Beneficial Effects of Ursodeoxycholic Acid on Metabolic Parameters and Oxidative Stress in Patients with Type 2 Diabetes Mellitus: A Randomized Double-Blind, Placebo-Controlled Clinical Study.

Background: Oxidative stress and inflammation are closely related pathophysiological processes, both occurring in type 2 diabetes mellitus (T2DM). In addition to the standard treatment of T2DM, a potential strategy has been focused on the use of bile acids (BAs) as an additional treatment. Ursodeoxycholic acid (UDCA), as the first BA used in humans, improves glucose and lipid metabolism and attenuates oxidative stress. The aim of this study was to evaluate the potential metabolic, anti-inflammatory, and antioxidative effects of UDCA in patients with T2DM. Methods: This prospective, double-blind, placebo-controlled clinical study included 60 patients with T2DM, randomly allocated to receive UDCA or placebo. Subjects were treated with 500 mg tablets of UDCA or placebo administered three times per day (total dose of 1500 mg/day) for eight weeks. Two study visits, at the beginning (F0) and at the end (F1) of the study, included the interview, anthropometric and clinical measurements, and biochemical analyses. Results: UDCA treatment showed a significant reduction in body mass index (p = 0.024) and in diastolic blood pressure (p = 0.033), compared to placebo. In addition, there was a statistically significant difference in waist circumference in the UDCA group before and after treatment (p < 0.05). Although no statistical significance was observed at the two-month follow-up assessment, an average decrease in glucose levels in the UDCA group was observed. After two months of the intervention period, a significant decrease in the activity of liver enzymes was noticed. Furthermore, a significant reduction in prooxidative parameters (TBARS, NO2-, H2O2) and significant elevation in antioxidative parameters such as SOD and GSH were found (p < 0.001). Conclusions: The eight-week UDCA administration showed beneficial effects on metabolic and oxidative stress parameters in patients with T2DM. Thus, UDCA could attenuate the progression and complications of diabetes and should be considered as an adjuvant to other diabetes treatment modalities. This trial is registered with NCT05416580.

Ten-year risk assessment for type 2 diabetes mellitus using the Finnish Diabetes Risk Score in family medicine.

Aim To assess ten-year risk of diabetes mellitus type 2 (T2DM) using the Finnish Diabetes Risk Score (FINDRISC) in respondents over 18, in Primary Health Centre in Banja Luka. Methods A prospective study was conducted using data from a population with undiagnosed T2DM in Primary Health Centre in Banja Luka. Eligible respondents were those aged 18 to 70 years. Sociodemographic, behavioural and anthropometric variables were those related to the risk models evaluated by FINDRISC. Results Data were collected from 520 individuals, 58.8% female and 41.2% male (p=0.005). A very high risk of developing T2DM in the next ten years was found in 5.6% females and 3.7% males. A high risk was found in 12.4% females and 15.9% males, 34.2% respondents ≥ 65 years, 28.8% with body mass index >30 kg/m2 , 26.6% who were not practicing physical activity (p=0.000), 24.0% who took antihypertensive drugs, 42.3% who were diagnosed with impaired glycaemia, 30.4% and 22.9% respondents whose parents and distant relatives, respectively, had T2DM. A moderate risk occurred in 31.4% females with waist circumference >88 cm. Half (50%) males with waist circumference >102 cm and 33.2% respondents who were not eating fruits and vegetables every day had a slightly increased risk of developing T2DM (p<0.05). Conclusion The FINDRISC may be used as a tool which would help general practitioners in everyday work, to detect patients with T2DM risk factors and to encourage them to change life style towards healthy habits.

Retrospective analysis of the role and performance of family medicine versus emergency medical services in the pre-hospital management of patients with AMI in Banja Luka.

OBJECTIVE: The aim of this study was to investigate the differences in pre-hospital care of patients with acute myocardial infarction between emergency medical services and family medicine. PATIENTS AND METHODS: This retrospective descriptive study included patients treated for acute myocardial infarction at the University Clinical Centre of Banja Luka, in the period from 1st January to 31st December 2011. The patients were divided into two groups: patients who received a hospital referral from the family medicine service and those who received one from the emergency medical service. RESULTS: The majority of patients (54.8%) received pre-hospital care from emergency medical services, while in 24.8% of cases the care was provided by family medicine physicians. The analysis showed that the time that passed from the onset of symptoms to the visit to the health institution of first medical contact was shorter in the emergency medical service (p<0.001). The average time from the onset of symptoms to arrival at the family practice was 24 hours, and to the emergency service 2 hours. The patients who established their first medical contact with the emergency service reported more severe symptoms than the ones who visited a family practice over the same period of time. CONCLUSION: The severity of symptoms affected the patients' decisions to seek help in a timely manner and to choose the facility of first medical contact. Interventions to decrease delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge of the benefits of early medical contact and treatment. Continuing education of family practitioners in this field is required.