[Women and diabetes].

J Perusicová

Vnitr Lek 2002, 48(12):1098-1102

The objective of the work was to assess, based on the results of studies conducted abroad and the author's own results from the Prague register of diabetic patients, whether there exist differences in the epidemiology, clinical course of diabetes mellitus (DM) and its complications between female and male diabetics. As far as type 1 DM is concerned there are significant differences in the clinical course of diabetes, i.e. deteriorated compensation of DM in girls and women in conjunction with menstruation and the menopause. As compared with men, young women have a higher mortality on account of diabetic nephropathy, and at any age they have as higher...

[4th Nationwide Diabetology Symposium. Diabetes and Gynecology. Hradec Kralove, 6-7 June 2002].

Vnitr Lek 2002, 48(12):1098-1117

[Biochemical changes in pregnant diabetics].

J Skrha

Vnitr Lek 2002, 48(12):1103-1106

In the course of pregnancy increasing insulin resistance develops due to deteriorated phosphorylation of the insulin receptor and its substrate (IRS-1). As a result of relations between secretion and the action of insulin the beta-cell reacts by insulin hypersecretion and thus the development of hyperinsulinaemia is influenced. Furthermore pregnancy is characterized by increasing differences between the anabolic and catabolic stage in the intermediary metabolism manifested in particular by a tendency towards ketosis and hypoglycaemia during fasting and also by hypoaminoacidaemia. In addition to these metabolic changes there are also other laboratory...

[Pregnancy and labor in diabetes from the viewpoint of the obstetrician].

A Měchurová

Vnitr Lek 2002, 48(12):1107-1110

Diabetes of all types is a known complication of pregnancy and is a risk for mother and foetus. Despite significantly improved care of pregnancies complicated by diabetes the perinatological results are still somewhat worse than in the healthy population. Therefore in the further improvement of perinatological indicators preconception care participates as well as systematic compensation of insulin dependent diabetes, preventive admission on hospital and correct timing of termination of pregnancy in pregestational as well as in gestational diabetes. All care of these pregnancies is shared by the obstetrician and diabetologist.

[Views of a diabetologist on pregnancy in diabetic patients].

K Andělová

Vnitr Lek 2002, 48(12):1111-1114

In recent years a very marked drop of complications in mothers with type 1 diabetes (DM 1) and type 2 diabetes (DM 2) was achieved. Nevertheless this group of patients is still considered at risk. The most serious possible complications are congenital malformations of the foetus and possible deterioration of long-term diabetic complications of the mother. The subsequent text is a brief review of contemporary views on pregnancy of diabetic patients.

[Gestational diabetes mellitus].

M Kvapil, D Bartásková

Vnitr Lek 2002, 48(12):1115-1117

Any degree of carbohydrate intolerance which develops for the first time during pregnancy is defined as gestational diabetes mellitus (GDM). GDM is often discovered late, in more than half the cases only during complications associated with pregnancy. Early diagnosis of GDM and early correct therapy of GDM leads to reduction of complications associated with pregnancy, delivery and the perinatal period of the infant. As in our country unequivocal rules for detection of gestational diabetes are still lacking. We feel that introduction of correct routine screening will contribute to the earlier diagnosis of GDM in all women and thus also to appropriate...

[Preconception care of the type I diabetic patient from the viewpoint of the diabetologist].

A Smahelová

Vnitr Lek 2002, 48(12):1118-1122

High standard metabolic compensation of diabetes reduces in a significant way the risk of developmental defects and the perinatal morbidity of children of diabetic mothers and the maternal mortality. A considerable proportion of diabetic women is inadequately informed on the risks of pregnancy. As many as two thirds of pregnancies in diabetic women are unplanned and thus the risk of inadequate compensation of diabetes in early stages of pregnancy increases. Preparation of diabetic women for planned pregnancy is therefore very important. Ensuring long-term normal blood sugar levels in type 1 diabetics has many pitfalls and involves in particular optimal...

[Gynecologic neoplasms in diabetic patients].

B Melichar

Vnitr Lek 2002, 48(12):1123-1129

Gynecologic malignancies (including breast cancer) represent a substantial proportion of neoplastic disorders in women. The problems associated with the treatment of gynecologic cancer is not limited to gynecology and oncology, but involve other specialties, including, in the case of breast cancer, surgery and radiology. The incidence of gynecologic cancer increases with age, similarly to other tumors or some internal disorders, including diabetes mellitus. In many patients, especially elderly, a coincidence of cancer and diabetes mellitus is observed. The presence of diabetes mellitus, similarly to that of other comorbid conditions, may have a profound...

[Urogenital infections in women with diabetes].

V Dostál

Vnitr Lek 2002, 48(12):1130-1133

[Anesthesia in labor and gynecologic procedures in women with diabetes].

V Cerný

Vnitr Lek 2002, 48(12):1134-1135

[Nutrition in women with diabetes in various stages of life].

L Sobotka

Vnitr Lek 2002, 48(12):1136-1141

The diet of diabetic women should not differ fundamentally from an ordinary healthy diet. The intake of the basic energy providing nutrients and of microelements should be balanced and if possible should be supplied in natural food products. This ensues among others from the fact that the relations between some micronutrients are not yet quite clear. During pregnancy it is however necessary to ensure in diabetic women 400 micrograms folic acid; increased attention must be paid to magnesium intake and during the menopause the vitamin D and calcium intake must be followed up.

[Metabolic aspects of the polycystic ovary syndrome].

S Svacina

Vnitr Lek 2002, 48(12):1142-1146

The author reviews the history of the term polycystic ovaries syndrome. He emphasizes the importance of insulin resistance in this disease. According to more recent criteria for the definition of the syndrome suffices the finding of hyperandrogenism, an irregular cycle (after elimination of other classical causes of this condition) and insulin resistance. The frequency of the disease varies in different populations up to 10%. It is significantly associated in particular with type 2 diabetes and obesity. The molecular biology of the syndrome is obscure. The metabolic syndrome as well as the polycystic ovaries syndrome have partly a genetic pathogenesis...

[Sexual problems in women with diabetes mellitus from the viewpoint of the diabetologist].

J Olsovský

Vnitr Lek 2002, 48(12):1147-1148

Diabetes mellitus, as every chronic disease, leads to the development of a number of complications. The author pays attention to sexual aspects of this disease in women from the aspect of the diabetologist.

[Urinary incontinence and diabetes mellitus in women].

M Otcenásek, M Halaska

Vnitr Lek 2002, 48(12):1149-1150

[Gynecologic complications in obesity].

S Svacina

Vnitr Lek 2002, 48(12):1151-1154

The author presents a review of gynaecological complications of obesity. He mentions the problem of gestation in obesity, surgical complications and hormonal abnormalities in obese women. A classical complication of obesity is sterility. Obesity is also a risk factor for a number of gynaecological tumours. The author emphasizes the importance of weight reduction in the treatment of sterility and for the prevention of gynaecological tumours. An increase of body weight must be prevented in gynaecological hormonal treatment and contraception.

[Hormone replacement therapy in female diabetic patients].

T Reslová

Vnitr Lek 2002, 48(12):1155-1163

[Contraception in female diabetic patients].

D Cibula

Vnitr Lek 2002, 48(12):1164-1168

[Effect of hormonal changes in women on hemostasis].

J Malý, P Dulícek

Vnitr Lek 2002, 48(12):1169-1173

Oral contraception and hormonal postmenopausal treatment is used worldwide by more than 100 million women. Since 1960 it is known that female sex hormones increase the risk of venous thrombosis, myocardial infarction and acute cerebrovascular attacks. This risk diminishes when small doses of oral contraceptives are administered but it still remains the main cause of thromboembolism in young women. The risk is greatest during the first year of contraceptive use, in women taking desogestrel and gestoden (so-called third generation progesterones) and in women with a prethrombotic predisposition. Hormonal substitution treatment (HRT) increases the risk...