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Authors: Andrea Molnár, Ágnes Anna Csontos, Sarolta Dakó, Rita Hencz, Dániel Áron Anton, Erzsébet Pálfi and Pál Miheller

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Bevezetés: A gyulladásos bélbetegségben szenvedő betegeknél kóros tápláltsági állapot alakulhat ki (gyulladásos citokinek termelődése, műtétek utáni katabolizmus, beszűkült étrend miatt), amit táplálásterápia elrendelése mellett is nehéz hatékonyan kezelni. Célkitűzés: A táplálásterápia hatékonyságának vizsgálata. Módszer: Kombinált tápláltsági állapot rizikószűrése (kérdőíves felméréssel és bioimpedanciás testösszetétel-analízissel) a vizsgálat elején és az egyéves vizsgálati periódus végén. Eredmények: A 205 betegből 82 bizonyult veszélyeztetettnek. Összesen 44-en részesültek hosszú távú táplálásterápiában, 45%-uknak elegendő volt a diétamódosítás, 50% orális és 5% parenteralis táplálást is igényelt. A mindkét mérési eljárás alapján magas rizikójúnak minősülők száma a beavatkozásokkal 31-ről 21 főre csökkent, a teljes és a zsírmentes testtömeg nyolc, illetve kilenc esetben 10%-ot meghaladóan növekedett, a tömegindexek (∆BMI: +1,3 kg/m2, p = 0,035, s.; ∆FFMI: +0,5 kg/m2, p = 0,296, n. s.) szintén növekedtek. A kutatás korlátai az alacsony esetszám és a monocentrumos bevonás. Következtetések: Kóros tápláltsági állapot kialakulásának magas kockázata miatt javasoljuk a kombinált rizikószűrést és a táplálásterápia hatékonyságának vizsgálatára a bioimpedanciás testösszetétel-analízist. Orv Hetil. 2017; 158(19): 731–739.

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Do our elderly diabetic patients keep the diet?

Primary care evaluation from Hungary

Author: I. Rurik

The medical nutritional therapy has high importance in the management of diabetes mellitus. The aim of this study was to collect information on how the diabetic elderly follow medical advices regarding nutrition. A population of 291 persons were selected consecutively from primary care patients in Hungary. Ninety-five type 2 diabetes patients were compared to 196 non-diabetics, focusing on nutritional habits, life style elements and anthropological parameters.  The diabetics were mainly overweight or obese and educated at lower levels. People with higher BMI (Body Mass Index) have eaten less frequently than people in the normal BMI range. The daily food frequency of diabetics was higher only on weekends and holidays. There were only minimal differences concerning food choices as well. The differences in the diet proved smaller than expected and recommended. The time spent with physical activity was low in general, especially among diabetics. The self-judgement showed that only 49% of diabetics kept their eating habit as healthy, vs. 63% of non-diabetics. The food choices were also modified by the economic situations of patients. It was observed that the majority of elderly diabetics did not pay enough attention to correct diabetic diet, therefore, they should be controlled more effectively by primary care staff.

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Authors: F. Salman, G. Erten, M. Unal, B. Kiran, S. Salman, G. Deniz, M. Yilmaz, A. Kayserilioglu and N. Dinccag

The essential therapy of diabetes mellitus includes medical nutrition therapy (MNT), exercise and medical therapy. Exercise, besides its metabolic effects, has positive influence on the immune system, but some forms of exercise may cause trauma for muscle and skeletal systems, they may also support negative effects on the immune system. Nineteen type 1 diabetic patients (mean age 22.1±2.8 yrs), followed by Diabetes Outpatient Clinic and twenty age matched male control subjects were included into the study, to demonstrate the effects of maximal, acute exercise on the immune system. The exercise test was performed according to Bruce protocol on treadmill. In diabetic subjects, increased CD19 and CD23 expressions were observed before exercise. In both groups (diabetic/control) CD3, CD4 expressions and CD4/CD8 ratio were decreased following the exercise, however expression of natural killer (NK) cells increased. Compared to type 1 diabetic patients healthy subjects had longer acute exercise that caused the increased level of CD8 expression, however type 1 diabetic patients did not show any difference. These results indicate that submaximal aerobic exercise might be recommended for type 1 diabetics without any complications because of its positive reflection on metabolic control and no negative effects on the immune system.

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. L. (2004): Medical nutrition therapy for upper gastrointestinal tract disorders. In Mahan, K.L., Escott-Stump, S. (eds): Krause’s Food, Nutrition, and Diet Therapy. Saunders, Philadelphia. Cheng, Y., Macera, C. A., Davis, D

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