Obtaining Wisent early blastocyst in vitro is a basic for protection and creation of biodiversity for this threatened species

Wisent, or European bison (Bison bonasus), is listed as "vulnerable" on the IUCN Red List of Threatened Species and is therefore protected by international law. For the first time, a Wisent embryo has been obtained in vitro. This procedure creates a new opportunity to protect and increase Wisent reproductive potential and thereby opens new possibilities for the establishment of a controlled and broad reserve of the gene pool.

Initiation and gradual intensification of premixed insulin lispro therapy versus Basal {+/-} mealtime insulin in patients with type 2 diabetes eating light breakfasts

OBJECTIVE

We compared two strategies initiating and intensifying insulin treatment and tested for noninferiority of premixed insulin to basal ± mealtime insulin analog in patients eating light breakfasts.

RESEARCH DESIGN AND METHODS

This randomized, open-label, 48-week study compared two algorithms. Up to three injections of insulin lispro mix 25 and/or insulin lispro mix 50 (premix; premixed insulin lispro) or basal insulin glargine plus up to three injections of insulin lispro (basal+; glargine + insulin lispro) were used in type 2 diabetic patients uncontrolled with oral antihyperglycemic medication and consuming <15% daily calories at breakfast. The hypothesis was to test noninferiority of premix to basal+ for glycemic control measured by HbA1c after 48 weeks, assessed using ANCOVA with a 0.4% margin.

RESULTS

Patients (n = 344; 176 [51%] females; mean [SD] age 54.3 [8.8] years; BMI 29.4 [4.6] kg/m(2); baseline HbA1c 9.02 [0.97]%) were randomized to premix (n = 171) or basal+ (n = 173). In the per-protocol analysis (n = 230), least squares means (95% CI) end point HbA1c were 7.40% (7.15-7.65) and 7.55% (7.27-7.82) in respective arms. Between-treatment difference was -0.14% (-0.42 to 0.13), with noninferiority met. Significantly more patients in premix achieved HbA1c targets of <7.0% compared with basal+ (48.2 vs. 36.2%; P = 0.024). Self-monitored blood glucose profiles, body weight changes, total insulin doses, and overall hypoglycemia (65 vs. 60%) were similar in premix and basal+ (P = 0.494), except nocturnal episodes (34.3 vs. 23.7%; P = 0.018) were more common in premix.

CONCLUSIONS

Both intensive insulin strategies improved glycemic control; however, final HbA1c levels were seen above those achieved in previous treat-to-target trials, likely due to the inadequate insulin titrations and probably due to the complexity of tested insulin regimens. A higher percentage of patients achieved target HbA1c <7% with multiple premixed insulins, but this treatment resulted in more nocturnal hypoglycemia than a basal-bolus regimen.

Mobile telecare system for intensive insulin treatment and patient education. First applications for newly diagnosed type 1 diabetic patients

The aim of the work was to develop and to evaluate the clinical efficiency of a mobile telecare system implementing teleconsultations based on the continuous transmission of patient-collected data directly to the physician and to the clinic. The developed TeleMed system consists of the patients' and the diabetologist's mobile units, the diabetologist's clinic and home workstations and the clinical server. The evaluation of the system was performed on a group of 13 newly diagnosed type 1 diabetic patients, during a single-arm study with 3-days run-in period, including a one-day intensive educational program, and 3-week study period, when the intensive insulin treatment was conducted without visits of patients to the clinic. The MBG dropped from 7.2 +/- 1.7 mmol/L before the study to 6.1 +/- 1.0 mmol/L in the third week of the study (P = 0.02) and the J-index from 30.2+/-19.2 to 19.7+/-7.7 (P = 0.04). Hemoglobin A1c decreased from 11.8 +/- 3.3% to 8.6 +/- 1.2% (P = 0.0002) in one month. The total daily insulin dose declined from 39.9 +/- 8.5 U to 20.0 +/- 9.6 U (P = 0.000006). The number of hypoglycemia episodes per patient per day decreased by 66% (P = 0.08) and the number of hyperglycemia episodes was reduced by 47% (P < 0.0001). The TeleMed facilitates not only efficient realization of the intensive insulin treatment but also successful remote patient training and education. No formal patient satisfaction study was done. However, some of the findings indicate that the application of the developed system increases patient self-confidence and quality of life.

Patterns of nuclear proto-oncogene expression during induced differentiation and proliferation of human B chronic lymphocytic leukaemia cells

Phorbol ester-induced differentiation of human B-chronic lymphocytic leukaemic cells was found to be preceded by a rapid transient induction in expression of the c-jun proto-oncogene, which paralleled that of c-fos. Induced expression of c-myc but not of c-fos/c-jun proto-oncogenes was markedly higher in a proliferating variant leukaemic cell population compared with that seen in typical lymphocytic leukaemia cells. These data suggest that the c-fos/c-jun nuclear oncogenes play a role in induced differentiation, whilst c-myc is more important in the proliferative response of B lymphocytes.

[Short-term subcutaneous infusion of insulin using a portable insulin pump in the treatment of diabetes mellitus]

The authors evaluated the effectiveness of treatment by means of constant subcutaneous insulin infusions (CPWI) in patients with diabetes staying in hospital. The infusions were made by means of portable insulin pumps (Microjet Bolus 1, Microjet Bolus 2 and Promedos E 1). The therapy was applied in a group of 15 patients with diabetes admitted to hospital because of symptoms of uncontrolled diabetes, among them 3 patients with diabetes freshly diagnosed. After 2-3 days of infusions 12 patients had glycaemia level approached to the physiological level. Only in one case of diabetes with significant resistance to insulin, the physicians were not able to control the diabetes. After 4-9 days of CPWI, patients who had been given conventional insulin injection had their insulin day demand reduced by 11-33%. In 4 cases the insulin demand had been established by means of Biostator GCIIS, after the introduction of the pumps the demand decreased by 40 +/- 5%, when the open loop system was applied. The above results suggest that the use of constant subcutaneous insulin infusion by means of a dosimeter may be recommended as a method of determining day demand for insulin, significantly shortening hospitalization period in patients with uncontrolled diabetes.

[Treatment of diabetes mellitus type 1 by long-term infusion of insulin]

In the article the authors evaluate the portable insulin pump, a prototype designed at the Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences, and also Promedos E1 pump produced by Siemens in the therapy of patients with diabetes type 1 brittle. Two patients underwent therapy by means of continuous intravenous insulin infusions (CDWI) for two months, two other patients--(CPWI) for about five years. The authors made an evaluation of the two methods by counting mean blood glucose, value M according to Schlichtkrull and determining the level of glycosylated haemoglobin. By continuous infusions of insulin, the authors achieved better diabetes control than with the previous conventional therapy.

[Effect of insulin sensitivity on the occurrence of early-morning hyperglycemia in patients treated with insulin]

The study was aimed at elucidation of the effect of insulin-sensitivity on the occurring of the dawn phenomenon. Diabetic patients were investigated in whom the fasting glycaemia was often higher than 17 mmol/l (300 mg%). In all patients the euglycaemic state was maintained by a continuous i.v. infusion of insulin using a micropump and a changing infusion of glucose using Biostator. A slight increase in the insulin-sensitivity was seen in the early morning in 3 patients in whom the glucose consumption during the constant insulin infusion was 4 mg/min/kg b.w. Among 7 patients with lower glucose consumption in 6 a markedly low insulin-sensitivity was seen at down. The investigations allow to assume that the dawn phenomenon occurs mainly in patients with uncompensated diabetes which induces changes in insulin-sensitivity.