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KLINICKÁ341804001074588109168189242288347
FARMAKOLOGIE709804001074291138211265312372415474533554598
A13288040010753
FARMACIE1403804001074191138210265316336380
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Farmakol2057804001074278105179220258305325
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2025;39(2):72-762617804001074487128172185229271295338360375416460485524565
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www.klinickafarmakologie.cz4568804001076513320121425327329234035839843647950254457164568672477179183988990895196610061045
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PŮVODNÍ341200012660132201274348422456
PRÁCE818200012661124196256314
METFORMIN34136001065284117148189225280297338
A695360010638
DEFICIT74936001063769100118152170202
VITAMINU9673600106365385122176194235276
B12125836001063412924200621937
–1343360010645
VLASTNÍ140436001063667109143175217234
POZOROVÁNÍ165436001063374105144180221258295336353
Z2023360010630
KLINICKÉ20693600106346583124141176212244
PRAXE232936001063368110148180
Metformin34092002982033294175016387289329961135
a15239200298127
deficit16999200298143268349417523588674
vitaminu24229200298127191278404608673811949
B123419920029814535531100017478146
–37489200298120
vlastní39169200298128192318420506647711
pozorování34011800298144281391528618755877100211401204
z159211800298113
klinické175311800298130198262401464571700822
praxe262311800298144233357482604
Dana3401580013777134199257
Weberová2,6191580013797153219277320383440498111615900803654
3,118315900803612201580013729
Pavel12711580013764121177233264
Weber1,15571580013798153219278320187515900803651
2,193915900803619761580013729
Hana20271580013776134198256
Meluzínová2230515800137941521832472993303954585155732877159008036
1Všeobecná3401740078333711740013361105160221283339389449501
interní896174001332586121174210271296
klinika1215174001335279104164189240293
LF15321740013352104
MU16601740013388158
a18421740013353
FN,19181740013354124147
Brno2088174001335995156216
2DIASTOP,3401890078333731890013373100166221276349408417
diabetologická814189001336287139201257293352378438500525574625678
a15161890013353
interní1592189001332686121175211272296
ambulance,19121890013353144206266292344404453507528
Brno2464189001335995156216
3Interní340204007833374204001332687122176211272297
gastroenterologická6952040013361113156193228288343404439493528588614674736761810860914
klinika1632204001335279104164189240294
LF19492040013352105
MU20772040013388159
a22592040013353
FN,23352040013354124147
Brno2505204001336095156216
Úvod:3402540012467121178238264
Dlouhodobé624255001216691146201257312369424482533
užívání1176255001215598121170219274297
metforminu14932550012182133167198254287370394449504
může20162550012183138181231
vést2266255001214797136171
vedle2456255001214797154178228
zažívacích2703255001214393136160208257302325370425
potíží,31472550012157113146169213236257
ke3423255001214796
vzniku3538255001214893148172219274
laktátové340269001212473121158209242298346397
acidózy,767269001214995119177234277328346
zhoršení11432690012143100157191232284341366
renálních1539269001213384141191215272296342399
funkcí1968269001212987144192237261
i22592690012124
k23132690012148
deficitu23912690012157109140167213237272328
vitaminu2750269001214873107158242267324380
B1231602690012155321227600713058
(VB12).32872690012129881443429276007130583487269001212948
Cílem3566269001215882109160245
naší3402830012155104144168
práce527283001215791140185235
bylo7822830012157104129185
poukázat9862830012157114170217267311361395
na14002830012156104
rizikovost1524283001213357101125172226274329369403
dlouhodobého1947283001215681136192248304362418476527584640
užití2606283001215599123157181
metforminu28062830012183135169201257291375399455510
zejména3336283001214393118202253309358
ve3714283001214897
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dávkách6692970012156105153201251297353
na10462970012155104
konkrétním11732970012147102159206241292327383407491
souboru1688297001213995152209266300357
námi20682970012155104188213
léčených2304297001212475121171228275319375
diabetiků2703297001215680129187239273297345401
2.3127297001215274
typu.3224297001213384143199221
Pacienti3403100012458110156185238298335364
a7233100012452
metodika:7943100012485139177236296325380434460
V12743110012155
roce1349311001213287133183
202415513110012151102151200
bylo17703110012157104128184
celkem1974311001214493118165214298
v22923110012147
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ambulanci30063110012148131189245269317373418442
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s.340325001214062
r.417325001213350
o.,48232500121557699
(NZZ611325001212995151209
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nestátní9313250012156108148184234267324348
zdravotnické13103250012143101134184232287322378402448496546
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dlouhodobě2281325001215681137194251307366422481533
léčeno2845325001212375122172229286
231613250012152
1363227325001215297149
diabetiků3407325001215781130188241275300348404
2.340339001215173
typu440339001213384143199
(T2DM),666339001212882135202283311331
a10233390012148
to1098339001213388
112133390012151
1111278339001215294136
mužů14413390012183139183239
a17063390012149
117813390012152
02518473390012151101153
žen.2027339001214293150172
Jejich2226339001213788113138183239
věk2492339001214898146
byl26653390012157104129
72,728213390012151103124175
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12,53109339001215297118172
roků.3307339001213389137193215
Z35483390012155
nich3630339001215680125181
703403530012151101
%4553530012180
bylo5613530012157104129186
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roků975353001213388137193
a11943530012148
12,61268353001215297118171
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bylo22933530012157104129185
v25053530012148
roce2579353001213388135185
202427903530012151102152201
pouze30183530012157114170214265
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dietou340367001215681132166221277
léčeno640367001212375121171228284
12946367001215297
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74,51411367001215197118172
±16053670012160
10,61687367001215199120173
roků).1882367001213388136193219239
Preparáty2143367001215386137195244278327361412
PAD,25773670012153110177196
inkretinovými2795367001212380127162213248272328384432484569593
mimetiky34113670012183107191243277301349400
nebo3403810012155107165222
inzulinem585381001212379123179204228284335420
v10283810012148
roce1098381001213388135185
202413063810012151102152201
bylo15303810012157104129185
léčeno1738381001212475122171228284
celkem2045381001214595120167217302
123693810012151
88024353810012151104157
diabetiků2615381001215680129187239274298345401
2.3039381001215174
typu3135381001213384143199
(883357381001212879132
%)35033810012179106
průměrného36313810012157911473403950012183135169225277334390
věku753395001214898146203
72,39793950012151102124178
±11803950012160
10,71263395001215199120171
roků.1457395001213388137193214
Šlo1694395001215074130
o18473950012155
retrospektivní1925395001213384118152207247305357405442466515573597
studii.2545395001213974130188212236258
Výsledky:3404080012464118162191245307363419447
Sledovanými816409001214974125183239287337393440525549
parametry13954090012157107140190274325360393445
byly18694090012157105130178
věk,2077409001214898146170
trvání2277409001213367119168225249
diabetu,2555409001215781130187240274330352
hodnocení29364090012156112170226282329379436460
polyneuropatie,34264090012156113138187244296352340423001213388146196230254305326
základní689423001214394142168217274330355
biochemické1067423001215782138184240292376400446494544
a16344230012148
hematologické17064230012155107191240274329354410468492538585635
vyšetření2365423001214899140191226259310366390
(krevní2779423001212876111162210268292
obraz),30944230012155113147197241270289
VB12,3407423001215611235164300071305735744230012121
folát3618423001212985110159193
a3404370012149
homocystein4204370012156113199256304355397432483508566
(u1017437001212882
nemocných11304370012156109195252299357404450507
s16684370012140
metforminem).17394370012184137172205262297383408465517603630650
Metforminem24214370012181134169202259294380405462514600
bylo30524370012158106132189
dlouhodobě3272437001215782139197254311370427487540
léčeno340451001212475122172229286
(ve656451001212976127
studii813451001214075131189214238
nejméně10814510012156108133218270327378
posledních14904510012157114155179231290346371417473
619934510012152
měsíců)20754510012184136177201247303329
52224354510012152102154
osob2619451001215596152211
–28604510012151
25029414510012152104156
žen3127451001214394151
a33094510012148
27233884510012151101153
mužů35714510012184140184241
věku340465001214898146203
68,85714650012151104127181
±7804650012160
10,4868465001215299120173
roků.1069465001213388137193214
Z13124650012155
nich1395465001215680125181
2416054650012151101
%17204650012179
bylo18284650012156104129185
≥20424650012159
6521164650012151102
roků2246465001213388137193
a24674650012148
525444650012151
%26104650012179
≥27174650012160
8027914650012152105
roků.2924465001213388137193214
Výrazný31674650012155104139188233289336
pokles35314650012157114162188240280
hladiny340479001215580129187211267313
VB12676479001215611278548600713057
pod8644790012157114172
1481059479001215198151
pmol/l12254790012157141198223258284
jsme1531479001212564148200
nalezli17544790012155104129180224249273
81krát2050479001215199141176226259
(15,52332479001212876121142196
%);25424790012179106125
hraniční2690479001215689138195219264320344
výsledek30574790012148100140165216274326374
v34544790012148
pásmu35244790012157107147231287
148–221340493001215198151205252304352
pmol/l7064930012157142198223259284
u10134930012155
1571092493001215197147
jedinců1262493001212475134158214260316
(30,11601493001212878130151197
%).18124930012180106126
Závěr:3405060012457111162214253280
Naše6395070012165114153203
sdělení861507001213996146170221277300
ve1180507001214897
shodě1296507001213994149206256
s15715070012140
literaturou163050700121234680129162211243298331386441
na20905070012155103
souboru2212507001213994150206262295351
našich25825070012155103142165210265
pacientů28665070012156105150173224279312367
poukazuje32525070012156112167214263307362386436
na37075070012155103
riziko340521001213357101125173228
rozvoje592521001213288131183238262314
deficitu9305210012156107138165211235269325
VB1212795210012156112138752800713057
ve1469521001214898
vztahu1591521001214894131181237293
k19085210012147
denní19795210012156107164220244
dávce22475210012157106153198248
metforminu.25195210012183135169202258292376401457513535
Podobně30785210012153107165221279336388
i34905210012123
věk3537521001214898146
by37075210012157105
měl3405350012183134159
vždy519535001214893150198
být7375350012157104141
brán898535001215690139195
v11135350012148
úvahu11805350012155104154209265
jako1465535001212472120174
další16595350012156105129168192
potencionálně18715350012156113147197253299322378434483507563614
rizikový2505535001213257100124172226274325
faktor2850535001212979126163217251
s31215350012139
respektováním3180535001213283123180232280316371419468524548632
všech340549001214887137183238
kontraindikací5975490012147100156189222270294349406429476525570593
a12095490012148
možných12765490012182138180235281325380
lékových1675549001212374121175222273317372
interakcí.2066549001212378111160193242289333356377
U24625490012164
diabetiků2545549001215679127184235269292339394
s29585490012139
deficitem30165490012156107137163208231265314397
VB1234325490012155110354055600713057
jsme3615549001212463146196
nenalezli3405630012155107164213237288333357381
závažné744563001214394142191235292343
klinické111056300121477397154178223271321
projevy1454563001215791146171222271323
(anémie1800563001212874130182266291342
atp.).2165563001214882139160188208
Klíčová340579001246190118163220272326
slova:691579001244371130182235260
diabetes976580001215680127184235269318357
2.1360580001215173
typu,1459580001213383141196217
metformin,17035800012183134167199254287370394449470
doba21995800012157112169218
a24435800012148
dávka25185800012156104151198247
užití2792580001215598121155178
metforminu,29965800012184134168199254287371394449504525
deficit35475800012157107137163208231264
vitaminu340594001214872105154237260315370
B12.7315940012155781601007130578405940012121
Metformin3406170012485138175210268306392419478
and8376170012453111170
vitamin1027617001245380117170256283341
B1213886170012460144462500733262
deficiency15266170012460112147176220248301360404459
–20046170012450
own20736170012458133192
observations22846170012457117160213251306359395423480539582
from2885617001243472130216
clinical3120617001244573100159186231284311
practice3450617001246098150195233261306358
Introduction:340634001242887124162220280339384422450508566592
Long-term9506350012147101156212244277326358442
use1409635001215594144
of1571635001215483
metformin16726350012183133166198252285368391446
can2136635001214493148
lead2301635001212474122178
to2497635001213386
digestive2601635001215679135185224257280328377
problems,2996635001215689143200224274357395416
lactic3430635001212471116151173218
acidosis,36666350012148921153406490012156111151174212233
and5916490012149104161
deterioration7706490012156106140189222245300333382414437492548
of1336649001215584
renal1438649001213382138186209
function,1665649001213085141186221244299355375
as2058649001214988
well21646490012173123147170
as2352649001214887
vitamin2457649001214872105154237260316
B1227916490012154284165600713057
deficiency.29166490012156107136163207230280336381431447
The33816490012150106156
aim3555649001214972155
of3728649001215584
our3406630012155110142
work5006630012174128161208
was7266630012173121160
to904663001213387
point10096630012157113136191224
out12516630012154110143
the1412663001213388138
risk156866300121335695141
of1727663001215584
long-term1829663001212378134190222255304337420
use2267663001215594145
of2430663001215584
metformin,25316630012184134168199254287370394449469
especially3018663001215090146197243266313337360407
in3443663001212378
higher3539663001215679135190240273
doses,3406770012156111151201241262
in623677001212379
a7236770012148
specific792677001214096148193216245272316
group1130677001215588143198255
of1406677001215584
patients15116770012157106138161211267299340
with1872677001217497130186
type2079677001213383140192
222926770012151
diabetes2364677001215780128184236269318358
treated2743677001213366115163196245302
by30676770012157103
us.3191677001215594116
Patients3406900012458110147175228288324369
and7336900012453112172
methodology:9296900012486140177237295355414442500559612639
In1594691001212479
2024,16996910012151102150199219
a19436910012149
total2017691001213488120169193
of2235691001215584
2,1362345691001215172117161212
patients25836910012157105138161211267299340
with2948691001217498131186
type3160691001213383140191
233776910012152
diabetes3454691001215780128184236269318358
(T2DM)340705001212880132197277303
were6607050012174122155204
treated882705001213365114162194242299
in1199705001212377
the1294705001213387137
diabetes1449705001215679126182233266314354
outpatient18207050012155109142198246279301351406438
clinic227570500121456890145168212
Diastop,2504705001216790137176209263319338
l.2860705001212344
t.2916705001213354
d.2982705001215676
(non-state3076705001212880134190221261294342374423
healthcare35177050012155105152175208262340719001214593126175
facility)533719001212978123146169192225274301
a8527190012148
long918719001212378134190
time1126719001213356139189
–13337190012150
1,1111401719001215167112153194
men16137190012183133189
and18207190012148103160
1,0251997719001215267119167218
women.22337190012173127211261317338
Of2589719001216899
these,2706719001213388139178228248
7029727190012151100
%30847190012179
were31817190012173123155205
≥34047190012160
6534767190012151101
years3594719001214797145177217
old340733001215579136
and5047330012148103160
12.6692733001215296117169
%8737330012180
were9817330012174123156206
≥12157330012160
8012877330012152104
years1419733001214797145177218
old.1665733001215579135156
Their18507330012149106156180212
age20917330012148104154
was22747330012173122161
72.724637330012152102123174
±26657330012159
12.52753733001215195116170
years.2951733001214797145177218239
Of32187330012169100
these,3347733001213388138178228248
123624733001215195
%37327330012179
(age340747001212873129180
74.5538747001215296117171
±7277470012160
10.6805747001215298119170
years)994747001214796144177217242
were12557470012173123156205
treated1479747001213366115163196245303
with1800747001217497131186
a20047470012148
diabetic2071747001215680127184235269292336
diet2426747001215680130163
alone2608747001214871127182233
in2859747001212479
2024.29577470012151101150198219
A31947470012161
total3274747001213387120169192
of3485747001215584
1,8803587747001215267120172224
patients3407610012157106138161211267299340
with698761001217498131186
T2DM9027610012150103168249
(881169761001212878130
%)13117610012179105
with1434761001217497130186
an16387610012148103
average1760761001214894144176225281331
age21107610012148104155
of2283761001215584
72.323857610012152102123177
±25807610012160
10.72658761001215298118169
years2845761001214797145177217
were30817610012173123156206
treated3305761001213366115163196245302
with3626761001217397130185
OAD3407750012169128194
preparations,555775001215790140197246278326359382437493531553
incretin1129775001212378123156206239262317
mimetics14687750012183106189240273296341382
or1871775001215588
insulin1980775001212379117172195218273
in2275775001212378
2024.23747750012152102151199219
It2615775001212457
was26937750012173122161
a28757750012148
retrospective2944775001213383116149203243299350396431454503552
study.3517775001214073128185233249
DECLARATIONS:4068257008648871301662142563043393604124625014570258008514
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