Janusz Krzymień

Janusz Krzymień
Polish Academy of Sciences | PAN

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69
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417
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Publications

Publications (69)
Article
Background Complications of infected wounds in patients with diabetic foot ulcer (DFU) are one of the greatest challenges in modern medicine. Analysis of the microbiological profile of infected ulcers may significantly improve treatment results. The aim of the study was to determine the profile of pathogens isolated in patients with DFU and to comp...
Article
Full-text available
The aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the carbohydrates, protein and fat content in a meal. By...
Article
Full-text available
Purpose: Diabetic foot is a complication of long-lasting diabetes mellitus affecting up to 15% of patients, both in type 1 and type 2 diabetes. Osteoprotegerin is involved in osteogenesis and calcification. The aim of the study was to assess the role of selected osteoprotegerin gene variants in diabetes patients with diabetic foot. Methods: The...
Conference Paper
There is a recommendation regarding diabetes treatment with insulin pens or pumps that elevated blood glucose concentration after meal should be compensated by insulin bolus. This requires effective estimation of food carbohydrates and performing arithmetic calculations, what may be challenging tasks for many persons with diabetes. Consequently, th...
Article
Full-text available
The aim of this work was to assess the accuracy of automatic macronutrient and calorie counting based on voice descriptions of meals provided by people with unstable type 1 diabetes using the developed expert system (VoiceDiab) in comparison with reference counting made by a dietitian, and to evaluate the impact of insulin doses recommended by a ph...
Article
Full-text available
Chronic kidney disease (CKD) is often observed among patients with type 2 diabetes mellitus (T2DM) and diabetic foot (DF) leading to end stage renal disease. The aim of this pilot study was to determine genetic and environmental factors involved in the etiology of CKD among patients with DF. The following polymorphisms were studied: rs1800469, rs75...
Article
In theory, the continuous subcutaneous insulin infusion (CSII) has a few advantages over the multiple daily insulin injections (MDI) that should lead to improved glycemic control and lower risk of hypoglycemia. In practice, both treatment regimens allow for adequate control of glycemia. The objective of this review is to discuss the most important...
Article
Full-text available
Background Glycated hemoglobin A1c (HbA1c) has been used as an index of glycemic control in the management, guidance, and clinical trials of diabetic patients for the past 35 years. The aim of this study was to validate the HbA1c model in patients with type 1 and type 2 diabetes and to use it to support interpretation of HbA1c in different clinical...
Conference Paper
Full-text available
An effective application of insulin treatment in diabetic patients requires ability of the patient to select proper insulin doses, which compensate ingested meals. This is difficult, time consuming and in some cases outreach patient’s abilities. The main objective of the developed VoiceDiab system is to help patients in calculation of the proper in...
Article
Purpose: The objective was to assess glucose, lactate, glycerol, and pyruvate concentrations in the interstitial fluid of the adipose tissue as well as the glucose relative recovery coefficient in reference to capillary blood (RC) during the first two days of the standard treatment of diabetic ketoacidosis (DKA) in patients with type 1 and type 2...
Conference Paper
Glycated hemoglobin A1c (HbA1c) has been the gold standard index of the metabolic control in the diabetes treatment for 30 years. The goal of this study was to estimate the overall glycation rate constant (k) in a simple mathematical model of HbA1c formation for patients with type 1 and type 2 diabetes based on the mean glycemia calculated using th...
Article
Introduction: Lactic acidosis is a relatively rare complication diagnosed in patients with diabetes. Objectives: The aim of this study was to identify causes of lactic acidosis in patients with diabetes and to measure the extent of metabolic disturbances based on the available laboratory test results. Patients and methods: A total of 29 diabet...
Article
The objectives were as follows: (1) estimating mean value of the overall hemoglobin glycation rate constant (k); (2) analyzing inter-individual variability of k; (3) verifying ability of the hemoglobin A1c (HbA1c) formation model to predict changes of HbA1c during red blood cells cultivation in vitro and to reproduce the clinical data. The mean k e...
Article
Diabetic foot ulcer area is a basic parameter used for monitoring the wound healing and effectiveness of the treatment applied. TeleDiaFoS (developed earlier in collaboration with the Department and Clinic of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Warsaw, Poland) is one of just a few systems available that make possi...
Article
Basal-bolus insulin therapy is a standard method of intensifying diabetes treatment. A common adverse effect of such treatment is hypoglycemia. Data on frequency of hypoglycemia when fast-acting insulin analogue is used in everyday clinical practice is scarce. The aim of the study was to investigate the risk of hypoglycemia after the use of insulin...
Article
Diabetic foot syndrome (DFS) is one of the major complications of diabetes, and it can lead to foot amputations. It is very important to assure good medical care for diabetic patients not only during their stay at hospital but also at home. Telecare can be one good solution for extending medical care to patients' homes. There are some reports regar...
Article
The paper presents results of comparison of the wound area assessment methods in the diabetic foot syndrome (DFS). Wound size is a basic parameter that is used to evaluate efficacy of the applied treatment. Four measurement methods were used: the rulers, the planimetric Visitrak (Smith & Nephew, England), the Silhouette (Aranz Medical, New Zealand)...
Article
Diabetes is considered as one of the most serious, challenging and expensive health problem of the world. Diabetes causes a number of late complications affecting mainly vascular and nervous systems and increasing risk of: cardiovascular disease, cerebrovascular disease, kidney failure, blindness, lower limb amputation, impotence, etc. Currently di...
Article
Background. In many articles the attention is drawn to the problem of lower blood glucose levels in the hospital conditions but there is no detailed analysis made so far concerning that problem. Material and methods. The aim of this article was to analyze the frequency of hypoglycemia episodes during hospitalization in Internal Medicine Department...
Chapter
Diabetes is a group of metabolic diseases affecting more than 200 mln people worldwide, which is characterized by elevated blood glucose level. Diabetes causes a number of late complications among which diabetic foot syndrome (DFS) is one of the most dramatic as a major cause of the lower limb amputations. In IBBE PAS the TeleDiaFoS system aimed at...
Article
Full-text available
Diabetes is a disease that can cause serious late complications. Among them diabetic foot syndrome is one of the most dangerous because can lead to foot amputation. It is very important to assure good medical care for diabetic patients not only during the stay at the hospital but also at home. Telecare can be good solution for extending medical car...
Article
Glycated hemoglobin A1c (HbA1c) concentration in blood is an index of the glycemic control widely used in diabetology. The aim of the work was to validate two mathematical models of HbA1c formation (assuming irreversible or reversible glycation, respectively) and select a model, which was able to predict changes of HbA1c concentration in response t...
Article
The objective of the study was to establish the quasi-continuous courses, using microdialysis technique, of glucose, lactate, and glycerol concentrations in interstitial fluid of abdominal adipose tissue during the standard treatment of acute diabetes complications. Clinical studies were carried out on 31 diabetic patients during the initial 48 h o...
Article
Glycated hemoglobin A1c (HbA1c) concentration in blood is an index of the glycemic control widely used in diabetology. The aim of the work was to validate two mathematical models of HbA1c formation (assuming irreversible or reversible glycation, respectively) and select a model, which was able to predict changes of HbA1c concentration in response t...
Article
Full-text available
One of the most difficult current medical problems is the growing epidemics of diabetes mellitus. The contemporary treatment aims not only to secure the patients survival and to protect from the acute symptoms but also to avoid the occurrence of the chronic complications of the disease. This paper contains a review of the role that postprandial hyp...
Article
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 diabetologi...
Article
Background. Earlier studies have shown that gestational diabetes mellitus (GDM) is often associated with reported increase of birth weights and with frequency of macrosomia. The aim of the study was to analyse body mass index (BMI) in women with GDM and body mass in newborns. Materials and methods. 358 women with identified GDM, treated in the Outp...
Article
Background. Several studies showed that diabetes mellitus is often associated with hypertension, also in women with gestational diabetes mellitus (GDM). The aim of the study was observation of blood pressure (BP) values in women with gestational diabetes mellitus based on the Gestational Diabetes Monitoring System (GeDiaMos). Materials and methods....
Article
Background. The purpose of the study was to evaluate the prevalence of the carbohydrate metabolism in women with previous gestational diabetes mellitus. Materials and methods. We analyzed 125 women with GDM who were admitted in Department of Gastroenterology and Metabolic Diseases at the Medical University of Warsaw in the years 1989-2002 basing on...
Article
Background. Women with gestational diabetes mellitus (GDM) have an increased risk of type 2 diabetes after pregnancy. The aim of the study was to analyze prevalence of the elements of metabolic syndrome (diabetes mellitus, hypertension, elevated level of total cholesterol, overweight/obesity) in women with GDM. Material and methods. Study included...
Article
Background. Previous studies have shown that gestational diabetes mellitus (GDM) is associated with a number of metabolic and hormonal disorders, such as lipid disorders. The purpose of the study was to evaluate the prevalence of elevated total cholesterol level in women with gestational diabetes mellitus. Material and methods. Study included 50 wo...
Conference Paper
The main objective of the work was to develop the telematic system supporting intensive insulin treatment of the newly diagnosed type 1 diabetic patients and to assess clinical efficacy of the system. The TeleMed system is made up of: the patient's mobile unit, the diabetologist's mobile unit, the central clinical server and the diabetologist's wor...
Article
Existing standards of the management of the diabetic patients are not efficient enough, and further improvement is needed. The major objective of this paper is to present and discuss the therapeutic effectiveness of an intensive care telematic system designed and applied for intensive treatment of pregnant type 1 diabetic women. The developed syste...
Article
A telematic system supporting intensive insulin treatment of pregnant type 1 diabetic out-clinic patients was implemented and technical efficiency of the system was evaluated over long-term ambulatory application. The system consists of a patient teletransmission module (PTM) and a central clinical control unit (CCU). The PTM contains a one-box blo...
Article
Continuous subcutaneous insulin infusion (CSII) has been used successfully in intesively treated patients with type 1 diabetes. The rapid onset and short duration of lispro insulin suggest that the analog may be especially useful in insulin pump therapy. We investigated the efficacy and safety of the short acting insulin lispro (Humalog®) and regul...
Article
An intensive care system designed and developed in IBBE PAS allows for electronic storage and automatic transmission of BG values and other parameters directly from a patient's BG meter and electronic logbook (Glucometer M+ Bayer) to central clinical computer by telematic connection. Despite effort made to keep the system as simple as possible, its...
Article
In group of 1026 patients with recent myocardial infarction (from program "Streptokinase in acute myocardial infarction"--patients below 70 years old, up to 12 hours from the onset of the symptoms) we analyzed the influence of diabetes on clinical course and hospital mortality. In this group were 77 patients with noninsulin-dependent diabetes (NIDD...
Article
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 h...
Article
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...
Article
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 i...
Article
Effects of insulin on plasma concentration and renal excretion of sodium and potassium were compared in conscious dogs 1) maintained in water and electrolytes balance (Series 1, 10 dogs), 2) depleted of electrolytes by repeated i.v. loading with 20% mannitol (Series 2, 10 dogs), and 3) aldosterone treated (0.8 micrograms.kg-1.h-1 i.v., Series 3, 10...
Article
Compact catalytic platinum-binder glucose sensors were developed, provided for the artificial beta-cell. These consist of three electrodes: the working electrode, a 0.5 mm diameter glass-sheathed platinum wire, covered with a mixture of platinum black and binder (PMMA, PVC) at the face, the reference electrode and the rejuvenating or counter electr...
Chapter
The blood-glucose analyser for bed-side automatic insulin infusion system (“artificial pancreas”) has been designed. In the analyser the electrocatalytic amperometric glucose sensor was used as the glucose detector. The sensor's selectivity was improved utilising the effect of concentration saturation of coreactans influences. The blood-glucose ana...
Article
The influence of selected physiologic coreactants on current-voltage scans of a (Pt-pvc) Pt electrode (the working electrode of the amperometric glucose sensor) was tested. It was shown that the electrode is sufficiently sensitive to glucose even in a case when a strong interference of tested substances was observed. On the basis of the preliminary...
Article
The blood-glucose analyser for bed-side automatic insulin infusion system (“artificial pancreas”) has been designed. In the analyser the electrocatalytic amperometric glucose sensor was used as the glucose detector. The sensor's selectivity was improved utilising the effect of concentration saturation of coreactans influences. The blood-glucose ana...

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