (90.6 %). Less than a half (40.4 %) were aware of glycated hemoglobin and importance of postprandial glycaemia. Only 33.2 % of those taught in „Diabetes school“ had adequate diabetes control. The target glycated hemoglobin was reached in 42.1 % of thosewho attended the inpatient „Diabetes school“ and only in 22.5 % of those who didn‘t. Diabetes complications have been diagnosed in 43.7 % of those whose glycated hemoglobin ≤ 7 % and in 76.2 % of those whose glycated hemoglobin > 7 %. Conclusions. Diabetes education in Kaunas Dainava outpatient clinic is not sistematic organized, the time of... [to full text]

Darbo tikslas. Įvertinti mitybos įtaką cukrinio diabeto kontrolei. Uždaviniai: 1. Įvertinti 1 ir 2 tipo cukriniu diabetu sergančiųjų, besigydančių KMUK endokrinologijos klinikoje, žinias apie mitybą sergant cukriniu diabetu. 2. Įvertinti respondentų mitybos kontrolę, remiantis faktoriais: kūno masės indeksu, glikemija ir hipoglikemija. 3. Nustatyti cukriniu diabetu sergančiųjų mitybos savikontrolės laikymąsi. Tyrimo metodika. Duomenys buvo surinkti anketinės apklausos būdu ištyrus 133 KMUK Endokrinologijos klinikoje dėl cukrinio diabeto besigydančius asmenis. Tyrimo duomenys buvo analizuojami statistiškai, naudojant SPSS 13 (Statistical Package for the Social Sciences) bei Microsoft Excel 2003 programas. Rezultatai. Bloga diabeto kontrolė skatina lėtinių diabeto komplikacijų, kurios mažina ligonių darbingumą, blogina gyvenimo kokybę bei mažina gyvenimo trukmę, atsiradimą ir progresavimą. Todėl sergantieji cukriniu diabetu yra didžiulė našta šalies sveikatos apsaugai. Nemaži ir šių ligonių mokymo bei gydymo kaštai. Dar daugiau papildomų lėšų reikia atsiradusioms komplikacijoms gydyti. Atliktame tyrime buvo siekta parodyti, kad cukrinio diabeto eigai didžiausią įtaką turi pats pacientas, jo pastangos kontroliuoti savo ligą. Vyriausybės, gydytojų, diabetologų pastangos gerinti žmonių gerbūvį nėra pakankamai veiksmingos, kol patys žmonės neturi atsakomybės už savo sveikatą. Atliktame tyrime buvo apklausti 133 KMUK Endokrinologijos klinikoje dėl cukrinio diabeto besigydantys... [toliau žr. visą tekstą] / The aim of the study: To evaluate influence of nutrition for the control of diabetes mellitus Objectives: 1. To evaluate patients with type 1 and type 2 diabetes mellitus, from KMUK clinic of endocrinology, knowledge about diabetes related nutrition. 2. To evaluate respondents nutritional control fallowing BMI, glycemia and hypoglycemia. 3. To evaluate patients nutritional self-control. Methods. Data was collected by performing an anonymous survey. Sample size – 133 patients with diabetes mellitus from KMUK clinics of endocrinology. Statistical data analysis was performed using SPSS 13.0 (Statistical Package for the Social Sciences) and Microsoft Excel 2003. Results. Insufficient control of diabetes promotes complications in this disease, which reduces patients’ efficiency, quality of life and patients life years. For this reason, patients with diabetes mellitus are a high burden for countries health care system. High costs are also for patients’ education and treatment. Even more financial resources are required in treatment of complications. The main idea of this research was to show that in treatment of diabetes mellitus, patient by him-self is a very important part for successful treatment and in controlling his disease. Nobody, even government, physicians or diabetologists can not guarantee the success in treatment, until the patient by-himself takes the responsibility for his health. The sample size of this study was 133 diabetic patients from KMUK clinics of... [to full text]

SANTRAUKA Vilniaus universiteto Medicinos fakultetas Reabilitacijos, sporto medicinos ir slaugos institutas Slaugos magistrantūros programa SERGANČIŲJŲ 2 TIPO CUKRINIU DIABETU GYVENIMO KOKYBĖS ĮVERTINIMAS Slaugos magistro baigiamasis darbas Darbo autorė: Aliona Zaborovskytė Darbo vadovė: prof. habil..dr. Danutė Kalibatienė Vilnius, 2008 m. Pagrindinės sąvokos: 2 tipo cukrinis diabetas, gyvenimo kokybė, SF-36 klausimynas. Tyrimo tikslas. Įvertinti 2 tipo sergančiųjų cukriniu diabetu gyvenimo kokybę. Tyrimo uždaviniai. Ištirti ir palyginti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybės skirtumus, atsižvelgiant į tiriamųjų lytį, amžių ir kūno masės indeksą. Įvertinti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybę, atsižvelgiant į socialinius veiksnius. Įvertinti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybę, atsižvelgiant į cukrinio diabeto komplikacijas. Tyrimo populiacija. Tyrime dalyvavo 196 asmenys, sergantys 2 tipo cukriniu diabetu. 67 vyrai (34,2 proc.) ir 129 moterys (65,8 proc.), kurių amžius buvo nuo 41 iki 77 metų (vidurkis – 60,5 ± 8,1 m.). Pacientai gydėsi Vilniaus miesto ligoninėse ir poliklinikose. Tyrimo metodai. Atliktas epidemiologinis tyrimas pritaikant anoniminės apklausos metodą. Analizuoti sergančiųjų 2 tipo cukriniu diabetu pacientų gyvenimo kokybės skirtumai, atsižvelgiant į tokius veiksnius, kaip lytis, amžius, KMI, socialinius veiksnius, diabeto trukmę, ligos kontrolę, diabeto gydymą, šeimos sergamumą cukriniu... [toliau žr. visą tekstą] / SUMMARY Vilnius University Faculty of Medicine Institute of Rehabilitation, Sport Medicine and Nursing Master’s degree Nursing Programme EVALUATION OF LIFE QUALITY OF PATIENS WITH TYPE 2 DIABETES Master’s degree final scientific research work Author of the master’s degree scientific research work: Aliona Zaborovskytė Head of the master’s degree scientific research work: prof. Danutė Kalibatienė Vilnius, 2008 Keywords: type 2 diabetes, quality of life, SF-36 questionnaire. The aim of research was to evaluate quality of life patients who has type 2 diabetes. The main tasks were to analyse and compare differences of quality of life patients with type 2 diabetes, considering their gender, age and the body mass index. To evaluate quality of life patients with type 2 diabetes considering social factors. To evaluate quality of life of patients with type 2 diabetes considering complications of diabetes. Population of research. This study focused on 196 subjects with Type 2 Diabetes between the age of 41 and 77 years-old (average 60,5 ± 8,1 year). They were recruited from Vilniaus hospitals and an Out patient Clinic. The distribution consisted of 67 males and 129 females. Methods. There was used epidemiologic research of prevalence method. A questionnaire was administered to determine and access specific demographic characteristics including the type and duration of onset of diabetes, prescribed treatments, complications, social factors and other relevant data. Short-Form Health... [to full text]

SANTRAUKA I IR II TIPO CUKRINIO DIABETO LABORATORINIŲ RODIKLIŲ ANALIZĖ KLAIPĖDOS UNIVERSITETINĖJE LIGONINĖJE Epidemiologiniai tyrimai rodo, kad sergančiųjų cukriniu diabetu (CD) daugėja. Todėl ypatingas dėmesys skiriamas tyrimams, skirtiems tobulinti CD diagnozavimą ir veiksmingą ligos kontrolę. Darbo tikslas: išanalizuoti I ir II tipo CD sergančių asmenų laboratorinių rodiklių ypatumus. Tikslui pasiekti buvo išsikelti tokie uždaviniai: nustatyti ir įvertinti I ir II tipo CD priklausomybę nuo paciento amžiaus ir lyties, įvertinti gliukozės, glikozilinto hemoglobino, kreatinino, C-peptido koncentracijas sergančiųjų I ir II tipo CD tiriamųjų grupėse bei laboratorinių rodiklių reikšmę diagnozuojant I ir II tipo CD. Tyrimo medžiaga ir metodai: buvo ištirti 452 pacientai, sergantys I ir II tipo CD, hospitalizuoti Klaipėdos universitetinėje ligoninėje. Gliukozės koncentracija nustatyta fermentiniu amperometriniu metodu, glikozilinto hemoglobino (HBA1c) tyrimas atliktas chromatografijos metodu, C-peptido tyrimas imunometriniu chemiliuminescencijos metodu, kreatinino tyrimas imunofermentiniu metodu. Rezultatai: I tipo CD sergančių pacientų buvo 22,8 proc., o sergančių II tipo CD — 77,2 proc. Statistiškai reikšmingi teigiami ryšiai tarp cukrinio diabeto ir sergančiųjų amžiaus parodė, kad I tipo CD dažniau serga jaunesni, o II tipo CD — vyresni asmenys. Nustatėme statistiškai reikšmingą ryšį tarp CD ir pacientų lyties: I tipo CD statistiškai reikšmingai dažnesnis vyrams, o II tipo CD —... [toliau žr. visą tekstą] / SUMMARY THE ANALYSIS OF LABORATORY INDICES OF TYPE I AND TYPE II DIABETES MELLITUS AT KLAIPEDA UNIVERSITY HOSPITAL Epidemiological studies suggest that number of patients with diabetes mellitus (DM) is increasing. Therefore, special attention is given to studies necessary to improve the diagnosis of DM and effective control of the disease. The aim: to analyse the peculiarities of laboratory indices of patients with type 1 and 2 DM. In order to reach this, the following goals were presented: to determine and evaluate type 1 and 2 DM’s dependency on patient’s age and sex; to assess the concentrations of glucose, glycosylated heamoglobin, creatinine, C-peptide in patient groups with type 1 and 2 DM and importance of laboratory indices for diagnosis of type 1 and 2 DM. Material and methods: 452 patients with I and II type MD were examined and hospitalized at Klaipeda University Hospital. Glucose concentration was determined by amperometric method, glycosylated heamoglobin (HbA1c) test was conducted by chromatographic method, C-peptide test was conducted by chemiluminescent immunometric method, creatinine test was conducted by immunoassay method. The results: 22.8 % of patients have type 1 DM, and 77.2 % - type 2. According to the statistically significant positive relationship, type 1 is more common among younger, and type 2 DM is more common among older patients. The statistically significant positive relationship between DM and the patient’s sex was determined: statistically... [to full text]

Aim of the study. To estimate timeliness of diagnosis of 2-type diabetes and causes of complications in Prienai district. Methods. In January – December 2005, questionnaire survey of the residents of Prienai district, to whom 2-type diabetes (n=76) was diagnosed for the first time and patients suffering of 2-type diabetes (n=219), was conducted. Statistical analysis package SPSS (9.0) was used to analyse the data. Dependence of two symptoms was researched by the use of Chi-Square test (χ²). Zero hypothesis was rejected, when p<0,05. Results. Diabetes was untimely diagnosed for 62,7 % patients, because at the moment of diagnosis they already had chronic complications, and 37.3% patients had their illness diagnosed in time. In cases when patients visited a health care institution for preventive reasons, diabetes was diagnosed more frequently and in a lighter stage than in the cases when patients addressed health care institutions due to complaints. If a family doctor suspected diabetes, diagnosis was timely diagnosed more frequently than if suspected by any other specialist. According to statistics, complications were caused by duration of illness, insufficient use of self-control means. Timeliness of diagnosis and rise of complications of diabetes did not depend on the age, sex, place of residence, marital status, education or occupation of the respondents. Conclusions. Timeliness of diagnosis of diabetes was determined by timeliness of glycaemia test, reason of a visit... [to full text]

Diabetinė neuropatija yra viena dažniausių cukrinio diabeto komplikacijų. Ši komplikacija išsivysto po 5-20 metų cukrinio diabeto ligos trukmės. Tačiau yra žinoma, kad 2 tipo cukrinio diabeto diagnozavimo data dažniausiai nesutampa su ligos pradžia. 2 tipo cukrinis diabetas pasireiškia palaipsniui, be ryškių simptomų, todėl diagnozė nustatoma pavėluotai, praėjus vidutiniškai 6-9 metams nuo ligos pradžios. Jutimų praradimas, pėdų opos, galūnių amputacijos didina mirtingumą nuo šios ligos. Mirtingumą taip pat įtakoja ir kardiovaskulinė autonominė neuropatija, padidėja mirčių rizika dėl širdies kraujagyslių ligų. Uždaviniai: 1. Nustatyti lėtinės sensomotorinės diabetinės neuropatijos dažnį sergantiesiems 2 tipo cukriniu diabetu. 2. Nustatyti autonominės neuropatijos dažnį ir ypatumus sergantiesiems 2 tipo cukriniu diabetu. 3. Įvertinti Mičigano klausimyno informatyvumą diabetinės neuropatijos diagnostikoje. 4. Įvertinti kiekybinių tyrimų informatyvumą diabetinės neuropatijos diagnostikoje. 5. Įvertinti sergančiųjų 2 tipo cukriniu diabetu, kuriems diagnozuota diabetinė neuropatija, gyvenimo kokybę. Atliktas darbas paskatins sudaryti diabetinės neuropatijos ištyrimo algoritmą, kad ir šeimos gydytojas, ir specialistas, kuo anksčiau nustatytų šią klastingą komplikaciją. / Diabetic neuropathy is one of the most prevalent complications of diabetes mellitus. It usually develops over 10 - 20 years of disease. However, it is known that the timing of disease diagnosis and the actual disease onset often differs. Since type 2 diabetes mellitus manifests gradually without obvious symptoms, the diagnosis is usually clarified only 6 - 9 years after the actual onset. Numbness, foot ulcers and amputation of the extremities increase this disease related mortality. Mortality is also affected by autonomic cardiovascular neuropathy and other cardiovascular diseases. The goals of the study: 1. Estimate a frequency of chronic sensory diabetic neuropathy in type 2 diabetes patients. 2. Estimate a frequency and characteristics of autonomic neuropathy in type 2 diabetes patients. 3. Evaluate a value of Michigan questionnaire in diagnostic of diabetic neuropathy. 4. Evaluate a value of quantitative methods in diagnostic of diabetic neuropathy. 5. Assess a life quality of patients with diabetic neuropathy. The study results stimulate to draft the recommendations and methods for the evaluation of diabetic neuropathy enabling family physicians and specialists to diagnose this complication early.

Aging lens undergoes the changes in the amount of water soluble lens proteins and their redistribution from low molecular weight to high. This results in the development of high molecular weight aggregates, which change the lens transparency, increase light scattering and contribute to the hardening of the lens. All these disturbances cause changes in ultrasound attenuation. Hardness of the cataractous lens is one of the major factors influencing the suitability of a patient for fhacoemulsification. Age and nuclear color have been shown to be good clinical markers of lens hardness, but there is a need of more quantitative and objective examination method. In this work a new methodics of assessement of eye lens hardness in vitro was developed, the hardness of dogs and human eye lenses was assessed experimentally, the investigation of ultrasound attenuation coefficient, the amount of water soluble lens proteins and their distribution to the fractions of different molecular weight was performed. A strong correlation between lens hardness and ultrasound attenuation was investigated. The results enable to evaluate lens hardness pre-operatively and non invasively and help surgeons when choosing patients to the phacoemulsification method of cataract extraction. The performed investigation confirmed that the opacification of the lens is due to the changes in the amount of water soluble lens proteins and the presence of high molecular weight compounds, which disturb the light... [to full text]