W pracy podjęto istotny temat bezpieczeństwa ruchu drogowego , w którym uczestniczą kierowcy chorzy na cukrzycę insulinozależną. Narażeni są oni na hipoglikemię, który to stan jest bardzo niebezpieczny, zarówno dla samego kierowcy, jak i innych uczestników ruchu drogowego. Wśród 120 kierowców-cukrzyków leczonych insuliną przeprowadzono ankietę ,na podstawie której badano ich wiedzę o zagrożeniach zdrowia w cukrzycy, reakcjach na objawy hipoglikemii, wyposażeniu ratunkowym w samochodzie. Wiedzę o cukrzycy oceniano w skali punktowej (1-3 punkty). Wyniki badań wykazały, że wszyscy respondenci znali teoretycznie objawy hipoglikemii (100%). Do epizodów niedocukrzenia w czasie kierowania pojazdem doszło u 30% osób. Prawidłowo reagowało na te objawy ponad 88% kierowców. 10% badanej grupy miało ze sobą w samochodzie odpowiedni zestaw diagnostyczno-ratunkowy. Badania wykazały, że nie wszyscy cukrzycy podróżują samochodem w sposób bezpieczny dla siebie i innych uczestników ruchu drogowego. Należy więcej uwagi poświęcić temu problemowi w czasie wizyt lekarskich.
EN
In the paper very important subject of the road traffic safety was analysed - the insulin-dependent diabetic drivers. They are in the group being run to risk of danger hypoglycemia. This complication of diabetes is danger not only for the ill driver, but also for another people in the traffic road. 120 diabetic-drivers were examined by questionnaire. The questions concerned of state emergency of the health in diabetes, reactions on hypoglycemic symptoms, life-saving equipment in the car. The knowledge about diabetes was also tested, using 1-3 points scale of answers. The results of examinations showed, that all drivers knew symptoms of hypoglycemia (100%). About the own episodes of low level of glucose wrote 30% respondents. More of them (88%) had correct reactions on the danger symptoms of this state. Only 10 % diabetic-drivers had a diagnostic-saving equipment in the car. The examinations showed, that not everything diabetic-drivers travel in safety way for themselves and another participants of the road traffic. Much more attention must be dedicated by doctors to this problems during medical visits.
Metformin is an orally administered drug that lowers blood glucose and improves insulin sensitivity in patients with non insulin-dependent diabetes. Although the antihyperglycemic effect of metformin has been extensively studied, its cellular mechanism(s) of action (including the effect on enterocyte) remains to be defined. This study was designed to examine the effect of metformin on glucose transporters in enterocyte. Na+-dependent glucose transporter-1 (SGLT-1) activity was followed as glucose-induced short-circuit current (Isc) in Ussing chambers. The effect of metformin (10 µmol/L, 3 min) on transmural glucose transport was studied in isolated rat jejunal loops. Its impact on abundance of transporters SGLT-1 and GLUT2 in jejunal brush border membranes (BBM) and its effect on the phosphorylation of AMP-activated protein kinase (AMPK) 2 subunit was studied by western blot. Acute effect of metformin was also measured in vivo by oral glucose tolerance test (OGTT). Metformin markedly inhibited glucose-induced Isc (~77%) after mucosal addition. In addition, metformin reduced the glucose-induced abundance of SGLT-1 in BBM and increased those of GLUT2, concomitantly increasing the phosphorylation of intracellular AMPK2. This effect of metformin was also observed using non-metabolizable sugar 3-O-methyl glucose. Transmural glucose transport measured in vitro was increased by 22% under metformin. Finally, oral metformin markedly increased glucose tolerance in OGTT. In conclusion, metformin slightly increases intestinal glucose absorption by inducing a re-distribution of glucose transporters in BBM through AMPK control in enterocyte. In addition to its action to other splanchnic tissues, this could constitute a peripheral signal contributing to the beneficial effect of metformin on glucose tolerance.
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