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Background: Medical nutrition therapy is essential for all people with diabetes, of any type or severity. Compliance with the recommended nutrition is an integral part of the treatment of type 1 diabetes (T1D). It remains unclear to what extent the dietary intake of patients with type 1 diabetes adheres to the recommendations for healthy eating.Objective: The primary aim of our study is to collect and analyze published articles on the nutrition of T1D patients in comparison with the general population and recommendations.Research Strategy and Methods: A literature search for articles, published between January 2006 and July 2021 was conducted, using electronic databases (PubMed and Google Scholar) for all available publications in English and Bulgarian. The process of study selection, identification, screening, eligibility and inclusion followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations for a flowchart. Based on the keywords search, 425 titles were retrieved, of which 27 were selected based on title and abstract. All papers were crosschecked and reviewed for selection by 3 independent reviewers. As a result, 19 titles were eligible and met inclusion criteria for a full review.Results: Energy intake tends to be lower in T1D patients or comparable to controls and in most cases within the general recommendations. The percentage of calories from protein is within the recommendations for children, adolescents and adults. Only two studies showed that T1D patients consume significantly less than the recommendation for total fat intake (<35E%). The median intake of carbohydrates is in the lower end of the recommended 45 to 60E%. The median intake of dietary fiber adjusted for total energy is too low for T1D patients and the general population.Conclusion: Study findings suggested a lack of knowledge or misunderstanding of diabetes dietary management. Patients with T1D, who are being consulted with a dietician as a part of their treatment plan may have better compliance to their recommended diet and as a result, are likely to have better health outcomes. Nutritional therapy should focus not only on glycemic control and pure carbohydrate counting but also on healthy eating and complication prevention.

Катедра по очни болести и зрителни науки, Медицински факултет, Медицински университет-Варна Специализирана болница по очни болести за активно лечение-Варна

PURPOSES: Osteoprotegerin (OPG) is an inhibitor of osteoclastogenesis, but is produced from vasculature, too. There is recent evidence of increased circulating OPG levels in patients with diabetes as well as in patients with coronary artery disease (CAD). Up to date, there are no sufficient data about OPG concentrations in newly-diagnosed type 2 diabetes mellitus (nT2DM) patients. The aim of our study was to determine the serum OPG levels in males with nT2DM without known concomitant CAD and to investigate the association of OPG with intima-media thickness (IMT) of common carotid arteries and glucometabolic parameters. CONCLUSION: Serum OPG is significantly elevated in nT2DM males without known CAD compared to non-diabetic controls. OPG levels show associations not only with some glucose indices but also with IMT, one of the earliest atherosclerotic markers. Probably, these glucose indices and this vascular parameter are involved in OPG regulation. We could suggest that OPG rises early in the evolution of diabetic disorders. However, further investigations are needed. MATERIAL AND METHODS

BACKGROUND AND PURPOSE: Despite numerous studies, the mechanisms of blood pressure and heart rate regulation in cerebrovascular diseases remain incompletely understood. The aim of the study was to determine the changes in blood pressure and heart rate in patients with acute hemispheric ischemic stroke and to seek a relationship with the severity of the cardiovascular autonomic dysfunction.

In recent years еpicardial adipose tissue has been reported to be an independent predictor of coronary risk, along with the already well established coronary calcium score. In our study we look for a corellation between these two markers in patients with long-term diabetes mellitus type 1 and healthy controls. Epicardial fat volume is quantified by semiautomatically and manually segmenting images acquired with computed tomography and magnetic resonance tomography. The two types of images demonstrate excellent correlation between them. A mild to moderate correlation between epicardial fat volume and coronary calcium score is found, regardless of which type of image the fat is calculated from.

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Хипергликемията по време на остър коронарен синдром (ОКС) при пациенти без известен диабет е честа и се счита, че е "стресова". От друга страна тя може да е първата индикация за предходно неразпознато гликемично нарушение. Цел: Да се потърси връзка между кръвната глюкоза (КГ) при спешна хоспитализация поради ОКС и глюкозните показатели в хода на орален глюкозотолерантен тест (ОГТТ). Материали и методи: При 96 лица с проведена KA±PCI и без анамнеза за гликемични нарушения се приложи стандартен ОГТТ между 3 и-10 и ден след дехоспитализацията. Глюкозният статус се класифицира според критериите на СЗО-2006 г., за плазмена глюкоза на гладно (ПГГ) и плазмена глюкоза на 2 ри час (2-ч-ПГ). Анализирана е КГ по време на спешен прием при 39 пациенти с ОКС. Резултати: Установихме нарушен глюкозен метаболизъм при 64.58%, а хипергликемия на 2 ри час (≥7,8 ммол/л)-при 52.1% от изследваните след проведения ОГТТ. Средната КГ при спешно приемане на лицата с новооткрит тип 2 заха-ABSTRACT Introduction: Hyperglycemia during acute coronary syndrome (ACS) in patients without known diabetes is common and is considered "stress hyperglycemia". On the other hand, it could be the first indication for previous unrecognized glycemic abnormality. Aim: To search for correlation between blood glucose (BG) at acute admission due to ACS and glycemic parameters during oral glucose tolerance test (OGTT). Materials and methods: A standard OGTT 3-10 days after hospital discharge was applied in 96 patients without history of glucose abnormalities who underwent coronary angiography (CA) ± percutaneous coronary intervention (PCI). Glucose tolerance was defined according to WHO-2006 criteria for fasting plasma glucose (FPG) and 2-hour-plasma glucose (2-h-PG). The BG at acute admission in 39 ACS patients was analyzed. Results: We found impaired glucose metabolism in 64.58% and 2-hour-hyperglycemia (≥7,8 mmol/L) in 52,1% of study participants after the OGTT. Mean BG at acute admission in subjects with newly-diagnosed type 2 diabetes mellitus (nT2DM) was 9,55±1,93 mmol/L.