Ambigapathy, Jayakumar; Sahoo, Jayaprakash; Kamalanathan, Sadishkumar
Antibodies against exogenous insulin are common in type 1 diabetes mellitus patients. They can cause hypoglycemia, albeit uncommonly. A 14-year-old girl with type 1 diabetes mellitus presented with recurrent hypoglycemia. High insulin, low C-peptide and raised insulin antibody levels documented during hypoglycemia. Plasmapheresis led to remission of hypoglycemia. Antibodies to exogenous insulin should be considered as a cause of recurrent refractory hypoglycemia in type 1 diabetes mellitus patients.
Yi, Bo; Huang, Gan; Zhou, Zhiguang
Diabetes can be simply classified into type 1 diabetes mellitus and type 2 diabetes mellitus. Zinc transporter 8 (ZnT8), a novel islet autoantigen, is specifically expressed in insulin-containing secretory granules of β-cells. Genetic studies show that the genotypes of SLC30A8 can determine either protective or diabetogenic response depending on environmental and lifestyle factors. The ZnT8 protein expression, as well as zinc content in β-cells, was decreased in diabetic mice. Thus, ZnT8 might participate in insulin biosynthesis and release, and subsequently involved deteriorated β-cell function through direct or indirect mechanisms in type 1 diabetes mellitus and type 2 diabetes mellitus. From a clinical feature standpoint, the prevalence of ZnT8A is gradiently increased in type 2 diabetes mellitus, latent autoimmune diabetes in adults and type 1 diabetes mellitus. The frequency and epitopes of ZnT8-specific T cells and cytokine release by ZnT8-specific T cells are also different in diabetic patients and healthy controls. Additionally, the response to ZnT8 administration is also different in type 1 diabetes mellitus and type 2 diabetes mellitus. In the present review, we summarize the literature about clinical aspects of ZnT8 in the pathogenesis of diabetes, and suggest that ZnT8 might play a different role between type 1 diabetes mellitus and type 2 diabetes mellitus. © 2015 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Poon, Myra; Hussain, Khalid
A patient with severe postprandial hyperinsulinaemic hypoglycaemia (PPHH) for 4 years developed type 1 diabetes mellitus. She had no insulin or insulin receptor antibodies but was positive for islet cell and glutamic acid decarboxylase (GAD) antibodies. PPHH prior to the onset of type 1 diabetes mellitus has not been previously described and may be a prodrome of type 1 diabetes mellitus.
Handorf, Andrew M; Sollinger, Hans W; Alam, Tausif
Type 1 diabetes mellitus is an autoimmune disease resulting from the destruction of pancreatic β cells. Current treatments for patients with type 1 diabetes mellitus include daily insulin injections or whole pancreas transplant, each of which are associated with profound drawbacks. Insulin gene therapy, which has shown great efficacy in correcting hyperglycemia in animal models, holds great promise as an alternative strategy to treat type 1 diabetes mellitus in humans. Insulin gene therapy refers to the targeted expression of insulin in non-β cells, with hepatocytes emerging as the primary therapeutic target. In this review, we present an overview of the current state of insulin gene therapy to treat type 1 diabetes mellitus, including the need for an alternative therapy, important features dictating the success of the therapy, and current obstacles preventing the translation of this treatment option to a clinical setting. In so doing, we hope to shed light on insulin gene therapy as a viable option to treat type 1 diabetes mellitus.
Kettner, Laura Ozer; Matthiesen, Niels Bjerregaard; Ramlau-Hansen, Cecilia Høst
OBJECTIVE: To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus. DESIGN: Nationwide birth cohort study. SETTING: Not applicable. PATIENT(S): All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003....... INTERVENTION(S): Not applicable. MAIN OUTCOME MEASURE(S): Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013. RESULT(S): The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination......, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus...
Yunir, E.; Nenfiati
Type 1 diabetes mellitus is a metabolic disease caused by insulin deficiency that results from destruction of β-cells in the pancreas. Based on American Diabetes Association, there are two types of type 1 diabetes mellitus: type 1A (autoimmune) and 1B (idiopathic). In this case, we are presenting a new archetype of type 1 diabetes named fulminant type 1 diabetes mellitus. This disease results from quick destruction of β-cells byanautoimmune mechanism. The manifestation of this disease consists of unspecific flu-like symptoms, abdominal symptoms, to specific hyperglycemia symptoms such as fatigue, malaise, change in mental status that are attributable to high blood glucose and ketosis. Laboratory examination reveals high blood glucose, normal glycosylated hemoglobin, ketosis or ketoacidosis, potassium depletion and elevation of liver function tests. Treatment consists of intravenous infusion followed by insulin injection for blood glucose control, followed by treatment of metabolic derangements such as acid-base and electrolyte disorder.
Tripathi, Avnish; Rizvi, Ali A; Knight, Lisa M; Jerrell, Jeanette M
To characterize rates of initial misclassification of type 1 diabetes mellitus as type 2/unspecified diabetes mellitus in a cohort of children/adolescents and to examine the impact of misclassification on the risk of diabetes-related complications. An 11-year dataset (1996-2006) was analyzed. Inclusion criteria included age 17 years and younger, enrollees in South Carolina State Medicaid, and diagnosis of type 2/unspecified or type 1 diabetes mellitus for at least two visits, 15 days apart. Survival analysis was used to assess the association of "misclassification" with the incidence of diabetic ketoacidosis (DKA), and the cumulative incidence of neuropathy, nephropathy, and cardiovascular complications, after controlling for individual risk factors and comorbid conditions. A total of 1130 individuals meeting the inclusion criteria were studied for a median of 7 years. Of the 1130 individuals, 669 (59.2%) maintained a diagnosis of type 2/unspecified diabetes mellitus, 205 (18.1%) were consistently diagnosed as type 1 diabetes mellitus, and the remaining 256 individuals (22.7%) were misclassified. Insulin treatment was used in 100% of the type 1 diabetes mellitus group and 73% of the misclassified group. Compared with the type 2 diabetes mellitus group, being misclassified was associated with earlier development of DKA (adjusted hazard ratio [aHR] 5.08, 95% confidence interval [CI] 3.09-8.37), neuropathy (aHR 1.94, CI 1.31-2.88), and nephropathy (aHR 1.72, CI 1.19-2.50), whereas being consistently classified with type 1 diabetes mellitus was associated only with earlier development of DKA (aHR 4.96, CI 2.56-9.61). Proper categorization of pediatric diabetes can be challenging, especially with comorbid obesity. Failure to ascertain type 1 diabetes mellitus in a timely manner in a pediatric population may increase the risk of substandard care and diabetes-related complications.
Bertuzzi, Federico; Stefani, Ilario; Rivolta, Benedetta; Pintaudi, Basilio; Meneghini, Elena; Luzi, Livio; Mazzone, Antonino
The growing incidence of diabetes and the need to contain healthcare costs empower the necessity to identify new models of care. Telemedicine offers an acknowledged instrument to provide clinical health care at a distance, increasing patient compliance and the achievement of therapeutical goals. The objective was to test the feasibility and the efficacy in the improvement of the glycemic control of the teleconsultation for patients with type 1 diabetes mellitus. A randomized open-label, parallel arms, controlled trial was conducted in two diabetes centers in Italy. Participants affected by type 1 diabetes mellitus have been randomly (1:1) assigned to receive their visits as standard or a web-based care. Patients in the teleconsultation group can arrange their appointments on a Web site and can also have access to web educational courses or to nutritional and psychological counseling. The primary outcome was the assessment of glycemic control by HbA1c measurement after a 12-month follow-up. Overall 74 participants were followed for 1 year. HbA1c changes were not statistically different within (p = 0.56 for standard care group; p = 0.45 for telemedicine group) and between (p = 0.60) groups when considering differences from baseline to the end of the study. Patients randomized to teleconsultation reported reduced severe hypoglycemic episodes (p = 0.03). In addition, they were largely satisfied with the activities, perceived a good improvement in the self-management of the diabetes, and reported to have a time saving and a cost reduction. In conclusion, TELEDIABE proposes a new system for the management of patients with type 1 diabetes mellitus.
Zhang, Qibin; Metz, Thomas O.
A method for identifying persons with increased risk of developing type 1 diabetes mellitus, or having type I diabetes mellitus, utilizing selected biomarkers described herein either alone or in combination. The present disclosure allows for broad based, reliable, screening of large population bases. Also provided are arrays and kits that can be used to perform such methods.
Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N; Gama, R
Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Three year retrospective study of diabetic patients with "unexplained" recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested.
Full Text Available AbstrakDiabetes mellitus (DM tipe 1 merupakan kelainan sistemik akibat terjadinya gangguan metabolisme glukosayang ditandai oleh hiperglikemia kronis. Keadaan ini disebabkan oleh proses autoimun yang merusak sel βpankreas sehingga produksi insulin berkurang bahkan terhenti, penderitanya akan memerlukan asupan insulineksogen. Penyakit ini menimbulkan komplikasi kronik sehingga memerlukan manajemen pengobatan yangberkelanjutan dan edukasi pada pasien serta keluarganya. Penyakit yang tidak terkontrol akan menimbulkanberbagai komplikasi metabolisme, gangguan makrovaskular dan mikrovaskular yang menyebabkan penurunankualitas dan harapan hidup penderita.Kata Kunci : Diabetes melitus tipe 1, makrovaskular, mikrovaskularAbstractDiabetes mellitus (DM type 1 is a result of the systemic disorder of glucose metabolism disorder characterized bychronic hyperglycemia. This situation is caused by the autoimmune processes that destroy pancreatic β cellsresulting in the production of insulin is reduced even halted, the sufferer will require exogenous insulin intake. Thisraises the complications of chronic disease that requires ongoing medication management and education forpatients and their families. Uncontrolled disease will cause various metabolic complications, macrovascular andmicrovascular disorders that cause loss of quality and life expectancy of the patient.Keywords: Type 1 diabetes mellitus, macrovascular, microvascular
Athar Abdul Samad Majeed
Full Text Available Objectives: Environmental factors play an important role in the pathogenesis of type 1 diabetes mellitus, many of these factors have been uncovered despite much research. A case-control study was carried out to determine the potential maternal, neonatal and early childhood risk factors for type 1 diabetes mellitus in children and adolescents in Basrah.Methods: A total of 96 diabetic patients who have been admitted to the pediatric wards at 3 main hospitals in Basrah, and those who have visited primary health care centers over the period from the 4th of November 2006 to the end of May 2007 were recruited. In addition, 299 non-diabetic children were included, their age ranged from 18 months to 17 years.Results: Family history of type 1 diabetes mellitus and thyroid diseases in first and second degree relatives was found to be an independent risk factor for type 1 diabetes mellitus, (p<0.001. Regarding maternal habits and illnesses during pregnancy, the study has revealed that tea drinking during pregnancy is a risk factor for type 1 diabetes mellitus in their offspring, (p<0.05. In addition, maternal pre-eclampsia and infections were found to be significant risk factor for type 1 diabetes mellitus, (p<0.001. Neonatal infections, eczema and rhinitis during infancy were also significantly associated with development of type 1 diabetes mellitus. Moreover, the results revealed that duration of <6 months breast feeding is an important trigger of type 1 diabetes mellitus.Conclusion: Exposure to environmental risk factors during pregnancy (tea drinking, pre-eclampsia, and infectious diseases, neonatal period (respiratory distress, jaundice and infections and early infancy are thought to play an important role in triggering the immune process leading to B-cell destruction and the development of type 1 diabetes mellitus.
Both type 1 and type 2 diabetes mellitus are associated with altered brain function, a complication referred to as diabetic encephalopathy. The issues surrounding the cognitive and emotional status in chronic, older diabetic patients remain complex. The literature shows contrasting findings and
Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N
Background Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Methods Three year retrospective study of diabetic patients with “unexplained” recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. Results 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Conclusion Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested. PMID:17551075
Sampaio, Norma; Mello, Sandra; Alves, Cresio
Type 1 diabetes mellitus (T1DM) is associated with various oral complications. However there is no consensus regarding the association of T1DM and caries. Critical revision of dental caries-associated risk factors and type 1 diabetes mellitus. Search of the MEDLINE and LILACS databases from 2000 to 2010, using, in different combination, the key words "dental caries", "diabetes mellitus" and "type 1 diabetes mellitus". The association between T1DM and dental caries remains controversial. Although some studies demonstrate a higher prevalence of caries due to the increased concentration of salivary glucose, acidity of the oral cavity, salivary viscosity, reduced salivary flow rate, and salivary gland dysfunction; other studies report a reduction of caries levels, probably caused by decreased ucrose ingestion. Although patients with uncontrolled T1DM and poor oral hygiene may present increased prevalence of dental caries, the literature does not describe a consistent relationship between T1DM and dental caries. Further investigations are warranted. If a true association is substantiated, intervention studies to prevent or reduce the occurrence of caries in this population should follow.
Damm, P; Binder, C
Glucocorticoid receptor binding characteristics were investigated in 8 males with poorly controlled Type 1 diabetes mellitus and 14 healthy males. The cell type studied was monocytes, and a method for correction for heterogeneity in glucocorticoid binding in a mononuclear leucocyte population...... or with HbA1c. In conclusion, no major abnormalities in glucocorticoid receptor binding characteristics could be demonstrated in Type 1 diabetes mellitus....... was introduced. The number of receptors and the dissociation constant KD were, respectively, 13,699 and 2.93 X 10(-8) mol/l for the control group and 15,788 and 2.75 X 10(-8) mol/l for diabetics (p greater than 0.05). In diabetics, KD correlated negatively with blood glucose (r = 0.762, p less than 0...
Full Text Available Background: Adipose tissues produce adipocytokines and other various substances that have useful actions in the body. One of such adipocytokines is visfatin which has been linked to diabetes mellitus. Aim: This study aimed at investigating the existence of a probable correlation between plasma levels of visfatin and the various types of diabetes mellitus: type 1, type 2 and gestational diabetes mellitus. Methods: A comprehensive literature search was performed using the Internet search engines linked to academic databases including Pubmed, Google Scholar, Ebsco, Hinari, etc. Studies involving visfatin were thoroughly searched and the references of such articles were also searched for any probable relevant information. Results/Findings: There is no agreed finding regarding the correlation between visfatin and diabetes mellitus. While some authors believed that plasma visfatin levels are elevated in diabetes mellitus, others believed that the contrary might be true. Conclusion: Various studies conducted so far have contrasting opinions about the correlation between plasma visfatin levels and diabetes mellitus.
Mahawar, Kamal K; De Alwis, Nimantha; Carr, William R J; Jennings, Neil; Schroeder, Norbert; Small, Peter K
Bariatric surgery is recognised as an effective treatment strategy for obese patients with type 2 diabetes mellitus. An increasing number of patients with type 1 diabetes mellitus also suffer with obesity and obesity-associated comorbidities but the role of bariatric and metabolic surgery in this group of patients is unclear. This systematic review investigates published English language scientific literature to understand the results of bariatric surgery in obese patients with type 1 diabetes mellitus. We found that these patients can experience significant weight loss and comorbidity resolution with bariatric surgery. Though most patients also see a decline in total insulin requirement, glycaemic control remains difficult. Most of the patients reported in literature have undergone gastric bypass but data is insufficient to recommend any particular procedure.
Choi, Y Sammy; Cucura, Jon
US Army soldiers diagnosed with type 1 diabetes were previously considered unfit for duty. For highly motivated soldiers, current advanced technologies allow the possibility of not only retention on active duty, but military deployment. We present our experience at Fort Bragg, North Carolina, taking care of soldiers newly diagnosed with type 1 diabetes mellitus. Through intensive diabetes education, extensive military and physical training, optimization of diabetes technology, and remote real-time monitoring, soldiers are able to continue to serve their country in the most specialized roles.
Al-Herbish, Abdullah S.; Al-Mouzan, Mohammad I.; Al-Salloum, Abdullah A.; Al-Qurachi, Mansour M.; Al-Omar, Ahmed M.
Objective was to determine the prevalence of type 1 diabetes mellitus among 0-19 years old Saudi children and adolescents. A nationwide Saudi Arabian project was conducted in the years 2001-2007 with the objective of establishing national growth charts and defining the prevalence of some chronic childhood diseases such as diabetes mellitus. The 14000 households were randomly selected based on a recent population statistic. The questionnaire used included demographic data and evidence of diabetes mellitus. The prevalence was estimated and expressed per 100,000. Breakdown of this figure per age and region was carried out. In the 11,874 out of the 14000 (84.9%) selected households, 45,682 children and adolescents were surveyed. Fifty children and adolescents were identified to have type 1 diabetes mellitus with a prevalence rate of 109.5 per 100,000. The male to female ratio was almost equal (26 males and 24 females). The distribution of prevalence of type 1 diabetes mellitus by region shows that the highest was 162 in the central region. Children and adolescents were also grouped by age into 5-6 (prevalence 100), 7-12 (prevalence 109), 13-16 (prevalence 243) and 17-18 (prevalence 150). We conclude that the prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents is 109.5 per 100,000. (author)
Carmody, David; Doyle, Aoife; Firth, Richard G R; Byrne, Maria M; Daly, Sean; Mc Auliffe, Fionnuala; Foley, Micheal; Coulter-Smith, Samuel; Kinsley, Brendan T
Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.
Muller, L.M.A.J.; Gorter, K.J.; Hak, E.; Goudzwaard, W.L.; Schellevis, F.G.; Hoepelman, A.I.M.; Rutten, G.E.H.M.
Background: Clinical data on the association of diabetes mellitus with common infections are virtually lacking, not conclusive, and often biased. We intended to determine the relative risks of common infections in patients with type 1 and type 2 diabetes mellitus (DM1 and DM2, respectively).
Yoda, Shigetoshi; Cureoglu, Sebahattin; Yildirim-Baylan, Muzeyyen; Morita, Norimasa; Fukushima, Hisaki; Harada, Tamotsu; Paparella, Michael M
To compare the prevalence of cupular and free-floating deposits in the semicircular canals between temporal bones of type 1 diabetes mellitus patients and normal controls. Case-control histopathologic human temporal bone study. Otopathology laboratory in a tertiary academic medical center. Twenty-eight temporal bones from 14 patients with type 1 diabetes mellitus and 56 normal temporal bones from 28 age-matched individuals were histopathologically examined. The cupula and lumina of the semicircular canals were examined for evidence of deposits. The prevalence of cupular and free-floating deposits in the lateral and posterior semicircular canals was significantly higher in type 1 diabetes mellitus patients compared with normal temporal bones (lateral, cupular deposits, odds ratio [OR], 5.47; 95% confidence interval [CI], 1.43 to 21.02; free-floating deposits, OR, 8.25; 95% CI, 2.42 to 27.85; posterior, cupular deposits, OR, 41.73; 95% CI, 5.96 to 275.50; free-floating deposits, OR, 7.44; 95% CI, 1.91 to 28.53). The prevalence of these deposits was associated with the duration of disease rather than with aging. The findings suggest that type 1 diabetes mellitus is associated with cupular and free-floating deposits in the semicircular canals. The patients with type 1 diabetes mellitus with a longer duration of disease have an increased probability of suffering from benign paroxysmal positional vertigo.
Kähler, Pernille; Grevstad, Berit; Almdal, Thomas
OBJECTIVE: To assess the benefits and harms of targeting intensive versus conventional glycaemic control in patients with type 1 diabetes mellitus. DESIGN: A systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. DATA SOURCES: The Cochrane Library, MEDLINE......, EMBASE, Science Citation Index Expanded and LILACS to January 2013. STUDY SELECTION: Randomised clinical trials that prespecified different targets of glycaemic control in participants at any age with type 1 diabetes mellitus were included. DATA EXTRACTION: Two authors independently assessed studies...... for inclusion and extracted data. RESULTS: 18 randomised clinical trials included 2254 participants with type 1 diabetes mellitus. All trials had high risk of bias. There was no statistically significant effect of targeting intensive glycaemic control on all-cause mortality (risk ratio 1.16, 95% CI 0.65 to 2...
Armas, Laura A G; Akhter, Mohammed P; Drincic, Andjela; Recker, Robert R
Patients with Type 1 Diabetes Mellitus (DM) have markedly increased risk of fracture, but little is known about abnormalities in bone microarchitecture or remodeling properties that might give insight into the pathogenesis of skeletal fragility in these patients. We report here a case-control study comparing bone histomorphometric and micro-CT results from iliac biopsies in 18 otherwise healthy subjects with Type 1 Diabetes Mellitus with those from healthy age- and sex-matched non-diabetic control subjects. Five of the diabetics had histories of low-trauma fracture. Transilial bone biopsies were obtained after tetracycline labeling. The biopsy specimens were fixed, embedded, and scanned using a desktop μCT at 16 μm resolution. They were then sectioned and quantitative histomorphometry was performed as previously described by Recker et al. . Two sections, >250 μm apart, were read from the central part of each biopsy. Overall there were no significant differences between diabetics and controls in histomorphometric or micro-CT measurements. However, fracturing diabetics had structural and dynamic trends different from nonfracturing diabetics by both methods of analysis. In conclusion, Type 1 Diabetes Mellitus does not result in abnormalities in bone histomorphometric or micro-CT variables in the absence of manifest complications from the diabetes. However, diabetics suffering fractures may have defects in their skeletal microarchitecture that may underlie the presence of excess skeletal fragility. Copyright © 2011 Elsevier Inc. All rights reserved.
Rusdiana; Savira, M.; Syahputra, M.; Santoso, A.
The aim of the study knowing the comparison creatinine plasma levels at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at Primary Health Care in Binjai city of North Sumatera in Indonesia. This cross-sectional study was conductedon 40 type 2 Diabetes Mellitus patients who attended Primary Health Care in Binjai. Patients with age > 40 years old, (both sexes) were included in the study. We recorded different demographic parameter as age, Body Mass Index, Blood Pressure, and personal history status. And we examined the biochemicalparameters including Hba1c, Fasting Blood Sugar Levels (FBL) and creatinine serum. We separated into two groups base on HbA1c test, controlled type 2 diabetes mellitus and uncontrolled type 2 diabetes mellitus. We measured FBL by using the portable measuring instrument, and Thamrin clinical laboratory measured Hba1c, andwe measured creatinine plasmaby spectrophotometry in Biochemistry laboratory. With statistical analysis using T-test found that there was asignificant differencein creatinine plasma levels between uncontrolled type 2 diabetes mellitus with controlled type 2 diabetes mellitus (p<0.005).
Chae, Young Kwang; Chiec, Lauren; Mohindra, Nisha; Gentzler, Ryan; Patel, Jyoti; Giles, Francis
Immune checkpoint inhibitors such as pembrolizumab, ipilimumab, and nivolumab, now FDA-approved for use in treating several types of cancer, have been associated with immune-related adverse effects. Specifically, the antibodies targeting the programmed-cell death-1 immune checkpoint, pembrolizumab and nivolumab, have been rarely reported to induce the development of type 1 diabetes mellitus. Here we describe a case of a patient who developed antibody-positive type 1 diabetes mellitus following treatment with pembrolizumab in combination with systemic chemotherapy for metastatic adenocarcinoma of the lung. We will also provide a brief literature review of other rarely reported cases of type 1 diabetes presenting after treatment with pembrolizumab and nivolumab, as well as discussion regarding potential mechanisms of this adverse effect and its importance as these drugs continue to become even more widespread.
Afzal, S.; Amin, M.K.; Ahmad, I.; Amer, H.; Shoaib, H.; Ibrahim, H.; Tayyab, M.; Hassan, M.; Javaid, M.A.; Rehman, M.A.
Diabetes Mellitus type 2 , formerly non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency1. The development of Diabetes Mellitus type 2 is associated with multiple risk factors, co-morbid medical conditions as well as psychosocial determinants. These psychosocial factors, which differ from population to population, can be identified and controlled to reduce the incidence of type 2 Diabetes Mellitus. Objective: To identify various psychosocial factors associated with type 2 Diabetes Mellitus. Design: Case-control study. Place and Duration: Diabetic clinic and Medical Units Mayo Hospital Lahore . July to December, 2012. Subjects and Methods: A population based case-control study with 1:1 case to control ratio was conducted. A total of 100 subjects (50 cases and 50 controls) having age above 35 years were recruited in the study. Selection was made on laid down criteria from patients coming to Mayo Hospital Lahore after taking consent. Interviews were conducted through a pretested questionnaire. Data was collected, compiled and analyzed through IBM SPSS version 20. Results: Out of 100 study subjects 67% were males and 33% were females. Among cases of Diabetes mellitus type 2, 64% were males, 70% in the age group 35-50 years, 96% were married, 36% were illiterates. Mean age was found 49.24, standard deviation 10.915. In bivariate analysis, Diabetes Mellitus type II was found significantly associated with Anxiety(OR: 5.348, 95% CI: 2.151-13.298) Depression(OR: 5.063, 95% CI: 1.703-15.050), High fat diet, (OR: 2.471, 95% CI: 1.100-5.547) Sedentary Lifestyle(OR: 4.529, 95% CI: 1.952-10.508) and Psychological Stress(OR:4.529, 95% CI: 1.952-10.508). However, in multivariate analysis while controlling all other risk factors, Anxiety(OR: 6.066, 95% CI: 1.918-19.191), High fat diet(OR: 3.648, 95% CI: 1
Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians should be aware of the frequent mild or asymptomatic manifestation of type 2 diabetes mellitus in childhood. Therefore, a screening seems meaningful especially in high risk groups such as children and adolescents with obesity, relatives with type 2 diabetes mellitus, and clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans). Treatment of choice is lifestyle intervention followed by pharmacological treatment (e.g., metformin). New drugs such as dipeptidyl peptidase inhibitors or glucagon like peptide 1 mimetics are in the pipeline for treatment of youth with type 2 diabetes mellitus. However, recent reports indicate a high dropout of the medical care system of adolescents with type 2 diabetes mellitus suggesting that management of children and adolescents with type 2 diabetes mellitus requires some remodeling of current healthcare practices. PMID:24379917
Fazeli Farsani, S.
The numbers of patients with diabetes mellitus (type 1 and type 2) are increasing globally, both in adults and children. Pediatric diabetes mellitus is an important health concern, since this disease has significant effects on health and quality of life, social function, use of medical services and
H-J. Aanstoot (Henk-Jan)
textabstractType 1 diabetes mellitus or insulin dependent diabetes mellitus is a disease characterized by the selective destruction of insulin producing B-cells in the islets of Langerhans. The exact cause of this destruction is unknown, but is mediated by cells of the immune system. The immune
Full Text Available Charcot-Marie-Tooth disease type 1A (CMT1A is caused by duplication of the peripheral myelin protein 22 (PMP22 gene on chromosome 17. It is the most common inherited demyelinating neuropathy. Type 2 diabetes mellitus is a common metabolic disorder that frequently causes predominantly sensory neuropathy. In this study, we report the occurrence of CMT1A in a Chinese family affected by type 2 diabetes mellitus. In this family, seven individuals had duplication of the PMP22 gene, although only four had clinical features of polyneuropathy. All CMT1A patients with a clinical phenotype also presented with type 2 diabetes mellitus. The other three individuals had no signs of CMT1A or type 2 diabetes mellitus. We believe that there may be a genetic link between these two diseases.
Lauszus, F F; Schmitz, O; Vestergaard, H
BACKGROUND: Leptin is an important weight regulator and during pregnancy leptin is not only synthesized in adipose tissue but also in the placenta. AIM: To examine changes in serum leptin levels in women with type 1 diabetes mellitus during pregnancy and post delivery in relation to concomitant...... changes in maternal body weight, birth weight, glycemic control, and blood pressure. METHODS: Non-fasting serum leptin from 45 women with type 1 diabetes mellitus were studied consecutively throughout pregnancy and 3 months post partum. RESULTS: Serum leptin was positively associated with HbA1c in week 18...... of serum leptin throughout pregnancy and it changed significantly differently from the women with higher blood pressure (p1 diabetes mellitus were associated with parallel changes in maternal body weight and glycemic control...
Lauszus, F.F.; Schmitz, O.; Vestergaard, H.
BACKGROUND: Leptin is an important weight regulator and during pregnancy leptin is not only synthesized in adipose tissue but also in the placenta. AIM: To examine changes in serum leptin levels in women with type 1 diabetes mellitus during pregnancy and post delivery in relation to concomitant...... changes in maternal body weight, birth weight, glycemic control, and blood pressure. METHODS: Non-fasting serum leptin from 45 women with type 1 diabetes mellitus were studied consecutively throughout pregnancy and 3 months post partum. RESULTS: Serum leptin was positively associated with HbA1c in week 18...... of serum leptin throughout pregnancy and it changed significantly differently from the women with higher blood pressure (ptype 1 diabetes mellitus were associated with parallel changes in maternal body weight and glycemic control...
Smits, Mark M.; Tonneijck, Lennart; Muskiet, Marcel H.A.; Hoekstra, Trynke; Kramer, Mark H.H.; Diamant, Michaela; Serné, Erik H.; Van Raalte, Daniël H.
Objective - To assess the effects of glucagon-like peptide (GLP)-1-based therapies (ie, GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) on microvascular function in patients with type 2 diabetes mellitus. Approach and Results - We studied 57 patients with type 2 diabetes mellitus
Defreyne, Justine; De Bacquer, Dirk; Shadid, Samyah; Lapauw, Bruno; T'Sjoen, Guy
The International Diabetes Federation estimates that approximately 0.4% of the Belgian population is diagnosed with type 1 diabetes mellitus, which is similar to other industrialized countries. The prevalence of transgenderism is estimated at 0.6% to 0.7% of all adults in Western populations. In this study, we evaluated whether there was an increased prevalence of type 1 diabetes mellitus in transgender people in the local cohort. Medical records of transgender patients were analyzed retrospectively. From January 1, 2007 until October 10, 2016, 1,081 transgender patients presented at a tertiary reference center to start hormonal treatment. Nine of these 1,081 patients were previously diagnosed with type 1 diabetes mellitus and 1 was diagnosed with latent autoimmune diabetes in adults. A 2.3-fold higher prevalence of type 1 diabetes mellitus was observed in transgender patients. We concluded that type 1 diabetes mellitus was more prevalent in transgender patients than one would expect from population prevalences. This could be a spurious result in a local cohort, because a causal relation seems unlikely, but our finding might encourage other centers to investigate this putative association. Defreyne J, De Bacquer D, Shadid S, et al. Is Type 1 Diabetes Mellitus More Prevalent Than Expected in Transgender Persons? A Local Observation. Sex Med 2017;5:e215-e218. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Fenske, Rachel J; Kimple, Michelle E
Since its discovery and purification by Frederick Banting in 1921, exogenous insulin has remained almost the sole therapy for type 1 diabetes mellitus. While insulin alleviates the primary dysfunction of the disease, many other aspects of the pathophysiology of type 1 diabetes mellitus are unaffected. Research aimed towards the discovery of novel type 1 diabetes mellitus therapeutics targeting different cell signaling pathways is gaining momentum. The focus of these efforts has been almost entirely on the impact of immunomodulatory drugs, particularly those that have already received FDA-approval for other autoimmune diseases. However, these drugs can often have severe side effects, while also putting already immunocompromised individuals at an increased risk for other infections. Potential therapeutic targets in the insulin-producing beta-cell have been largely ignored by the type 1 diabetes mellitus field, save the glucagon-like peptide 1 receptor. While there is preliminary evidence to support the clinical exploration of glucagon-like peptide 1 receptor-based drugs as type 1 diabetes mellitus adjuvant therapeutics, there is a vast space for other putative therapeutic targets to be explored. The alpha subunit of the heterotrimeric G z protein (Gα z ) has been shown to promote beta-cell inflammation, dysfunction, death, and failure to replicate in the context of diabetes in a number of mouse models. Genetic loss of Gα z or inhibition of the Gα z signaling pathway through dietary interventions is protective against the development of insulitis and hyperglycemia. The multifaceted effects of Gα z in regards to beta-cell health in the context of diabetes make it an ideal therapeutic target for further study. It is our belief that a low-risk, effective therapy for type 1 diabetes mellitus will involve a multidimensional approach targeting a number of regulatory systems, not the least of which is the insulin-producing beta-cell. Impact statement The expanding
Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM) by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progressi...
Schloot, N C; Hübinger, A; Scherbaum, W A
A 22-year-old man was admitted in a severely reduced condition. Type 1 diabetes mellitus had been diagnosed when he was 13 years old, hypothyroidism was treated with L-thyroxine for 2 years. For the past 3 years he suffered from repetitive hypoglycemia, combined with vertigo, weakness and low blood pressure. He presented with hypotension and hyperpigmentation of the skin. Pathological laboratory results were: serum creatinine 2.5 mg/dl; urea 145 mg/dl; sodium 124 mmol/l; potassium 8.3 mmol/l, HbA (1c) 9.1%. The ECG showed large T waves. Additionally, plasma aldosterone was decreased (diabetes mellitus type 1 and hypothyroidism (Schmidt-Carpenter-Syndrome) were diagnosed. Initially, the patient was treated with sodium chloride 0.9% i. v. and oral sodium 5 g 4 times/day. In addition, he was given hydrocortisone 100 mg i. v., and then switched to 40 mg per day (20-10-10 mg), fludrocortisone 0.05 mg/ day and L-thyroxine 75 microg/ day orally the clinical condition improved dramatically within 24 hours. Intensified conventional insulin therapy was continued. In patients with type 1 diabetes, especially in combination with associated organ-specific autoimmune diseases, autoimmune polyglandular syndrome should be considered and adequately treated with those hormones that are reduced.
Mathieu, Chantal; Gillard, Pieter; Benhalima, Katrien
The treatment of type 1 diabetes mellitus consists of external replacement of the functions of β cells in an attempt to achieve blood levels of glucose as close to the normal range as possible. This approach means that glucose sensing needs to be replaced and levels of insulin need to mimic physiological insulin-action profiles, including basal coverage and changes around meals. Training and educating patients are crucial for the achievement of good glycaemic control, but having insulin preparations with action profiles that provide stable basal insulin coverage and appropriate mealtime insulin peaks helps people with type 1 diabetes mellitus to live active lives without sacrificing tight glycaemic control. Insulin analogues enable patients to achieve this goal, as some have fast action profiles, and some have very slow action profiles, which gives people with type 1 diabetes mellitus the tools to achieve dynamic insulin-action profiles that enable tight glycaemic control with a risk of hypoglycaemia that is lower than that with human short-acting and long-acting insulins. This Review discusses the established and novel insulin analogues that are used to treat patients with type 1 diabetes mellitus and provides insights into the future development of insulin analogues.
Zalewska, Anna; Knaś, Małgorzata; Kuźmiuk, Anna; Waszkiewicz, Napoleon; Niczyporuk, Marek; Waszkiel, Danuta; Zwierz, Krzysztof
It should be expected that type 1 diabetes mellitus may disturb innate and acquired immunity. There are no data on type 1 diabetes mellitus-related changes in the salivary flow and the protein output responsible for the innate immunity of saliva depending on the quality of dentition reflecting the age of child. The aim of this work was the evaluation of parameters responsible for the innate immunity of saliva in children and adolescents with type 1 diabetes mellitus. In diabetic children, adolescent and healthy volunteers, the salivary flow, the output and the concentration of the activity of peroxidase (colorimetry), lysozyme (radial immunodiffusion) and lactoferrin (ELISA) were determined. In children with mixed and permanent dentition, type 1 diabetes mellitus significantly decreases (as compared with the appropriate controls) the unstimulated salivary flow, the output, concentration of peroxidase and the output of the lysozyme and lactoferrin. In conclusion, it may be stated that type 1 diabetes mellitus causes functional changes in the salivary glands, resulting in a decrease of the salivary flow and weakening of the salivary innate defense system, thus creating a threat to the oral and general health of type 1 diabetes mellitus children. The results showed that the salivary glands of younger children, when compared to adolescents with type 1 diabetes mellitus, are more susceptible to the injurious effects of the disease.
Adis Tyaning Puspitasari
Full Text Available Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia due to insulin deficiency. As a result, there will be metabolic disturbances on carbohydrate, fat, and protein. Diabetes mellitus type 1 may occur because of pancreatic B cells damage resulting in decreased secretion of insulin in absolute terms. Xerostomia is the medical term for the subjective complaint of dry mouth due to the lack of saliva and can occur in patients with type 1 diabetes mellitus. The purpose of this study was to obtain data on the salivary flow rate and oral dryness complaints in children with type 1 diabetes mellitus The method of this study was descriptive by survey technique. The sample was obtained by purposive sampling and consisted of 30 children with type 1 diabetes mellitus in RSUPN Dr. Cipto Mangunkusumo Jakarta in April to May 2010. The study was conducted with an objective examination by measuring the salivary flow rate and subjective examination using a questionnaire. The results showed that the salivary flow rate from an average of 30 respondents was below normal values. The most common complaints about the dryness of the mouth cavity were thirst, 24 patients (80.00%, and oral dryness 19 patients (63.33%. The conclusion from this study showed that children with type 1 diabetes mellitus were having oral dryness complaints and the decrease of salivary flow rate.
Björk, Anna; Svensson, Ann-Marie; Fard, Mir Nabi Pirouzi; Eriksson, Peter; Dellborg, Mikael
Approximately 1% of children are born with CHD, and 90-95% reach adulthood. Increased exposure to infections and stress-strain can contribute to an increased risk of developing type 1 diabetes mellitus. CHD may increase the risk of more serious infections, stress-strain, and increased risk of developing type 1 diabetes mellitus. We analysed the onset of and the risk of mortality and morbidity associated with concurrent CHD in patients with type 1 diabetes mellitus compared with patients with type 1 diabetes mellitus without CHD. The study combined data from the National Diabetes Register and the National Patient Register. A total of 104 patients with CHD and type 1 diabetes mellitus were matched with 520 controls. Patients with CHD and type 1 diabetes mellitus had an earlier onset of diabetes (13.9 versus 17.4 years, p1), longer duration of diabetes (22.4 versus 18.1 years, p1), higher prevalence of retinopathy (64.0 versus 43.0%, p=0.003), higher creatinine levels (83.5 versus 74.1 µmol/L, p=0.03), higher mortality (16 versus 5%, p=0.002), and after onset of type 1 diabetes mellitus higher rates of co-morbidity (5.28 versus 3.18, p⩽0.01), heart failure (9 versus 2%, p=0.02), and stroke (6 versus 2%, p=0.048) compared with controls. From a nationwide register of patients with type 1 diabetes mellitus, the coexistence of CHD and type 1 diabetes mellitus was associated with an earlier onset, a higher frequency of microvascular complications, co-morbidity, and mortality.
Barski, Leonid; Nevzorov, Roman; Harman-Boehm, Ilana; Jotkowitz, Alan; Rabaev, Elena; Zektser, Miri; Zeller, Lior; Shleyfer, Elena; Almog, Yaniv
Diabetic ketoacidosis (DKA) occurs most often in patients with type 1 diabetes, however patients with type 2 diabetes are also susceptible to DKA under stressful conditions. The aims of our study were to evaluate and compare the clinical and biochemical characteristics and outcomes of type 1 versus type 2 diabetes mellitus (DM) patients with DKA. A retrospective cohort study of adult patients hospitalized with DKA between January 1, 2003, and January 1, 2010. The clinical and biochemical characteristics of DKA patients with type-1 DM were compared with those of patients with type-2 DM. The primary outcome was in-hospital all-cause mortality. The study cohort included 201 consecutive patients for whom the admission diagnosis was DKA: 166 patients (82.6%) with type-1 DM and 35 patients (17.4%) with type-2 DM. The patients with DKA and type-2 DM were significantly older than patients with type-1 DM (64.3 versus 37.3, P ventilation and bed-ridden state were independent predictors of 30-day mortality.
Younger maternal age at delivery has been linked to adverse reproductive outcomes. Pregnancy complicated by type 1 diabetes mellitus (T1DM) is also associated with adverse pregnancy outcomes. Optimising diabetic glycaemic control prior to pregnancy is known to reduce the rate of congenital abnormalities and improve pregnancy outcomes. Teenage pregnancies are not usually planned and little data exist on teenage pregnancy complicated by T1DM. We sought to identify the glycemic control achieved in teenage pregnancy with T1DM and to clarify if there is an associated increase in adverse pregnancy outcomes compared to those seen in older women with T1DM. We compared outcomes in 18 teenagers (TG) with 582 older women with T1DM (CON) from 1995-2007. TG booked to the combined diabetes-obstetrical service at a median gestational age of 11 weeks (range 6-22) compared to 7 weeks in CON (range 4-40, p < 0.02). Glycaemic was worse in TG compared to CON at 13, 26 and 35 weeks gestation, despite higher insulin doses. First trimester miscarriage rate did not differ between groups. Major congenital anomaly rate was 6.2% (1\\/16) compared to 3.2% in CON. This preliminary study has demonstrated that pregnant teenage women with T1DM book later to specialised care and have worse glycaemic control in pregnancy compared to older women with T1DM. This group also appear to be more insulin resistant than older women in early pregnancy. Our data would suggest that teenagers with type 1 diabetes mellitus may constitute a high-risk group for adverse pregnancy outcomes.
Tight metabolic control in Type 1 Diabetes Mellitus (T1DM) reduces incidence and delays progression of micro-vascular complications. Severe hypoglycaemia remains a significant barrier to achieving optimal diabetes control. Continuous subcutaneous insulin infusion (CSII) systems refine insulin delivery with programmable basal rates and mealtime bolusing
Yuriko I. Sánchez-Zamora
Full Text Available Autoimmunity and chronic low-grade inflammation are hallmarks of diabetes mellitus type one (T1DM and type two (T2DM, respectively. Both processes are orchestrated by inflammatory cytokines, including the macrophage migration inhibitory factor (MIF. To date, MIF has been implicated in both types of diabetes; therefore, understanding the role of MIF could affect our understanding of the autoimmune or inflammatory responses that influence diabetic pathology. This review highlights our current knowledge about the involvement of MIF in both types of diabetes in the clinical environment and in experimental disease models.
Insulin oedema in a 9 year old child with type 1 diabetes mellitus: a case report. ... with Type 1 Diabetes Mellitus (T1DM) however, its clinical use is associated with ... in 1928.1 In the 1960's it was reported in two series from East Africa.2-3 and ...
Yan, Dandan; Zhao, Enfa; Zhang, Hong; Luo, Xiaohui; Du, Yajuan
A potential association between type 1 diabetes mellitus and subsequent epilepsy emerged in recent studies. This study aimed to evaluate the possible relationship between type 1 diabetes mellitus and epilepsy using meta-analysis. Pubmed, ISI Web of Knowledge, Embase and Cochrane Library were searched for potential studies of the association between type 1 diabetes mellitus and epilepsy from inception to February 1, 2017. Two investigators independently screened studies for inclusion and extracted related data; discrepancies were solved by consensus. Random effects model of Hazard Ratio (HR) was used to estimate the strength of association. We identified 13 papers from potentially relevant articles of which 3 cohort studies met the inclusion criteria. Random effects meta-analysis showed that type 1 diabetes mellitus was associated with an increased risk of epilepsy with HR = 3.29 (95% CI: 2.61-4.14; I 2 = 0, p = 0.689). Similar results were observed in type 1 diabetes mellitus patents younger than 18-years-old with HR = 2.96 (95% CI: 2.28-3.84; I 2 = 0, p = 0.571). Meta-analysis of 2 studies that adjusted for potential confounders yielded an increased risk of epilepsy with HR = 2.89 (95% CI: 2.26-3.70; I 2 = 0, p = 0.831). The meta-analysis indicates that type 1 diabetes mellitus is associated with a statistically significant increased risk for epilepsy compared to those without type 1 diabetes mellitus.
Naing, Cho; Mak, Joon Wah
Incidence of type 1 diabetes mellitus is increasing worldwide. Monitoring glycaemia is essential for control of diabetes mellitus. Conventional blood-based measurement of glucose requires venepuncture or needle prick, which is not free from pain and risk of infection. The non-invasiveness, ease and low-cost in collection made saliva an attractive alternative sample. The objective of this review was to systematically review the evidence on the relationship between salivary glucose level and blood glucose level in monitoring glycaemia in patients with type 1 diabetes mellitus. We searched studies which evaluate salivary glucose levels and serum glycaemia in type 1 diabetes mellitus in electronic databases of MEDLINE, EMBASE, Ovid and Google Scholar. We selected the eligible studies, following the inclusion criteria set for this review. Due to heterogeneity of studies, we conducted qualitative synthesis of studies. Ten observational studies were included in this review, including a total of 321 cases and 323 controls with ages between 3 and 61 years and the majority were males (62%). Two studies were done exclusively on children below 17 years old. The significant difference between salivary glucose levels in type 1 diabetes mellitus and controls were reported in 6 studies with 8 data sets. Five studies with 7 datasets reported the correlation coefficient between salivary glucose and blood glucose in patients with diabetes. Findings suggest that salivary glucose concentrations may be helpful in monitoring glycaemia in type 1 diabetes mellitus. However, the utility of using salivary glucose level to monitor glycaemia should be evaluated in future well designed, prospective studies with adequate number of participants with type 1 diabetes mellitus.
Kekäläinen, Päivi; Tirkkonen, Hilkka; Laatikainen, Tiina
We assessed the prevalence of Type 1 diabetes mellitus and determined how the targets established in the guidelines for patients with Type 1 diabetes mellitus were achieved in clinical practice in North Karelia, Finland. All adult Type 1 diabetes mellitus patients (n=1075) were identified from the regional electronic patient database. The data for HbA1c and LDL cholesterol measurements during the years 2013 and 2014 were obtained from medical records. The prevalence of Type 1 diabetes mellitus in the adult population in North Karelia was 0.8%, which is among the highest worldwide. HbA1c and LDL cholesterol were measured in 93% and 90% of participants, respectively. Nineteen percent of patients reached the HbA1c target of diabetes achieved glycaemic control targets compared with 13-16% of younger patients with diabetes. Glycaemic control was in line with the recommendations in only one-fifth of Type 1 diabetes mellitus patients and less than half of them had LDL cholesterol levels within the target range. Interestingly, older Type 1 diabetes mellitus patients met the glycaemic control target more often than younger patients with diabetes. The targets established for patients with Type 1 diabetes mellitus are not achieved satisfactorily in daily practice. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Myocardial accumulation of MIBG was studied in forty diabetic patients, including 17 with type 1 diabetes mellitus (type 1 DM, mean age 52.1±17 y.) and 23 with type 2 diabetes mellitus (type 2 DM, mean age 61.6±12 y.). Sixteen nondiabetic normal volunteers without hypertension (mean age 54.6±16 y.) were studied as controls. Type 2 DM patients showed a significantly lower heart-to-mediastinum ratio (15 min.: 2.34±0.35, 3 hr.: 2.27±0.41) than control subjects (15 min.: 2.73±0.25, 3 hr.: 2.95±0.40) (p<0.05), but Type 2 DM patients did not. Type 2 DM patients showed higher washout rate of MIBG (31.7±12%) than control subjects (19.3±7.4%) (p<0.05), but type 2 DM patients did not. Thirteen of the 17 type 1 DM patients (76.4%) and 12 of the 23 type 2 DM patients (52.2%) showed regional defects on MIBG SPECT. Myocardial MIBG defects in diabetics were mainly found in the inferior, septal and lateral regions of the myocardium. In type 1 DM, the patients with MIBG defects had longer duration of the disease, showed much more decrease of the systolic pressure with standing and lower CV level of the R-R interval on ECG than the patients without MIBG defects, but not in type 2 DM patients. These results show that type 1 DM patients show much more abnormal MIBG accumulation than type 2 DM patients. It suggests that the glycemic control including the early stage of diabetes influences the cardiac sympathetic function in diabetics. (author)
Nancy S. Elbarbary. Assistant Professor of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Background. Diabetes mellitus type 1 (T1DM) is a complex disease resulting from the interplay of genetic, epigenetic, and environmental factors.1 Worldwide,. T1DM epidemic represents an increasing global.
Subramaniam, Priya; Sharma, Akhliesh; Kaje, Keerthan
Metabolic disturbances in diabetes mellitus can affect oral health. Altered levels of salivary lipids have been suggested as a risk for dental caries. There has been lack of research in this regard and in children with type 1 diabetes mellitus. To assess the salivary triglycerides and cholesterol levels in children with type 1 diabetes mellitus and correlate them with their dental caries status. Thirty children aged 12-16 years with type 1 diabetes mellitus and 30 age- and gender-matched healthy children were included in the study. Unstimulated saliva was collected from each child and evaluated for salivary triglyceride and cholesterol levels. Dental caries status (DMFT) was recorded. Salivary cholesterol and triglyceride levels were significantly higher in children with type 1 diabetes mellitus (p ≤ 0.05). In comparison to controls, mean DMFT score was higher in the diabetic children. Salivary triglycerides showed a significant correlation with dental caries status in the study group (p = 0.035). In normal children, salivary cholesterol levels showed a significant association with dental caries. (p = 0.008). Both salivary cholesterol and triglycerides levels were significantly higher in children with type 1 diabetes mellitus. Salivary triglycerides showed a significant association with dental caries in these children. © 2014 Special Care Dentistry Association and Wiley Periodicals, Inc.
Kettner, Laura Ozer; Matthiesen, Niels Bjerregaard; Ramlau-Hansen, Cecilia Høst; Kesmodel, Ulrik Schiøler; Bay, Bjørn; Henriksen, Tine Brink
To investigate the association between specific types of fertility treatment and childhood type 1 diabetes mellitus. Nationwide birth cohort study. Not applicable. All pregnancies resulting in a live-born singleton child in Denmark from 1995 to 2003. Not applicable. Childhood type 1 diabetes mellitus identified from redeemed prescriptions for insulin until 2013. The study included 565,116 singleton pregnancies. A total of 14,985 children were conceived by ovulation induction or intrauterine insemination, and 8,490 children were conceived by in vitro fertilization or intracytoplasmic sperm injection. During the follow-up period, 2,011 (0.4%) children developed type 1 diabetes mellitus. The primary analyses showed no association between fertility treatment and childhood type 1 diabetes mellitus. In secondary analyses, ovulation induction or intrauterine insemination with follicle-stimulating hormone was associated with an increased risk of type 1 diabetes mellitus (hazard ratio 3.22; 95% confidence interval 1.20 to 8.64). No clear associations were seen with other types of fertility treatment or with specific treatment indications. No association between fertility treatment and childhood type 1 diabetes mellitus was found. Ovulation induction or intrauterine insemination with follicle-stimulating hormone may be associated with an increased risk of childhood type 1 diabetes mellitus. However, this finding may be due to chance or to confounding by indication and thus requires further investigation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Desta, Semere Tekeste
Høgskulen på Vestlandet Avdeling for helsefag for sykepleiere Tittel: Diabetes type 1 Bakgrunn for val av tema: I 2000 var det ca. 130 000 personer i Norge med diabetes, av disse hadde ca. 20 000 diabetes type 1. I dag er det ca. 230 000 personer som har diabetes i Norge. Av disse ca. 28 000 type 1 diabetes. Tallet viser hvor alvorlig sykdommen er, fordi det har vært og fortsatt er, en økning av antall diabetikere i Norge. Type 1 diabetes kan komme i alle aldersgrupper, men vanligvis...
Langendam, Miranda; Luijf, Yoeri M.; Hooft, Lotty; DeVries, J. Hans; Mudde, Aart H.; Scholten, Rob J. P. M.
Background Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that
Passanisi, Stefano; Timpanaro, Tiziana; Lo Presti, Donatella; Caruso-Nicoletti, Manuela
Primary adrenocortical insufficiency or Addison's disease is caused by a progressive destruction of the adrenal cortex, resulting into a reduction of glucocorticoids, mineralocorticoids, and androgens. Autoimmune Addison's disease is the most common etiological form, accounting for about 80% of all cases. We describe the case of a 16-year-old Caucasian boy affected by type-1 diabetes mellitus and autoimmune thyroiditis, who experienced recurrent hypoglycaemia as presenting symptom of Addison's disease. Hypoglycaemia is not a common presenting feature of Addison's disease, both in patients with type-1 diabetes mellitus and in non-diabetic patients. However, hypoglycaemia may occur in association with primary and secondary glucocorticoid deficiency as a result of an enhanced insulin sensitivity. Hypoglycaemia is the most common acute complication of insulin therapy in patients with type-1 diabetes mellitus. Addison's disease has been described in approximately 0.5% of patients with type-1 diabetes mellitus, being more frequent in females and occurring in middle-aged patients. An association among type-1 diabetes mellitus, autoimmune thyroiditis, and Addison's disease is found in the "Schmidt's syndrome", a rare disorder that may occur in the paediatric age. Our case suggests that the presence of Addison's disease should be taken into consideration in patients with type-1 diabetes mellitus and frequent episodes of hypoglycaemia. We wish to highlight that there are no specific indications to screen for the association between Addison's disease and type-1 diabetes mellitus, although an early diagnosis of Addison's disease in diabetic patients would prevent the morbidity and potential mortality of this association.
Li, Wentao; Li, Muwei; Gao, Chuanyu; Wang, Xianpei; Qi, Datun; Liu, Jun; Jin, Qiangsong
To evaluate the influence of type 2 diabetes mellitus on the long-term outcomes of Chinese patients with previous myocardial infarction, we studied 864 patients with previous myocardial infarction, including 251 with type 2 diabetes mellitus and 613 without type 2 diabetes mellitus, over a median follow-up time of 2.9 years. The type 2 diabetes mellitus patients were subdivided into 95 insulin-treated diabetes mellitus and 156 non-insulin-treated diabetes mellitus subjects. The crude incidences (per 1000 patient-years) in the type 2 diabetes mellitus subjects versus the non-type 2 diabetes mellitus subjects were 43.7 versus 25.1 for recurrent myocardial infarction, 68.7 versus 28.3 for all-cause death and 99.8 versus 49.9 for the composite end point (i.e. recurrent myocardial infarction or all-cause death). Cox regression analysis showed that the adjusted hazard ratios for recurrent myocardial infarction, all-cause death and their combination were 1.67 (95% confidence interval: 1.06-2.74), 1.90 (1.25-2.90) and 1.72 (1.23-2.40), respectively. Significant associations were also observed between insulin treatment and all-cause death. Our findings suggested that type 2 diabetes mellitus is an independent risk factor for recurrent myocardial infarction, all-cause death and the composite end point among previous myocardial infarction patients. © The Author(s) 2016.
Full Text Available Objectives: To describe the demographic characteristics and clinical presentation of Omani children with type 1 diabetes mellitus at Sultan Qaboos University Hospital, Muscat, Oman. Methods: A retrospective analysis of all children with type 1 diabetes mellitus attending the Pediatric Endocrine Unit at Sultan Qaboos University Hospital, Oman from June 2006 to May 2013. Results: One hundred and forty-four patients were included in the study. The mean±SD of age at diagnosis was 6.7 ± 3.7 years. The median duration of symptoms was 10 days (IQR; 5-14. The most commonly reported presenting symptoms were polyuria (94%, polydipsia (82%, and weight loss (59%. Diabetic ketoacidosis at initial presentation was diagnosed in 31% of the patients. Different insulin regimens were prescribed: multiple daily injections in 109 (76% patients, twice daily insulin regimen in 23 (16% patients, and insulin pump therapy in 12 (8% patients. Family history of type 1 diabetes mellitus was present in 31 (22% patients. There were no significant differences in presenting complaints (polyuria, p=0.182; polydipsia, p=0.848, duration of symptoms (p=0.331, reported weight loss (p=0.753, or diabetic ketoacidosis at presentation (p=0.608 between patients with and without family history of type 1 diabetes mellitus. Conclusion: Polyuria, polydipsia and weight loss are the most common presenting symptoms. Family history of type 1 diabetes mellitus is highly prevalent among the studied patients. Diabetic ketoacidosis was found to be less common in Oman compared to other diabetes centers in the Middle East.
biochemical features.2 It is a coordinated series of events for the ... sex matched subjects with no clinical or laboratory signs or family history of ... Keywords: lymphocyte apoptosis; CD95 system; type 1 DM; prediabetes. Eman M. ..... percentage among complicated and non-complicated cases of type-1 diabetes mellitus.
Li, Wei; Huang, Edgar; Gao, Sujuan
Type 1 diabetes mellitus (T1DM) is a major subtype of diabetes and is usually diagnosed at a young age with insulin deficiency. The life expectancy of T1DM patients has increased substantially in comparison with that three decades ago due to the availability of exogenous insulin, though it is still shorter than that of healthy people. However, the relation remains unclear between T1DM and dementia as an aging-related disease. We conducted a systematic review of existing literature on T1DM and cognition impairments by carrying out searches in electronic databases Medline, EMBASE, and Google Scholar. We restricted our review to studies involving only human subjects and excluded studies on type 2 diabetes mellitus or non-classified diabetes. A meta-analysis was first performed on the relationship between T1DM and cognitive changes in youths and adults respectively. Then the review focused on the cognitive complications of T1DM and their relation with the characteristics of T1DM, glycemic control, diabetic complications, comorbidities, and others. First, age at onset, disease duration, and glycemic dysregulation were delineated for their association with cognitive changes. Then diabetic ketoacidosis, angiopathy, and neuropathy were examined as diabetic complications for their involvement in cognitive impairments. Lastly, body mass index and blood pressure were discussed for their relations with the cognitive changes. Future studies are needed to elucidate the pathogenesis of T1DM-related cognitive impairments or dementia.
Dafoulas, George E; Toulis, Konstantinos A; Mccorry, Dougall; Kumarendran, Balachadran; Thomas, G Neil; Willis, Brian H; Gokhale, Krishna; Gkoutos, George; Narendran, Parth; Nirantharakumar, Krishnarajah
The aim of this research was to explore the relationship between incident epilepsy and type 1 diabetes in British participants. Using The Health Improvement Network database, we conducted a retrospective, open-cohort study. Patients who were newly diagnosed with type 1 diabetes mellitus at the age of ≤40 years were identified and followed-up from 1 January 1990 to 15 September 2015. These patients, identified as not suffering from epilepsy at the time of diagnosis, were randomly matched with up to four individuals without type 1 diabetes mellitus, based on age, sex and participating general practice. A Cox regression analysis was subsequently performed using Townsend deprivation index, cerebral palsy, head injury and learning disabilities as model covariates. The study population consisted of a total of 24,610 individuals (4922 with type 1 diabetes and 19,688 controls). These individuals were followed up for a mean of 5.4 years (approximately 132,000 person-years of follow up). Patients with type 1 diabetes were significantly more likely to be diagnosed with epilepsy during the observation period compared with controls (crude HR [95% CI]: 3.02 [1.95, 4.69]). The incidence rate was estimated to be 132 and 44 per 100,000 person-years in patients and controls, respectively. This finding persisted after adjusting for model covariates (adjusted HR [95% CI]: 3.01 [1.93, 4.68]) and was also robust to sensitivity analysis, excluding adult-onset type 1 diabetes mellitus. Patients with type 1 diabetes are at approximately three-times greater risk of developing epilepsy compared with matched controls without type 1 diabetes. This should be considered when investigating seizure-related disorders in patients with type 1 diabetes mellitus.
Oleg Gennad'evich Motovilin; Ol'ga Vital'evna Lunyakina; Elena Viktorovna Surkova; Yuliya Andreevna Shishkova; Ol'ga Georgievna Mel'nikova; Aleksandr Yur'evich Mayorov
Aims: To compare disease attitudes in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM) and to evaluate relationship between attitudes and psychological welfare of these groups.Materials and Methods: We examined 140 patients with T1DM and 70 patients with T2DM on insulin therapy (mean age 22.6±3.2 and 60.1±7.8 years; male/female ratio 47/93 and 15/55; duration of diabetes 12.1±5.7 and 11.4±6.5 years, HbA1c 9.3±2.2 и 9.0±1.4%, respectively). Psychological parameters were assess...
Ping, Zhang; Aiqun, Ma; Jiwu, Li; Liang, Shao
Inflammation plays an important role in heart failure and diabetes mellitus. Traditional serum markers have limited predictive value in heart failure and diabetes. TNFR1 and TNFR2 (TNFR1/2) have been proven to be strongly associated with heart failure and diabetes complications. This study aimed to assess the association of sTNFR1 and sTNFR2 levels and incidental HF risk in diabetes patients.We detected the mRNA, protein, and serum expression of TNFR1/2, their downstream signaling pathway protein NF-kB, and JNK expression and some traditional serum inflammatory markers in a heart failure group without diabetes mellitus or abnormal glucose tolerance (n = 84), a diabetes mellitus group without heart failure (n = 86), and a heart failure with diabetes mellitus group (n = 86).TNFR1/2 were significantly higher in patients with heart failure and diabetes mellitus based on mRNA expression to protein expression and serum expression. However, there were no differences in mRNA, protein, and serum levels of TNFR1/2 between the HF group and DM group. Furthermore, there were no differences between the groups in some traditional serum inflammatory markers.This study demonstrated higher expressions of TNFR, NF-kB, and JNK in patients with heart failure and diabetes mellitus. Compared with traditional serum markers, TNFR1 and TNFR2 are associated with heart failure risk in type 2 diabetes mellitus patients.
Vistisen, Dorte; Andersen, Gregers Stig; Hansen, Christian Stevns; Hulman, Adam; Henriksen, Jan Erik; Bech-Nielsen, Henning; Jørgensen, Marit Eika
Patients with type 1 diabetes mellitus are at increased risk of developing cardiovascular disease (CVD), but they are currently undertreated. There are no risk scores used on a regular basis in clinical practice for assessing the risk of CVD in type 1 diabetes mellitus. From 4306 clinically diagnosed adult patients with type 1 diabetes mellitus, we developed a prediction model for estimating the risk of first fatal or nonfatal CVD event (ischemic heart disease, ischemic stroke, heart failure, and peripheral artery disease). Detailed clinical data including lifestyle factors were linked to event data from validated national registers. The risk prediction model was developed by using a 2-stage approach. First, a nonparametric, data-driven approach was used to identify potentially informative risk factors and interactions (random forest and survival tree analysis). Second, based on results from the first step, Poisson regression analysis was used to derive the final model. The final CVD prediction model was externally validated in a different population of 2119 patients with type 1 diabetes mellitus. During a median follow-up of 6.8 years (interquartile range, 2.9-10.9) a total of 793 (18.4%) patients developed CVD. The final prediction model included age, sex, diabetes duration, systolic blood pressure, low-density lipoprotein cholesterol, hemoglobin A1c, albuminuria, glomerular filtration rate, smoking, and exercise. Discrimination was excellent for a 5-year CVD event with a C-statistic of 0.826 (95% confidence interval, 0.807-0.845) in the derivation data and a C-statistic of 0.803 (95% confidence interval, 0.767-0.839) in the validation data. The Hosmer-Lemeshow test showed good calibration (P>0.05) in both cohorts. This high-performing CVD risk model allows for the implementation of decision rules in a clinical setting. © 2016 American Heart Association, Inc.
Structural barriers to coping with Type 1 Diabetes Mellitus in Ghana: Experiences of diabetic youth and their families. ... Methods: Qualitative study conducted with families with a child with T1DM, receiving care in the greater Accra area. Total of 17 individuals ... Social support networks need to be explored and strengthened.
Holst, Jens Juul
inhibition of gastrointestinal motility and secretion in the presence of nutrients in the lower small intestine). However, because of these same actions, the hormone can normalise the blood glucose of patients with Type 2 diabetes mellitus, and, in contradistinction to insulin and sulphonylurea, it does...... not cause hypoglycaemia. Therefore, treatment of Type 2 diabetes based on GLP-1 is currently being investigated. As a peptide, it must be administered parenterally, and, in addition, it is metabolised extremely rapidly. However, several methods to circumvent these problems have already been developed. A GLP......-1- based therapy of diabetes mellitus and perhaps also obesity is therefore likely to become a realistic alternative to current therapies of these disorders....
Full Text Available Temporary remission of type 1 diabetes mellitus (T1DM occurs following initiation of insulin therapy. This period of temporary remission without insulin therapy is called ‘honeymoon period’. But no such temporary remission usually occurs in type 2 diabetes (T2DM. We report here two cases of type 2 diabetes mellitus where such honey moon period was observed. Ibrahim Med. Coll. J. 2008; 2(2: 67-69
Kodama, Satoru; Fujihara, Kazuya; Ishiguro, Hajime; Horikawa, Chika; Ohara, Nobumasa; Yachi, Yoko; Tanaka, Shiro; Shimano, Hitoshi; Kato, Kiminori; Hanyu, Osamu; Sone, Hirohito
The present meta-analysis aimed to clarify the association of unstable bodyweight with the risk of type 2 diabetes mellitus, an association that has been controversial among longitudinal studies. An electronic literature search using EMBASE and MEDLINE was followed up to 31 August 2016. The relative risks (RRs) of type 2 diabetes mellitus in individuals with unstable bodyweight were pooled using the inverse variance method. Eight studies were eligible for the meta-analysis. The median duration of measurements of weight change and follow-up years for ascertaining type 2 diabetes mellitus were 13.5 and 9.4 years, respectively. The pooled RR for the least vs most stable category was 1.33 (95% confidence interval 1.12-1.57). Between-study heterogeneity was statistically significant (P = 0.048). Whether type 2 diabetes mellitus was ascertained by blood testing explained 66.0% of the variance in the logarithm of RR (P = 0.02). In three studies in which blood testing was carried out, type 2 diabetes mellitus risk was not significant (RR 1.06, 95% confidence interval 0.91-1.25). Furthermore, publication bias that inflated type 2 diabetes mellitus risk was statistically detected by Egger's test (P = 0.09). Unstable bodyweight might be modestly associated with the elevated risk of type 2 diabetes mellitus; although serious biases, such as diagnostic suspicion bias and publication bias, made it difficult to assess this association. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Full Text Available Islet transplantation is an attractive treatment of type 1 diabetes mellitus (T1DM. Animal models of diabetes mellitus (DM contribute a lot to the experimental studies of islet transplantation and to evaluations of isolated islet grafts for future clinical applications. Diabetic nonhuman primates (NHPs represent the suitable models of DMs to better evaluate the effectiveness of islet transplantation, to assess new strategies for controlling blood glucose (BG, relieving immune rejection, or prolonging islet survival, and eventually to translate the preclinical data into tangible clinical practice. This review introduces some NHP models of DM, clarifies why and how the models should be used, and elucidates the usefulness and limitations of the models in islet transplantation.
Horton, William B; Subauste, Jose S
Type 1 diabetes mellitus (T1DM) results from a highly specific immune-mediated destruction of pancreatic β cells, resulting in chronic hyperglycemia. For many years, one of the mainstays of therapy for patients with T1DM has been exercise balanced with appropriate medications and medical nutrition. Compared to healthy peers, athletes with T1DM experience nearly all the same health-related benefits from exercise. Despite these benefits, effective management of the T1DM athlete is a constant challenge due to various concerns such as the increased risk of hypoglycemia. This review seeks to summarize the available literature and aid clinicians in clinical decision-making for this patient population. PubMed searches were conducted for "type 1 diabetes mellitus AND athlete" along with "type 1 diabetes mellitus AND exercise" from database inception through November 2015. All articles identified by this search were reviewed if the article text was available in English and related to management of athletes with type 1 diabetes mellitus. Subsequent reference searches of retrieved articles yielded additional literature included in this review. The majority of current literature available exists as recommendations, review articles, or proposed societal guidelines, with less prospective or higher-order treatment studies available. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the management of athletes living with T1DM. Managing T1DM in the context of exercise or athletic competition is a challenging but important skill for athletes living with this disease. A proper understanding of the hormonal milieu during exercise, special nutritional needs, glycemic control, necessary insulin dosing adjustments, and prevention/management strategies for exercise-related complications can lead to successful care plans for these patients. Individualized management strategies should be created with close cooperation
Maleckas, A; Venclauskas, L; Wallenius, V; Lönroth, H; Fändriks, L
The prevalence of diabetes is increasing worldwide, and most of the cases are type 2 diabetes mellitus. The relationship between type 2 diabetes mellitus and obesity is well established, and surgical treatment is widely used for obese patients with type 2 diabetes mellitus. The aim was to present current knowledge about the possible mechanisms responsible for glucose control after surgical procedures and to review the surgical treatment results. Medical literature was searched for the articles presenting the impact of surgical treatment on glycemic control, long-term results, and possible mechanisms of action among obese individuals with type 2 diabetes mellitus. Remission of type 2 diabetes mellitus after bariatric surgery depends on the definition of the remission used. Complete remission rate after surgery with the new criteria is lower than was considered before. Randomized controlled studies demonstrate that surgery is superior to best medical treatment for the patients with type 2 diabetes mellitus. The recurrence of type 2 diabetes mellitus after bariatric surgery is observed in up to 40% of cases with ≥ 5 years of follow-up. Despite the recurrence of type 2 diabetes mellitus in this group, better glycemic control and lower risk of macrovascular complications are present. Incretin effects on glycemic control after bariatric surgery are well described, but the role of other possible mechanisms (bile acids, microbiota, intestinal gluconeogenesis) in humans is unclear. Surgery is an effective treatment of type 2 diabetes mellitus in obese patients. The most optimal surgical procedure for the treatment of obese patients with type 2 diabetes mellitus is still to be established. More research is needed to explore the mechanisms of glycemic control after bariatric surgery. © The Finnish Surgical Society 2015.
Ramadass, S; Basu, Sharbari; Srinivasan, A R
Magnesium deficiency is commonly associated with endocrine and metabolic disorders, especially with Diabetes Mellitus type 2 though the mechanism of hypomagnesemia in Diabetes Mellitus is not completely known. There is a close association between metabolic control of Diabetes Mellitus and impaired magnesium balance. To estimate the serum levels of magnesium in patients of with Diabetes Mellitus type 2 and to find a correlation if any, with the duration and control (by estimating HbA1c) of Diabetes Mellitus type 2. Fifty patients of Diabetes Mellitus type 2 were included in the study. Blood samples were analyzed for fasting and post prandial glucose, HbA1c and magnesium. The patients were grouped into three categories based upon their HbA1c levels into those with good control, need intervention and poor control. The three groups were compared with reference to their mean levels of blood glucose and magnesium. Association of serum magnesium levels with HbA1c, Fasting and postprandial blood glucose and duration of Diabetes Mellitus was also done. Serum magnesium levels were found to decline with rise in HbA1c levels and with duration of Diabetes Mellitus type 2. Hypomagnesemia is linked to poor control of Diabetes Mellitus type 2 and depletion of serum magnesium occurs exponentially with duration of disease. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Moura, Denizielle de Jesus Moreira; Moura, Nádya Dos Santos; Menezes, Luciana Catunda Gomes de; Barros, Ariane Alves; Guedes, Maria Vilani Cavalcante
to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition. the work resulted in the production of the final version of the educational booklet, which was titled Aplicando a insulina: a aventura de Beto [Applying insulin: Beto's adventure]. The process of developing of the booklet was based on the active participation of the children and guided by the theoretical framework of Piagetian Constructivism. the resource is a facilitator for the improvement of the knowledge and practices of self care of children with Diabetes Mellitus type 1.
Full Text Available Introduction/Objective. Hand functions have an enormous impact on activities of daily living in patients with diabetes mellitus (DM, such as self-care, administering insulin injections, and preparing and eating meals. The aim of the study was to evaluate hand functions and grip strength in patients with type 1 and type 2 DM. Methods. This was an observational case-control study investigating the hand functions and grip strength in patients with type 1 and type 2 DM. The study comprised 41 patients with type 1 DM aged 25–50 years sex- and age-matched, 40 non-diabetic controls, and 91 patients with type 2 DM aged 40–65 years sex- and age-matched 60 non-diabetic controls. Patients with documented history of diabetic sensorimotor neuropathy and adhesive capsulitis were excluded. The Duruoz Hand Index was used to assess the functional hand disability. Grip strength was tested with a calibrated Jamar dynamometer. Results. The Duruoz Hand Index scores in patients with type 2 DM were significantly higher than in persons in the control group (p 0.05. Grip strength values of patients with type 1 DM were significantly lower compared to those in the control group (p < 0.05, whereas there was no significant difference between patients with type 2 DM and their control group. There was a negatively significant correlation between grip strength and the Duruoz Hand Index scores in patients with both type 1 and type 2 DM (p < 0.05. Conclusion. Patients with type 1 DM and type 2 DM have different degrees of hand disability as compared to healthy control groups.
Li, Xia; Wang, Jingli; Yang, Qin; Shao, Shiying
Obesity is one of the most significant contributors to the development of type 2 diabetes mellitus. Tissue-specific glucocorticoids regulated by 11β-hydroxysteroid dehydrogenase enzyme (11β-HSD) type 1 are involved in central obesity and obesity-related comorbidities. Moderate downregulation of 11β-HSD1 can attenuate insulin insensitivity and the impairment of glucose-stimulated insulin secretion. Some of the beneficial effects of 11β-HSD1 inhibition may be mediated, at least in part, through inactivation of tissue-specific glucocorticoid action related to insulin signaling mechanisms, alleviation of abnormal cytokine profile and the improvement of β-cell function. Thus, 11β-HSD1 is a promising target for the treatment and prevention of type 2 diabetes mellitus with obesity. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
Fang, Penghua; Shi, Mingyi; Zhu, Yan; Bo, Ping; Zhang, Zhenwen
The increasing prevalence of type 2 diabetes mellitus with its high morbidity and mortality becomes an important health problem. The multifactorial etiology of type 2 diabetes mellitus is relative to many gene and molecule alterations, and increased insulin resistance. Besides these, however, there are still other predisposing and risk factors accounting for type 2 diabetes mellitus not to be identified and recognized. Emerging evidence indicated that defects in galanin function played a crucial role in development of type 2 diabetes mellitus. Galanin homeostasis is tightly relative to insulin resistance and is regulated by blood glucose. Hyperglycemia, hyperinsulinism, enhanced plasma galanin levels and decreased galanin receptor activities are some of the characters of type 2 diabetes mellitus. The discrepancy between high insulin level and low glucose handling is named as insulin resistance. Similarly, the discrepancy between high galanin level and low glucose handling may be denominated as galanin resistance too. In this review, the characteristic milestones of type 2 diabetes mellitus were condensed as two analogical conceptual models, obesity-hyper-insulin-insulin resistance-type 2 diabetes mellitus and obesity-hyper-galanin-galanin resistance-type 2 diabetes mellitus. Both galanin resistance and insulin resistance are correlative with each other. Conceptualizing the etiology of type 2 diabetes mellitus as a disorder of galanin resistance may inspire a new concept to deepen our knowledge about pathogenesis of type 2 diabetes mellitus, eventually leading to novel preventive and therapeutic interventions for type 2 diabetes mellitus. Copyright © 2015 Elsevier Inc. All rights reserved.
Forga, Luis; Tamayo, Ibai; Chueca, María; Ibáñez, Berta; Sainz de Los Terreros, Amaya; Goñi, María José
Incidence of type 1 diabetes mellitus raises a number of controversies. Our study aim was to contribute to answer the following questions: Is incidence of T1DM increasing? Is age at onset of type 1 diabetes mellitus decreasing? Which are the sex differences? Which are the characteristics in adults? A cross-sectional descriptive study using data from a primary source and 3 secondary sources from Navarre collected between 01/01/2009 and 12/31/2016. Annual incidence rates and incidence rate expressed as 100,000 person-years were estimated in the study period by age and sex group. The comparison of the sex and age incidence was made estimating the incidence rate using Poisson's regression methods. The completeness of the register was 96.08%. During the 8 years analyzed, 428 new cases of type 1 diabetes mellitus were reported (incidence: 8.4/100,000 person-years, 95% CI: 7.6-9.2). Incidence has remained stable and is higher in the group under 15 years old (21.5) than in adults (5.9). Males aged 10-14 years and females aged 5-9 years were the groups with the highest incidence. Incidence then decreased with increasing age. Type 1 diabetes mellitus predominates in males aged 10-45 years, and no changes were seen in age at onset when analized by four-year periods. Navarre shows a very high incidence of type 1 diabetes mellitus in childhood and a low incidence in adulthood. Peak incidence is seen earlier in girls, but the disease predominates in males. Neither incidence nor age at onset have changed. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.
Tøraasen, Lisa Vangen; Al-Sultan, Zainab
Bacheloroppgave i sykepleie, 2014 Hvert år blir rundt 600 nordmenn diagnostisert med sykdommen diabetes type 1, og Norge er et av landene i verden med størst andel av barnediabetes. I dag er det 15 000- 20 000 personer i Norge som har diabetes type 1, og antall barn som får diabetes har fordoblet seg de siste 30 årene (Diabetesforbundet, 2014). Problemstillingen vår gikk ut på hvordan sykepleiere kan veilede og undervise ungdom med nyoppdaget diabetes type på sykehus. Ut i fra litteraturst...
Tøraasen, Lisa Vangen; Al-Sultan, Zainab
Hvert år blir rundt 600 nordmenn diagnostisert med sykdommen diabetes type 1, og Norge er et av landene i verden med størst andel av barnediabetes. I dag er det 15 000- 20 000 personer i Norge som har diabetes type 1, og antall barn som får diabetes har fordoblet seg de siste 30 årene (Diabetesforbundet, 2014). Problemstillingen vår gikk ut på hvordan sykepleiere kan veilede og undervise ungdom med nyoppdaget diabetes type på sykehus. Ut i fra litteraturstudiet har vi arbeidet oss frem for å ...
Ana Paula Martins
Full Text Available Introduction: Glucagon-like peptide analogues are a new class of drugs used in the treatment of type 2 diabetes mellitus that mimic the endogenous hormone glucagon-like peptide 1. Glucagon-like peptide 1 regulates glucose levels by stimulating glucose-dependent insulin secretion, suppressing glucagon secretion, delayed gastric emptying and promoting satiety. The individualized treatment of type 2 diabetes mellitus, using various glucagon--like peptide receptor agonists, has recently been described and the interest related to these drugs continues to grow. Objectives: To review the efficacy and safety of glucagon-like peptide 1 agonists in patients with inadequately controlled type 2 diabetes mellitus on metformin alone, highlighting their added value in therapeutic use comparatively to second line oral therapies used in type 2 diabetes mellitus. Methods: Studies were obtained from electronic searches of The Cochrane Library and PubMed. Randomized controlled trials were selected if they were at least 8 weeks in duration; compared a glucagon-like peptide 1 analogue with an oral anti-diabetic agent in patients experiencing inadequate glycemic control with metformin monotherapy; and reported hemoglobin A1c data in non-pregnant adults with type 2 diabetes mellitus. Results: Of 72 potentially relevant articles identified, 23 were retrieved for detailed evaluation and 10 met the inclusion criteria. The majority of glucagon-like peptide 1 agonists showed equivalent or superior efficacy than most active comparators for reducing hemoglobin A1c, with a greater proportion of patients achieving hemoglobin A1c <7%. Glucagon-like peptide 1 agonists also showed extra-glycemic effects such as weight loss and the reduction of important cardiovascular parameters. Side effects included gastrointestinal complications, mainly nausea, vomiting and diarrhea. The incidence of hypoglycemia was less common for this class of agents. Conclusion: Glucagon-like peptide 1
Alves, Cresio; Menezes, Rafaela; Brandão, Marcia
Although type 1 diabetes mellitus (T1DM) has a significant impact on oral health, its association with dental caries is yet not clear. The aim of this study was to evaluate the salivary flow rate and caries in Brazilian youth with type 1 diabetes mellitus. A Cross-sectional study was performed in a tertiary university hospital. Fifty-one age matched subjects suffering from type 1 diabetes mellitus were selected for the study and evaluated for the following: salivary flow rate, number of decayed, missing and filled tooth in permanent dentition (DMF-T) and decayed, extracted, filled tooth index in the deciduous dentition (def-t); visible plaque index (VPI) and gingival bleeding index (GBI). STATISTICS AND ANALYSIS: The t test was utilized when the variables showed normal distribution. The Mann-Whitney test was utilized for comparing non-normal variables. Kolmorgorov-Smirnov test was used to assess the normality assumption. The differences were considered significant when P diabetics was 9.7 ± 1.9%. Salivary flow rate was lower in the diabetic patients as compared to controls (P = 0.02). No differences were found in the DMF-T/def-t indices of diabetic and non-diabetic patients (P = 0.43/0.14). VPI was similar in both the groups (P = 0.15). GBI was higher in the diabetics (8.1 vs. 5.18; P = 0.11). There were no differences in the dental caries experience and dental plaque in the two groups. The lower salivary flow rate in diabetics could have been related to their higher GBI. The higher GBI in the diabetics is a matter of concern in the diabetics and is a sign for higher chances of developing periodontal problems.
Hansen, Lars; Pedersen, Oluf
Throughout the last decade, molecular genetic studies of non-autoimmune diabetes mellitus have contributed significantly to our present understanding of this disease's complex aetiopathogenesis. Monogenic forms of diabetes (maturity-onset diabetes of the young, MODY) have been identified...... and classified into MODY1-6 according to the mutated genes that by being expressed in the pancreatic beta-cells confirm at the molecular level the clinical presentation of MODY as a predominantly insulin secretory deficient form of diabetes mellitus. Genomewide linkage studies of presumed polygenic type 2...... diabetic populations indicate that loci on chromosomes 1q, 5q, 8p, 10q, 12q and 20q contain susceptibility genes. Yet, so far, the only susceptibility gene, calpain-10 (CAPN10), which has been identified using genomewide linkage studies, is located on chromosome 2q37. Mutation analyses of selected...
Sejling, Anne-Sophie; Kjaer, Troels W; Pedersen-Bjergaard, Ulrik
of hypoglycemia. METHODS: Twenty-four patients with type 1 diabetes mellitus (10 with normal hypoglycemia awareness, 14 with hypoglycemia unawareness) were studied on 2 consecutive days by hyperinsulinemic glucose clamp at hypoglycemia (2.0-2.5 mmol/L) during a 1-h period. EEG was recorded, cognitive function...... assessed, and hypoglycemia symptom scores and counterregulatory hormonal responses were obtained. RESULTS: Twenty-one patients completed the study. Hypoglycemia-associated EEG changes were identified on both days with no differences in power or frequency distribution in the theta, alpha, or the combined...... diabetes mellitus....
Feb 28, 2018 ... COMMENTARY. DERMATOGLYPHIC PATTERNS IN TYPE 2 DIABETES. MELLITUS ... contributions in diabetes mellitus and in various medical disorders. Hence dermatoglyphic .... female cases. These findings are similar to ...
Machado, Diogo; Coelho, Ana; Paula, Anabela; Caramelo, Francisco; Carrilho, Francisco; Barros, Luísa; Batista, Carla; Melo, Miguel; Ferreira, Manuel Marques; Carrilho, Eunice
In addition to macro and microvascular complications that are associated with the disease, hyperglycaemia is also a risk factor for several oral complications. The aim of this study is to establish a relationship between dental caries in patients with type 1 diabetes mellitus treated with multiple insulin injections and that of individuals without diabetes. It is also an aim to characterize the oral hygiene habits of this population. An observational clinical study of analytical and cross-sectional nature was conducted. Thirty patients with type 1 diabetes mellitus and 30 individuals without diabetes were observed and questioned about information regarding their medical history. Oral examination was conducted according to the standards of the World Health Organization and ICDAS was used for caries detection. Statistical analysis was performed and the significance level was set at 5%. Patients with diabetes mellitus showed similar caries levels to that of individuals without diabetes. Patients with diabetes mellitus had a higher dental plaque index. Only 10% of the patients having episodes of nocturnal hypoglycaemia brush their teeth after glucose intake. Although there's some controversy in the literature regarding the prevalence of caries in patients with diabetes mellitus, the results are in agreement with a great number of studies. However, patients with diabetes mellitus have a higher plaque index which can be associated with a higher risk for developing certain oral pathologies. No statistically significant association was found between type 1 diabetes mellitus and dental caries.
Rhee, Ki-Jong; Lee, Chang Gun; Kim, Sung Woo; Gim, Dong-Hyeon; Kim, Hyun-Cheol; Jung, Bae Dong
Diabetes mellitus (DM) is caused by either destruction of pancreatic β-cells (type 1 DM) or unresponsiveness to insulin (type 2 DM). Conventional therapies for diabetes mellitus have been developed but still needs improvement. Many diabetic patients have complemented conventional therapy with alternative methods including oral supplementation of natural products. In this study, we assessed whether Ginkgo biloba extract (EGb) 761 could provide beneficial effects in the streptozotocin-induced type 1 DM and high-fat diet-induced type 2 DM murine model system. For the type 1 DM model, streptozotocin-induced mice were orally administered EGb 761 for 10 days prior to streptozotocin injection and then again administered EGb 761 for an additional 10 days. Streptozotocin-treated mice administered EGb 761 exhibited lower blood triglyceride levels, lower blood glucose levels and higher blood insulin levels compared to streptozotocin-treated mice. Furthermore, liver LPL and liver PPAR-α were increased whereas IL-1β and TNF-α were decreased in streptozotocin-injected mice treated with EGb 761 compared to mice injected with streptozotocin alone. For the type 2 DM model, mice were given high-fat diet for 60 days and then orally administered EGb 761 every other day for 80 days. We found that mice given a high-fat diet and EGb 761 showed decreased blood triglyceride levels, increased liver LPL, increased liver PPAR-α and decreased body weight compared to mice given high-fat diet alone. These results suggest that EGb 761 can exert protective effects in both type 1 and type 2 DM murine models.
Kwai, Natalie; Arnold, Ria; Poynten, Ann M; Lin, Cindy S-Y; Kiernan, Matthew C; Krishnan, Arun V
Diabetic peripheral neuropathy is a common and debilitating complication of diabetes mellitus. Although strict glycaemic control may reduce the risk of developing diabetic peripheral neuropathy, the neurological benefits of different insulin regimens remain relatively unknown. In the present study, 55 consecutive patients with type 1 diabetes mellitus underwent clinical neurological assessment. Subsequently, 41 non-neuropathic patients, 24 of whom were receiving multiple daily insulin injections (MDII) and 17 receiving continuous subcutaneous insulin infusion (CSII), underwent nerve excitability testing, a technique that assesses axonal ion channel function and membrane potential in human nerves. Treatment groups were matched for glycaemic control, body mass index, disease duration and gender. Neurophysiological parameters were compared between treatment groups and those taken from age and sex-matched normal controls. Prominent differences in axonal function were noted between MDII-treated and CSII-treated patients. Specifically, MDII patients manifested prominent abnormalities when compared with normal controls in threshold electrotonus (TE) parameters including depolarizing TE(10-20ms), undershoot and hyperpolarizing TE (90-100 ms) (P type 1 diabetes is maintained within normal limits in patients treated with continuous subcutaneous insulin infusion and not with multiple daily insulin injections. This raises the possibility that CSII therapy may have neuroprotective potential in patients with type 1 diabetes. Copyright © 2014 John Wiley & Sons, Ltd.
Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians sh...
Morgan, Eileen; Halliday, Sophia R; Campbell, Gemma R; Cardwell, Chris R; Patterson, Chris C
The aim of this study was to investigate the association between routine vaccinations and the risk of childhood type 1 diabetes mellitus by systematically reviewing the published literature and performing meta-analyses where possible. A comprehensive literature search was performed of MEDLINE and EMBASE to identify all studies that compared vaccination rates in children who subsequently developed type 1 diabetes mellitus and in control children. ORs and 95% CIs were obtained from published reports or derived from individual patient data and then combined using a random effects meta-analysis. In total, 23 studies investigating 16 vaccinations met the inclusion criteria. Eleven of these contributed to meta-analyses which included data from between 359 and 11,828 childhood diabetes cases. Overall, there was no evidence to suggest an association between any of the childhood vaccinations investigated and type 1 diabetes mellitus. The pooled ORs ranged from 0.58 (95% CI 0.24, 1.40) for the measles, mumps and rubella (MMR) vaccination in five studies up to 1.04 (95% CI 0.94, 1.14) for the haemophilus influenza B (HiB) vaccination in 11 studies. Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with high methodology quality scores. Neither this restriction by quality nor the original authors' adjustments for potential confounding made a substantial difference to the pooled ORs. This study provides no evidence of an association between routine vaccinations and childhood type 1 diabetes.
Hirsch Irl B
Full Text Available Abstract Introduction The presentation, diagnosis, clinical course and treatment of a man with hyperthyroidism secondary to autoimmune thyroiditis in the setting of type 1 diabetes mellitus has not previously been described. Case presentation A 32-year-old European-American man with an eight-year history of type 1 diabetes mellitus presented with an unintentional 22-pound weight loss but an otherwise normal physical examination. Laboratory studies revealed a suppressed thyroid-stimulating hormone concentration and an elevated thyroxine level, which are consistent with hyperthyroidism. His anti-thyroid peroxidase antibodies were positive, and his thyroid-stimulating immunoglobulin test was negative. Uptake of radioactive iodine by scanning was 0.5% at 24 hours. The patient was diagnosed with autoimmune thyroiditis. Six weeks following his initial presentation he became clinically and biochemically hypothyroid and was treated with thyroxine. Conclusion This report demonstrates that autoimmune thyroiditis presenting as hyperthyroidism can occur in a man with type 1 diabetes mellitus. Autoimmune thyroiditis may be an isolated manifestation of autoimmunity or may be part of an autoimmune polyglandular syndrome. Among patients with type 1 diabetes mellitus who present with hyperthyroidism, Graves' disease and other forms of hyperthyroidism need to be excluded as autoimmune thyroiditis can progress quickly to hypothyroidism, requiring thyroid hormone replacement therapy.
Pouwer, Frans; Kupper, Nina; Adriaanse, Marcel C
and the development of type 2 diabetes mellitus. Results of longitudinal studies suggest that not only depression but also general emotional stress and anxiety, sleeping problems, anger, and hostility are associated with an increased risk for the development of type 2 diabetes. Conflicting results were found......According to the World Health Organization, approximately 220 million people worldwide have type 2 diabetes mellitus. Patients with type 2 diabetes not only have a chronic disease to cope with, they are also at increased risk for coronary heart disease, peripheral vascular disease, retinopathy......, nephropathy, and neuropathy. The exact causes of type 2 diabetes are still not clear. Since the 17th century, it has been suggested that emotional stress plays a role in the etiology of type 2 diabetes mellitus. So far, review studies have mainly focused on depression as a risk factor for the development...
Hirsch Irl B; Amory John K
Abstract Introduction The presentation, diagnosis, clinical course and treatment of a man with hyperthyroidism secondary to autoimmune thyroiditis in the setting of type 1 diabetes mellitus has not previously been described. Case presentation A 32-year-old European-American man with an eight-year history of type 1 diabetes mellitus presented with an unintentional 22-pound weight loss but an otherwise normal physical examination. Laboratory studies revealed a suppressed thyroid-stimulating hor...
Koga, Masafumi; Kanehara, Hideo; Bando, Yukihiro; Morita, Shinya; Kasayama, Soji
Markedly elevated plasma glucose and relatively low HbA1c compared to plasma glucose is one diagnostic criterion for fulminant type 1 diabetes mellitus (FT1DM). Glycated albumin (GA) is a glycemic control marker that reflects glycemic control in shorter period than HbA1c. This study investigated whether GA is useful for differential diagnosis between FT1DM and acute-onset autoimmune type 1 diabetes mellitus (T1ADM) or not. This study included 38 FT1DM patients and 31 T1ADM patients in whom both HbA1c and GA were measured at the time of diagnosis. In FT1DM patients, as compared to T1ADM patients, both HbA1c and GA were significantly lower (HbA1c; 6.6±0.9% vs. 11.7±2.6%, P1, GA; 22.9±4.8% vs. 44.3±8.3%, P1). For differential diagnosis between FT1DM and T1ADM, ROC analysis showed that the optimum cut-off value for GA was 33.5% with sensitivity and specificity of 97.4% and 96.8%, respectively, while the optimum cut-off value for HbA1c was 8.7% with sensitivity and specificity of 100% and 83.9%, respectively. GA also may be useful for the differential diagnosis between FT1DM and T1ADM when the cut-off value can be set at 33.5%. Copyright © 2015 Elsevier B.V. All rights reserved.
Palumbo, Claudia; Nicolaci, Nora; La Manna, Andrés A; Branek, Natalia; Pissano, María N
Central diabetes insipidus is a rare disease of the hypothalamus and neurohypophysis. It is very unusually found in the adult with type 2 diabetes mellitus. It is manifested by a polydipsic polyuric syndrome, which must be distinguished from the poorly controlled type 2 diabetes mellitus. Given the similarity of both entities and the unusual nature of their coexistence, their suspicion is difficult. The case of a 72-year-old male with type 2 diabetes mellitus with poor insulin control (fasting hyperglycemia greater than 180 mg/dl) who had a long-standing polyuric syndrome is here presented. Hypernatremia and plasma osmolality elevated together with a low urinary osmolality led to the suspicion of diabetes insipidus, which was subsequently confirmed by the dehydration test and the administration of desmopressin sc. With 61% increase in the calculated urinary osmolarity one hour post desmopressin s.c., diabetes insipidus of central type was diagnosed. Nuclear Magnetic Resonance showed a bright spot with normal neurohypophysis, contributing to the diagnosis of the idiopathic form.
Work specifies the problems of children with diabetes mellitus type 1 - of site for health, in nutrition and social problems. The theoretical part is characterized by diabetes mellitus type 1, its causes, symptoms, treatment with diet and takes into account the specific problems arising from this condition for age. The practical part comprises the results of the questionnaire survey, which focuses on the problems of diabetes mellitus type 1 in childhood, and the level of knowledge about diabe...
Vilsbøll, T; Krarup, T; Sonne, J
in patients with diabetes mellitus. The aim of the present investigation was to investigate incretin secretion, in obesity and type 1 and type 2 diabetes mellitus, and its dependence on the magnitude of the meal stimulus. Plasma concentrations of incretin hormones (total, reflecting secretion and intact...... subjects (22% P = 0.04) during the large meal, compared with the small meal, perhaps reflecting the increased incretin response. We conclude: 1) that a decreased GLP-1 secretion may contribute to impaired insulin secretion in type 2 diabetes mellitus, whereas GIP and GLP-1 secretion is normal in type 1......, reflecting potential action) were measured during two meal tests (260 kcal and 520 kcal) in eight type 1 diabetic patients, eight lean healthy subjects, eight obese type 2 diabetic patients, and eight obese healthy subjects. Both in diabetic patients and in healthy subjects, significant increases in GLP-1...
Luik, PT; Kerstens, MN; Hoogenberg, K; Navis, GJ; Dullaart, RPF
Background Data on levels and responsiveness of PRA and aldosterone in type 1 diabetes mellitus are conflicting. Earlier studies were not standardized with respect to the type of diabetes mellitus, the presence of diabetic complications or sodium intake. Therefore, we studied plasma renin activity
O'Connor, T M
INTRODUCTION: Patients with Type 1 diabetes mellitus have a high prevalence of coeliac disease, symptoms of which are often mild, atypical, or absent. Untreated coeliac disease is associated with an increased risk of malignancy, particularly of lymphoma. We describe four patients with Type 1 diabetes mellitus and coeliac disease who developed lymphoma. CASE REPORTS: Two patients were male and two female. In three patients, coeliac disease and lymphoma were diagnosed simultaneously. Enteropathy-associated T cell lymphoma occurred in two patients, Hodgkin\\'s disease in one, and B cell lymphoma in one. Response to treatment was in general poor, and three patients died soon after the diagnosis of lymphoma was made. CONCLUSION: As the relative risk of lymphoma is reduced by a gluten-free diet, a high index of suspicion for coeliac disease should exist in all Type 1 diabetic patients with unexplained constitutional or gastrointestinal symptoms.
To summarize the data on the prevalence of type 1 diabetes mellitus among 15-34-year-aged Lithuania inhabitants (1991-2010). New prevalent cases consist of growing-up patients with diabetes onset in childhood, i.e., up to 14 years, new onset 15-34-year-aged type 1 diabetic patients Lithuanian inhabitants, and immigrants. The data on type 1 diabetes was collected with the help of general practitioners and regional endocrinologists in Lithuania. On 31 December 1991, there were 1202 adolescent and adult 15-34-year-aged patients with type 1 diabetes mellitus or 103.59 per 100,000 inhabitants of the same age group (95% Poisson CI 97.90-109.62), and at the end of 2010 - 1533 or 187.80 (178.63-197.44), respectively in Lithuania. During 19-year period the mean increase of type 1 diabetic patients was 1.25±1.94% per year or 1.47±2.74 per 100,000 inhabitants per mean year of the study period (for males 1.42±2.14% or 1.69±3.05/100,000 and for females 1.05±1.99%, or 1.24±2.92/100,000). Regression-based linear trends showed that the prevalence of type 1 diabetes mellitus in 15-34-year-age group had a tendency to increase among males (r=0.953; p1) and females (r=0.970; p1). The age adjusted prevalence frequencies for males and females in 1991 were correspondingly 102.81/100,000 and 104.55/100,000, and in 2010 - 193.75 and 182.01. The prevalence of type 1 diabetes mellitus among 15-34-year-age males and females had a tendency to increase during 1991-2010. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
Pu Li; Ji Ning; Zhu Wei
Objective: To investigate correlation between glycemic excursion by CGMS and diabetic retinopathy among type 2 diabetes mellitus. Methods: Used continuous glucose monitoring system (CGMS) to monitoring glycemic excursion within a day of twenty four patients with type 2 diabetes mellitus, and inspect fundus photography, correlation was analyzed. Results: Glycemic excursion might reveal the risk for diabetic retinopathy better than HbA1c does. Conclusion: Diabetic retinopathy may correlate with glycemic excursion. (authors)
Ratjen, I; Weber, K S; Roden, M; Herrmann, M-E; Müssig, K
The number of patients with type 1 diabetes mellitus who are actively participating in competitive sports is increasing. Here, we aimed to assess individual experiences of competitive athletes with type 1 diabetes and to compare these experiences with current recommendations. A survey of 20 competitive athletes with type 1 diabetes, categorized as endurance (n=10) and non-endurance (n=10) athletes, was performed. Endurance and non-endurance athletes did not differ in gender distribution, age, body mass index, and known diabetes duration. Self-reported target blood glucose values prior to exercise were lower in non-endurance than in endurance athletes (195±34 vs. 137±28 mg/dl, P=0.001). The majority of all athletes experienced activity-induced hypo- and hyperglycemic events, independently of exercise type. However, endurance athletes used additional carbohydrate units to prevent activity-induced hypoglycemic events more frequently without monitoring their blood glucose levels than non-endurance athletes (50% vs. 0%, P=0.01). The reduction of the insulin dose on training and competition days compared to days without exercise was similar for endurance and non-endurance athletes. These results point to a very individual adaption of the athlete's therapy during training and competition. However, there are distinct differences in diabetes management between endurance and non-endurance athletes. © Georg Thieme Verlag KG Stuttgart · New York.
Kittilsen, Jannike Granum; Lerfaldet, Hanne Nyhus; Norhaug, Anikken Thomassen; Tangen, Emmy Helene
Innledning: Diabetes mellitus type 2 er et økende problem både i Norge og internasjonalt. Forekomsten av diabetes mellitus type 2 er firedoblet fra 1980 til 2014. Hensikt: Undersøke hvordan livsstilsendringer kan forebygge utviklingen av diabetes mellitus type 2, og hva sykepleiers rolle er i forebyggingen. Metode: Det har blitt benyttet litteraturstudie som metode. Systematiske søk ble gjort i databasene: Cinahl Complete, Ovid Nursing Database og Medline. Resultat: Gjennom systematisk søk er...
Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.
S. V. Gautier; S. V. Arzumanov
Diabetes mellitus is a significant social problem. In the Russian Federation, the prevalence of diabetes type 1 is 340.000 people, 21% of them having diabetic nephropathy, as well as other secondary complications leading to disability and high mortality. There are several options for diabetic patients with chronic kidney disease dialysis: kidney transplantation with insulin therapy, simultaneous kidney-pancreas transplant or islet transplant. Good long-term results could be obtained by the wh...
Boehncke, S; Poettgen, K; Maser-Gluth, C; Reusch, J; Boehncke, W-H; Badenhoop, K
Treatment of type 1 diabetes mellitus (DM) aims to prevent complications by strictly optimizing blood glucose levels. Although physical exercise is an important part of metabolic control, endurance sports are considered hazardous for patients with type 1 diabetes because of the extreme physiological stress they represent. To further elucidate the metabolic challenge this form of exercise presented we investigated the performance of triathlon competitors with type 1 diabetes. Ten patients (32-61 years) with type 1 diabetes (disease duration 2-35 years) were followed for three years, during which each year they participated in one triathlon long-distance competitions (2.4 miles swimming, 26.2 miles running and 112 miles cycling; Ironman Germany 2005-2007). Glucose, cortisol, aldosterone, renin, thyroid hormones, testosterone, growth hormone and catecholamines were measured in blood and saliva. Five non-diabetic competitors served as controls. The performance equalled those of age-matched healthy athletes. Several participants experienced hyperglycemia early in the bike leg, whereas all of them developed low blood glucose levels during the marathon leg. Basal insulin supply was reduced up to 50 % on race day. Hormone levels in athletes with type 1 DM and healthy controls were similar. Patients with type 1 DM can successfully sustain extreme endurance challenges. Physiological alterations of the metabolic state complicated by type 1 DM can readily be compensated by adapting intensified insulin therapy and nutritional modifications. Thus 1 DM should not be regarded a contraindication to participating in high endurance sports.
Tavares Bello, Carlos; Capitão, Ricardo Miguel; Sequeira Duarte, João; Azinheira, Jorge; Vasconcelos, Carlos
Type 2 diabetes mellitus is a common disease, affecting up to 13.1% of the Portuguese population. In addition to the known micro and macrovascular complications, drug side effects constitute a major concern, leading to changes in the treatment guidelines, which favor safety over efficacy. Metformin is the first-line pharmacological treatment for most patients with type 2 diabetes mellitus; however, it has been associated with vitamin B12 deficiency in up to 30% of treated patients. The authors describe the prevalence of vitamin B12 deficiency in a diabetic population and explore the possible underlying factors. Retrospective, observational study. Clinical and laboratory data of type 2 diabetes mellitus patients whose vitamin B12 status was evaluated in the last decade (2005 - 2016) were analyzed. Patients with known malabsorptive syndromes or having undergone bariatric surgery were excluded from the study. Statistical analysis of the data was done and the results were considered statistically significant at p values 2.2 years and 11 ± 10.4 years of type 2 diabetes mellitus duration. These patients had a high prevalence of complications: diabetic renal disease 47.7%, neuropathy 9.2%, retinopathy 14.9%, coronary artery disease 8.4%, cerebrovascular disease 10.9%, and peripheral arterial disease 5.5%. Vitamin B12 deficiency (21.4% of the population and this subgroup was older (68.4 vs 65.8 years, p = 0.006), had a longer type 2 diabetes mellitus duration (13.35 vs 10.36 years; p = 0.001), higher prevalence of retinopathy (20.9% vs 13.3%; p = 0.005) and thyroid dysfunction (34% vs 23.7%; p = 0.002). Vitamin B12 deficiency was also more frequent in patients treated with metformin (24.7% vs 15.8%; p = 0.017), antiplatelet agents (25.4% vs 16.2%, p 26.8% vs 18.2%; p = 0.001). After adjustment for possible confounders, the variables associated with B12 deficiency were: metformin, hypothyroidism, age and type 2 diabetes mellitus duration. Despite the retrospective design
Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B
Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.
Hermann, Julia M; Rosenbauer, Joachim; Dost, Axel; Steigleder-Schweiger, Claudia; Kiess, Wieland; Schöfl, Christof; Holl, Reinhard W
Seasonal variation in blood pressure (BP) has been observed in different populations. However, only few studies have focused on BP seasonality in diabetic patients. This study examined the seasonal patterns in BP in 62,589 patients with type 1 diabetes mellitus (T1DM) and in 99,546 patients with type 2 diabetes mellitus (T2DM) from the German/Austrian Diabetes Follow-up Registry. Adjusted mean BP values revealed seasonal cycles of 12 months, with higher BP in colder months. Using harmonic regression models, the estimated systolic BP difference throughout the year was 2.28/2.48 mm Hg in T1DM/T2DM (both P1). Interestingly, seasonal variation in diastolic BP was larger in T1DM than in T2DM (1.24/0.64 mm Hg, P1). A sex difference was observed in T1DM only, while age differences occurred in both types of diabetes. Correlations between BP and potentially related factors such as outdoor temperature indicated that reasons underlying BP seasonality are likely to be complex and vary by subgroup. © 2015 Wiley Periodicals, Inc.
Full Text Available Central diabetes insipidus is a rare disease of the hypothalamus and neurohypophysis. It is very unusually found in the adult with type 2 diabetes mellitus. It is manifested by a polydipsic polyuric syndrome, which must be distinguished from the poorly controlled type 2 diabetes mellitus. Given the similarity of both entities and the unusual nature of their coexistence, their suspicion is difficult. The case of a 72-year-old male with type 2 diabetes mellitus with poor insulin control (fasting hyperglycemia greater than 180 mg/dl who had a long-standing polyuric syndrome is here presented. Hypernatremia and plasma osmolality elevated together with a low urinary osmolality led to the suspicion of diabetes insipidus, which was subsequently confirmed by the dehydration test and the administration of desmopressin sc. With 61% increase in the calculated urinary osmolarity one hour post desmopressin s.c., diabetes insipidus of central type was diagnosed. Nuclear Magnetic Resonance showed a bright spot with normal neurohypophysis, contributing to the diagnosis of the idiopathic form.
Larsen, Claus M; Faulenbach, Mirjam; Vaag, Allan
BACKGROUND: The expression of interleukin-1-receptor antagonist is reduced in pancreatic islets of patients with type 2 diabetes mellitus, and high glucose concentrations induce the production of interleukin-1beta in human pancreatic beta cells, leading to impaired insulin secretion, decreased cell...... proliferation, and apoptosis. METHODS: In this double-blind, parallel-group trial involving 70 patients with type 2 diabetes, we randomly assigned 34 patients to receive 100 mg of anakinra (a recombinant human interleukin-1-receptor antagonist) subcutaneously once daily for 13 weeks and 36 patients to receive...... placebo. At baseline and at 13 weeks, all patients underwent an oral glucose-tolerance test, followed by an intravenous bolus of 0.3 g of glucose per kilogram of body weight, 0.5 mg of glucagon, and 5 g of arginine. In addition, 35 patients underwent a hyperinsulinemic-euglycemic clamp study. The primary...
Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel
AND RELEVANCE: This study determines the contribution of genetic and environmental factors to the interaction between obesity, type 2 diabetes mellitus, and psoriasis. Psoriasis, type 2 diabetes mellitus, and obesity are also strongly associated in adults after taking key confounding factors, such as sex, age...... diagnoses of type 2 diabetes mellitus and self-reported BMI. Data were collected in the spring of 2002. Data were analyzed from January 1 to October 31, 2014. MAIN OUTCOMES AND MEASURES: Crude and adjusted odds ratios (ORs) were calculated for psoriasis in relation to type 2 diabetes mellitus, increasing...
Qiu, Ying-Hua; Deng, Fei-Yan; Li, Min-Jing; Lei, Shu-Feng
Type 1 diabetes mellitus is a serious disorder characterized by destruction of pancreatic β-cells, culminating in absolute insulin deficiency. Genetic factors contribute to the susceptibility of type 1 diabetes mellitus. The aim of the present study was to identify more susceptibility genes of type 1 diabetes mellitus. We carried out an initial gene-based genome-wide association study in a total of 4,075 type 1 diabetes mellitus cases and 2,604 controls by using the Gene-based Association Test using Extended Simes procedure. Furthermore, we carried out replication studies, differential expression analysis and functional annotation clustering analysis to support the significance of the identified susceptibility genes. We identified 452 genes associated with type 1 diabetes mellitus, even after adapting the genome-wide threshold for significance (P diabetes mellitus, which were ignored in single-nucleotide polymorphism-based association analysis and were not previously reported. We found that 53 genes have supportive evidence from replication studies and/or differential expression studies. In particular, seven genes including four non-human leukocyte antigen (HLA) genes (RASIP1, STRN4, BCAR1 and MYL2) are replicated in at least one independent population and also differentially expressed in peripheral blood mononuclear cells or monocytes. Furthermore, the associated genes tend to enrich in immune-related pathways or Gene Ontology project terms. The present results suggest the high power of gene-based association analysis in detecting disease-susceptibility genes. Our findings provide more insights into the genetic basis of type 1 diabetes mellitus.
Tong, Hoang Van; Luu, Nguyen Kim; Son, Ho Anh; Hoan, Nguyen Van; Hung, Trinh Thanh; Velavan, Thirumalaisamy P; Toan, Nguyen Linh
Adipose tissue-derived hormones are associated with metabolic disorders including type 2 diabetes mellitus. The present study investigated the levels of adiponectin and pro-inflammatory cytokines including tumor necrosis factor-α (TNF-α), interleukin-1 beta (IL-1β) and IL-10 in Vietnamese patients with type 2 diabetes mellitus, and their correlations with clinical parameters of overweight and type 2 diabetes mellitus. Based on body mass index, 73 patients with type 2 diabetes mellitus were categorized either as overweight or non-overweight. As healthy controls, 57 overweight and non-overweight individuals without type 2 diabetes mellitus were included. The adiponectin, TNF-α, IL-1β and IL-10 levels were measured in the sera samples in all study participants by enzyme-linked immunosorbent assay and were correlated with clinical parameters. The adiponectin levels were lower in patients with type 2 diabetes mellitus (2.5 ± 1.5 μg/mL) compared with controls (16 ± 18.6 μg/mL; P < 0.0001), and were decreased in overweight individuals compared with those who were not overweight. The TNF-α and IL-1β levels were increased, whereas the IL-10 levels were decreased in patients with type 2 diabetes mellitus and in overweight controls compared with non-overweight controls (P < 0.0001). The adiponectin levels were correlated with the TNF-α, IL-1β, IL-10 levels, and the clinical parameters of overweight and type 2 diabetes mellitus. The quantitative insulin sensitivity check index and homeostasis model assessment insulin resistance indexes were correlated with the relative ratios of adiponectin/TNF-α, adiponectin/IL-1β, adiponectin/IL-10, TNF-α/IL-10 and IL-1β/IL-10. Adiponectin and pro-inflammatory cytokines are associated with type 2 diabetes mellitus, and might serve as a prognostic marker and a therapeutic intervention for overweight-related type 2 diabetes mellitus. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the
Full Text Available Myotonic dystrophy type 1 (DM1 is an autosomal dominant multisystem disease affecting muscles, the eyes and the endocrine organs. Diabetes mellitus and primary hypogonadism are endocrine manifestations typically seen in patients with DM1. Abnormalities of hypothalamic–pituitary–adrenal (HPA axis have also been reported in some DM1 patients. We present a case of DM1 with a rare combination of multiple endocrinopathies; diabetes mellitus, a combined form of primary and secondary hypogonadism, and dysfunction of the HPA axis. In the present case, diabetes mellitus was characterized by severe insulin resistance with hyperinsulinemia. Glycemic control improved after modification of insulin sensitizers, such as metformin and pioglitazone. Hypogonadism was treated with testosterone replacement therapy. Notably, body composition analysis revealed increase in muscle mass and decrease in fat mass in our patient. This implies that manifestations of hypogonadism could be hidden by symptoms of myotonic dystrophy. Our patient had no symptoms associated with adrenal deficiency, so adrenal dysfunction was carefully followed up without hydrocortisone replacement therapy. In this report, we highlight the necessity for evaluation and treatment of multiple endocrinopathies in patients with DM1.
Banser, Alena; Naafs, Jolanda C; Hoorweg-Nijman, Jantine Jg; van de Garde, Ewoudt Mw; van der Vorst, Marja Mj
Advanced glycation end products (AGEs) are considered major contributors to microvascular and macrovascular complications in adult patients with diabetes mellitus. AGEs can be measured non-invasively with skin autofluorescence (sAF). The primary aim was to determine sAF values in children with type 1 diabetes mellitus and to study correlations between sAF values and HbA1c and mean HbA1c over the year prior to measurement In children with type 1 diabetes mellitus, sAF values were measured using the AGE Reader®. Laboratory and anthropometric values were extracted from medical charts. Correlations were studied using Pearson's correlation coefficient. Multivariable linear regression analysis was conducted to evaluate the effect of multiple study parameters on sAF values. The mean sAF value was 1.33 ± 0.36 arbitrary units (AU) in children with type 1 diabetes mellitus (n = 144). sAF values correlated positively with HbA1c measured at the same time (r = 0.485; p 1), mean HbA1c over the year prior to measurement (r = 0.578; p 1), age (r = 0.337; p 1), duration of type 1 diabetes mellitus (r = 0.277; p = 0.001), serum triglycerides (r = 0.399; p 1), and total cholesterol (r = 0.352; p = 0.001). sAF values were significantly higher in patients with non-white skin (1.56 vs. 1.27 AU, respectively, p = 0.001). In children with type 1 diabetes, sAF values correlate strongly with single HbA1c and mean HbA1c, making the non-invasive sAF measurement an interesting alternative to provide information about cumulative hyperglycemic states. To determine the value of sAF measurement in predicting long-term microvascular and macrovascular complications, further prospective follow-up studies are needed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
de Cássia Sparapani, Valéria; Liberatore, Raphael D. R., Jr.; Damião, Elaine B. C.; de Oliveira Dantas, Isa R.; de Camargo, Rosangela A. A.; Nascimento, Lucila C.
Background: Children with type 1 diabetes mellitus (T1DM) need to perform self-management activities at school and in other environments. Learning about their experiences at school is crucial to assist them in this challenging task. Methods: Qualitative interviews were conducted with children with T1DM, aged between 7 and 12. A scenario was…
1) Adolescent female patients with type 1 diabetes mellitus have better glycemic control and higher levels of diabetes distress than male patients. 2) Parents of adolescents using insulin pumps experience higher diabetes distress than parents of adolescents using multiple daily injections. 3) No differences in diabetes-related factors, emotional state, diabetes-related distress (in adolescent patients and in their primary care-givers) and social factors in groups of adolescent patients ...
Vreugdenhil, Gienke Rolien
Type I diabetes mellitus is a chronic autoimmune disease that results from the destruction of the insulin-producing beta-cells in the endocrine pancreas. There is strong evidence that besides genetic factors, environmental factors are involved in the pathogenesis of the disease. Increasing
Olokoba, A.B.; Bojuwoye, B.J.; Olokoba, K.B.; Braimoh, K.T.; Inikori, A.K.
To determine the factors predisposing patients with type-2 diabetes mellitus to gallstone disease. One hundred type 2 diabetic patients and 100 age and gender-matched controls underwent real time ultrasonography to study factors predisposing patients with type 2 diabetes mellitus to gallstone disease. The age, gender, body mass index (BMI), duration of diabetes mellitus and serum lipids were determined in the individuals enrolled for the study. Fifteen percent of the diabetic patients had ultrasound evidence of gallstone disease as compared to 7% in non-diabetic controls. There was a steady increase in the incidence of gallstone disease in diabetic patients with age with a peak incidence in the seventh decade i.e. 60-69 years, and a decline in the eighth decade i.e. 70 - 79 years. The average age of the diabetic patients with gallstone disease - 59.1+ 9.5 years was significantly higher than in those without gallstone disease - 51.8 + 10.5 years (p 0.014). The mean duration of disease in the diabetic patients with gallstone disease was 5.0 + 4.9 years compared with 4.5 + 3.8 years in the diabetic patients without gallstone disease (p=0.772). The mean serum cholesterol and triglyceride levels - 4.3 + 1.3 mmol/L and 1.5 + 0.8 mmol/L respectively in the diabetic patients with gallstone disease was higher than in those without gallstone disease - 3.4 + 0.5 mmol/L (p=0.0941) and 1.4 + 0.7 mmol/L (p=0.712) respectively. The mean body mass index for the diabetic patients with gallstone disease was 26.2 + 5.5 kg /m 2 compared with 25.7 + 6.7 kg/m2 in those without gallstone disease (p=0.755) . Increasing age is a risk factor for gallstone disease in diabetic patients. Hyperlipidaemia, female gender, heavier weight and a longer duration of diabetes mellitus appear to be associated risk factors. (author)
Zulfiya Raisovna Alimetova
Full Text Available Aim. To study excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus depending on gestational ageand albuminuria level. Materials and methods. A total of 60 pregnant women with type 1 diabetes mellitus were examined. Proximal and distal tubular function was estimatedfrom daily excretion of amine nitrogen and ammonia respectively. Results. Daily excretion of amine nitrogen and ammonia in urine of pregnant women with type 1 diabetes mellitus was lower than in healthycontrols in the 2nd trimester regardless of albuminuria and in the 3rd trimester in patients with microalbuminuria (MAU and proteinuria (PU.Ammonia excretion was twice lower than normal in the 2nd trimester in women with MAU and PU, and in the 3rd trimester in patients with PU.Healthy pregnant women showed significant correlation between ammonia and amine nitrogen excretion throughout pregnancy (r?0.833,p
Barma, Punyakrit Deb; Ranabir, Salam; Prasad, Lallan; Singh, Thangjam Premchand
Background: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m 2 . Materials and Methods: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). Results and Conclusion: The mean duration of diabetes was 51.7 months (rang...
Farahna, Mohammed; Seke Etet, Paul F; Osman, Sayed Y; Yurt, Kıymet K; Amir, Naheed; Vecchio, Lorella; Aydin, Isınsu; Aldebasi, Yousef H; Sheikh, Azimullah; Chijuka, John C; Kaplan, Süleyman; Adem, Abdu
The development of compounds able to improve metabolic syndrome and mitigate complications caused by inappropriate glycemic control in type 1 diabetes mellitus is challenging. The medicinal plant with established hypoglycemic properties Garcinia kola Heckel might have the potential to mitigate diabetes mellitus metabolic syndrome and complications. We have investigated the neuroprotective properties of a suspension of G. kola seeds in long-term type 1 diabetes mellitus rat model. Wistar rats, made diabetic by single injection of streptozotocin were monitored for 8 months. Then, they were administered with distilled water or G. kola oral aqueous suspension daily for 30 days. Body weight and glycemia were determined before and after treatment. After sacrifice, cerebella were dissected out and processed for stereological quantification of Purkinje cells. Histopathological and immunohistochemical analyses of markers of neuroinflammation and neurodegeneration were performed. Purkinje cell counts were significantly increased, and histopathological signs of apoptosis and neuroinflammation decreased, in diabetic animals treated with G. kola compared to diabetic rats given distilled water. Glycemia was also markedly improved and body weight restored to non-diabetic control values, following G. kola treatment. These results suggest that G. kola treatment improved the general condition of long-term diabetic rats and protected Purkinje cells partly by improving the systemic glycemia and mitigating neuroinflammation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Ana Paula Morais Fernandes
Full Text Available O diabetes mellitus do tipo 1 tem sido considerado uma doença auto-imune órgão-específica, decorrente da destruição seletiva das células betapancreáticas. Apresenta patogenia complexa, envolvendo a participação de vários fatores, dentre esses a susceptibilidade imunogenética com forte associação aos genes de histocompatibilidade (HLA, eventos ambientais e resposta auto-imune com presença de auto-anticorpos e/ou linfócitos auto-reativos, culminando em anormalidades metabólicas. Neste estudo, a revisão da literatura descreve os mecanismos pelos quais determinados fatores conferem susceptibilidade para o seu desencadeamento e, adicionalmente, as inovações na predição dessa desordem que, certamente, contribuirão para a assistência de enfermagem aos pacientes portadores do diabetes tipo 1.La Diabetes Mellitus tipo 1 ha sido considerada una enfermedad autoinmune órgano-específica debido a la destrucción selectiva de las células beta pancreáticas. Presenta una patogenia compleja, involucrando la participación de varios factores, entre esos la susceptibilidad inmunogenética con fuerte asociación a los genes de histocompatibilidad (HLA, eventos ambientales y respuesta autoinmune con presencia de auto-anticuerpos y/o linfocitos auto-reactivos, culminando en anormalidades metabólicas. En este estudio, la revisión de la literatura describe los mecanismos por los cuales determinados factores resultan en susceptibilidad para su desarrollo y, adicionalmente, las innovaciones en la predicción de ese desorden que, por cierto, van a contribuir para la atención de enfermería a los pacientes portadores de la diabetes tipo 1.Type 1 diabetes mellitus has been considered an organ-specific autoimmune disease derived from the selective destruction of pancreatic beta cells. It presents a complex pathogenesis, involving the participation of several factors, including the immunogenetic susceptibility with strong association to
Hashim, N A; Ariaratnam, S; Salleh, M R; Said, M A; Sulaiman, A H
To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus. This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes. A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors. The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.
Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM) by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progression starts at glycated hemoglobin (HbA1c) level of 7%. As per the American Diabetes Association, a new pediatric glycemic control target of HbA1c 20 years as compared to patients <10 years of age. Screening of these complications should be done regularly, and appropriate preventive strategies should be followed. Angiotensin converting enzyme inhibitors and angiotensin II receptor blocker reduce progression from microalbuminuria to macroalbuminuria and increase the regression rate to normoalbuminuria. Diabetic microvascular complications can be controlled with tight glycemic therapy, dyslipidemia management and blood pressure control along with renal function monitoring, lifestyle changes, including smoking cessation and low-protein diet. An integrated and personalized care would reduce the risk of development of microvascular complications in T1DM patients. The child with diabetes who receives limited care is more likely to develop long-term complications at an earlier age. Screening for subclinical complications and early interventions with intensive therapy is the need of the hour. PMID:25941647
Ahmed-Sarwar, Nabila; Nagel, Angela K; Leistman, Samantha; Heacock, Kevin
The purpose of this review is to identify and evaluate disease management of patients with type 1 diabetes mellitus (T1DM) who were treated with a sodium-glucose cotransporter 2 (SGLT-2) inhibitor as an adjunct to insulin therapy. A PubMed (1969 to March 2017) and Ovid (1946 to March 2017) search was performed for articles published utilizing the following MESH terms: canagliflozin, empagliflozin, dapagliflozin, type 1 diabetes mellitus, insulin dependent diabetes, insulin, sodium-glucose transporter 2. There were no limitations placed on publication type. All English-language articles were evaluated for association of SGLT-2 inhibitors and type 1 diabetes. Further studies were identified by review of pertinent manuscript bibliographies. All 3 SGLT-2 inhibitors, when combined with insulin, resulted in an overall reduction of hemoglobin A1C (up to 0.49%), lower total daily insulin doses, and a reduction in weight (up to 2.7 kg). The combination therapy of insulin and SGLT-2 inhibitors also resulted in a lower incidence of hypoglycemia. Study duration varied from 2 to 18 weeks. A review of the identified literature indicated that there is a potential role for the combination of SGLT-2 inhibitors with insulin in T1DM for improving glycemic control without increasing the risk of hypoglycemia. The short duration and small sample sizes limit the ability to fully evaluate the incidences of diabetic ketoacidosis and urogenital infections. The risks associated with this combination of medications require further evaluation.
Kor, Yilmaz; Geyikli, Iclal; Keskin, Mehmet; Akan, Muslum
Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Forty children and adolescents with T1DM (18 boys and 22 girls) and 30 healthy control subjects (17 boys and 13 girls) participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P 1). Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.
Shaikh, M.A.; Yakta, D.E.
Background: Diabetic retinopathy is one of the most common and serious complications of type 2 diabetes mellitus and a leading cause of blindness not only in Pakistan but also worldwide. So we conducted this study to record the frequency of diabetic retinopathy in known diabetic patients ten years after diagnosis of type 2 diabetes mellitus. Methods: The study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan for a period of 1 year from January 2008 to January 2010. The study group comprised of 200 patients of type 2 diabetes mellitus attending the medical clinic. All patients who were diagnosed as type 2 diabetes mellitus since ten years duration were included in the study. Retinopathy was graded into background, pre proliferative and proliferative retinopathy. Type 2 diabetes was diagnosed using the WHO criteria. Statistical analysis was carried out using the SPSS-11. Results: Diabetic retinopathy was found in 25.5% of the total Type 2 patients after ten years of diagnosis, and of these 4% of patients had proliferative retinopathy. Conclusion: Type 2 diabetic patients should be screened as early as possible to prevent permanent visual loss by timely management of diabetic retinopathy because diabetes is one of most common preventable cause of blindness in the world. (author)
Skelley, Jessica W; Elmore, Lindsey K; Kyle, Jeffrey A
To review the pharmacology, pharmacokinetics, safety, and efficacy of teplizumab and evaluate relevant clinical trial data. Searches of MEDLINE, International Pharmaceutical Abstracts, ClinicalTrials.gov, American Diabetes Association scientific posters, and Google Scholar (1966-May 2012) were conducted using the key words teplizumab, anti-CD3 monoclonal antibody, MGA031, and hOKT3γ1 (Ala-Ala). Searches were limited to articles published in English. Clinical trials evaluating teplizumab for type 1 diabetes mellitus (T1DM) published in English were selected from the data sources. All published relevant abstracts were included. References cited in identified articles were used for additional citations. T1DM accounts for up to 10% of all cases of diabetes mellitus. T1DM is characterized as a chronic and progressive autoimmune disease leading to the destruction of insulin-producing β-cells of the pancreas. Teplizumab is a humanized Fc-mutated anti-CD3 monoclonal antibody that alters the function of the T-lymphocytes that mediate the destruction of the insulin-producing β-cells. While clinical data are limited, both Phase 2 and Phase 3 studies have demonstrated preserved C-peptide response as a measure of insulin production, decreased exogenous insulin use, and improved glycemic control following a 12- to 14-day teplizumab infusion in patients diagnosed with T1DM within the previous 6 weeks. However, 1 Phase 3 trial failed to find the same benefits in those diagnosed with T1DM within the previous 12 weeks when a lower cumulative teplizumab dose was used. Initial studies indicated that teplizumab is well tolerated, with a self-limiting rash as the most commonly reported adverse effect. Teplizumab is an anti-CD3 human monoclonal antibody with promising activity in treatment of patients with T1DM. Results from Phase 3 trials are needed to further determine safety, efficacy, and dosing frequency.
Clausen, Tine D; Mathiesen, Elisabeth R; Hansen, Torben
Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes Context: In animal studies exposure to intrauterine hyperglycemia increases the risk of cardiovascular disease through only partly understood epigenetic mechanisms....... Human long-term follow-up studies on the same topic are few. Objective: To study the risk of overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus (GDM) or type 1 diabetes, and additionally to study associations between estimates of maternal...... hyperglycemia and outcome in the offspring Design: Follow-up study of 1,066 primarily Caucasians aged 18-27 years. Setting: Center for pregnant women with diabetes, Rigshospitalet, Denmark Participants: Offspring of women with diet-treated GDM (n=168) and an un-exposed reference group (n=141). Offspring...
Jebbink, H. J.; Bravenboer, B.; Akkermans, L. M.; vanBerge-Henegouwen, G. P.; Smout, A. J.
Reports on motor abnormalities in Type 1 (insulin-dependent) diabetes mellitus are inconsistent. In 20 Type 1 diabetic patients and in 11 control subjects antroduodenojejunal manometry was performed under euglycaemic conditions in order to examine the prevalence of gastric and small intestinal motor
Zhao Jinhua; Zhao Peiqin; Zhao Yan; Liu Fuyuan; Meng Juanjuan; Chen Huidong
Objective: To investigate the characteristic rCBF abnormalities and the relationship between rCBF and cognitive disorders in type 2 diabetes mellitus patients. Methods: The study subjects were 11 middle aged, glycemic controlled type 2 diabetes mellitus patients. Age range of type 2 diabetes mellitus patients was 46 - 59 years. Eleven age-, sex-, education- and occupation- matched normal controls (age range 41 - 58 years) were studied under identical conditions. Cognitive functions were evaluated by Wechsler Memory Scale (WMS), Trail Marking Test A and Wisconsin Card Sorting Test (WCST), respectively. 99 Tc m -ECD (ethyl-cysteine ate dimer) SPECT imaging was performed on all patients and normal controls. Results: 1) Cognitive test scores of type 2 diabetes mellitus patients were lower than that of normal controls. Diabetic patients were scored lower in memory test than controls (accumulation adding, visual recognition, learning and total memory quotient of WMS, P < 0.05). Type 2 diabetes mellitus patients needed much more time to complete the trail marking test (74.2 s vs. 48.7 s). WCST scores were significantly different between two groups. 2) The rCBF values of frontal, temporal and parietal lobe were decreased significantly in type 2 diabetes mellitus patients. 3) For type 2 diabetes mellitus patients, there was a correlation between rCBF values of right frontal lobe and adding, understanding scores of WMS (positively correlated), preservative errors(%) of WCST (negatively correlated). The rCBF values of right temporal lobe were positively correlated with inverted counting. Conclusions: 1) Impairments of central nervous system are existed in glycemic controlled (lack of repeated hypoglycemia) type 2 diabetes mellitus patients. Abnormalities in CNS can express as cognitive dysfunction, such as decrement of memory, attention, thinking and conceptual reasoning abilities. 2) Hypo-perfusions of frontal, temporal and parietal cortex can be identified in patients of
Full Text Available Objective: Melatonin is an indolamine hormone, synthesized from tryptophan in the pineal gland primarily. Melatonin exerts both antioxidative and immunoregulatory roles but little is known about melatonin secretion in patients with type 1 diabetes mellitus (T1DM. The aim of this study was to measure serum melatonin levels in patients with T1DM and investigates their relationship with type 1 diabetes mellitus. Materials and Methods: Forty children and adolescents with T1DM (18 boys and 22 girls and 30 healthy control subjects (17 boys and 13 girls participated in the study. All patients followed in Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine and also control subjects had no hypertension, obesity, hyperlipidemia, anemia, and infection. Blood samples were collected during routine analysis, after overnight fasting. Serum melatonin levels were analyzed with ELISA. Results: There were no statistically significant differences related with age, sex, BMI distribution between diabetic group and control group. Mean diabetic duration was 2.89 ± 2.69 years. The variables were in the equation. Mean melatonin level in diabetic group was 6.75 ± 3.52 pg/ml and mean melatonin level in control group was 11.51 ± 4.74 pg/ml. Melatonin levels were significantly lower in diabetic group compared to controls (P < 0.01. Conclusions: Melatonin was associated with type 1 diabetes mellitus significantly. Because of the varied roles of melatonin in human metabolic rhythms, these results suggest a role of melatonin in maintaining normal rhythmicity. Melatonin may play role in preventing process of inflammation and oxidative stress.
Lindblad, Ida; Engström, Ann-Charlotte; Nylander, Charlotte; Fernell, Elisabeth
Managing type 1 diabetes mellitus requires efficient cognitive and executive skills, and adolescents who have attention-deficit/hyperactivity disorder (ADHD) may face specific challenges. This study explored young people's experiences of diabetes treatment and care. In a population-based study, comprising 175 patients aged 5-16 years with type 1 diabetes mellitus in two Swedish counties, we found that eight also met criteria for ADHD. Six of these, aged 14.5-16 years, participated 2013-2014 in interviews that targeted aspects of their diabetes treatment. Conducted by two psychologists, these used the inductive qualitative, semi-structured interview format. The two boys and four girls all reported difficulties in creating routines for their diabetes treatment and that problems were aggravated during stress. They had been criticised by their parents and the diabetes team when their blood levels indicated inadequate diabetes control. They requested ongoing information, involvement of their friends, group meetings and easy access to the healthcare system during difficult times. Patients with type 1 diabetes mellitus and concomitant ADHD faced problems with their diabetes management, especially during stressful situations. Diabetes care provision should pay particular attention to patients with co-existing neuropsychiatric and neurodevelopmental disorders such as ADHD. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Oleg Gennad'evich Motovilin
Full Text Available Aims. To compare disease attitudes in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM and to evaluate relationship between attitudes and psychological welfare of these groups. Materials and Methods. We examined 140 patients with T1DM and 70 patients with T2DM on insulin therapy (mean age 22.6?3.2 and 60.1?7.8 years; male/female ratio 47/93 and 15/55; duration of diabetes 12.1?5.7 and 11.4?6.5 years, HbA1c 9.3?2.2 и 9.0?1.4%, respectively. Psychological parameters were assessed by following methods: Bekhterev Disease Attitude Typing (DAT, Colour Attitude Test (CAT, SF-36 (36-Item Short Form Health Survey, Spielberger Anxiety Inventory (SAI, CES-D Depression Scale, Dembo-Rubinstein (DR technique for self-esteem assessment. Results. DAT showed increased sensitive attitude to their disease in patients with T1 and T2DM, being significantly higher in T2DM. According to CAT, T2DM patients perceive DM as a disease, associated with severe manifestations and complications, while T1DM patients tend to incorporate the notion of diabetes with lifestyle. Cluster analysis showed negative disease attitude to be associated independently of diabetes type with decrease in quality of life and emotional deterioration (higher anxiety and depression score, as measured by SF-36, SAI and CES-D. Conclusion. Disease attitude typing and correction is important in management of DM. Emotional acceptance allows improvement in quality of life and promotes psychological welfare. Also, despite the absence of direct relationship between HbA1c and disease attitudes (which, is plausibly non-linear, emotional acceptance may favour glycemic compensation due to increase in compliance.
Song, Fei; Bao, Cuiping; Deng, Meiyu; Xu, Hui; Fan, Meijuan; Paillard-Borg, Stéphanie; Xu, Weili; Qi, Xiuying
The purpose of this study was to investigate the prevalence of hypothyroidism among hospitalized patients with type 2 diabetes mellitus and its related factors, and to assess the prevalence of macrovascular and microvascular diseases among type 2 diabetes mellitus inpatients with hypothyroidism and euthyroidism. A total of 1662 type 2 diabetes mellitus inpatients hospitalized at the Metabolic Diseases Hospital, Tianjin Medical University from 1 January 2008 to 1 March 2013 were included in this study. Information on demographic and anthropometric factors and additional variables related to hypothyroidism were collected from medical records. Prevalence rates were calculated and standardized using direct method based on the age-specific and sex-specific structure of all participants. Data were analyzed using binary logistic regression with adjustment for potential confounders. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and 77.0 % of the patients with hypothyroidism had subclinical hypothyroidism. The prevalence of hypothyroidism increased with age, and was higher in women (10.8 %) than in men (3.4 %). Older age (odds ratio, 1.74; 95 % confidence interval, 1. 05 to 2.89), female gender (odds ratio, 2.02; 95 % confidence interval, 1.05 to 3.87), and positive thyroid peroxidase antibody (odds ratio, 4.99; 95 % confidence interval, 2.83 to 8.79) were associated with higher odds of hypothyroidism among type 2 diabetes mellitus inpatients. The type 2 diabetes mellitus inpatients with hypothyroidism had higher prevalence of cerebrovascular diseases than those with euthyroidism after adjustment for age and gender. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and most patients had subclinical hypothyroidism. Older age, female gender, and positive thyroid peroxidase antibody could be indicators for detecting hypothyroidism in type 2 diabetes mellitus inpatients.
Full Text Available Rossella Mazzilli, Norina Imbrogno, Jlenia Elia, Michele Delfino, Olimpia Bitterman, Angela Napoli, Fernando Mazzilli Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Unit of Diabetology and Endocrinology, University of Rome Sapienza, Rome, Italy Background: The aim of this work was to evaluate the impact of diabetes on female sexuality and to highlight any differences between sexuality in the context of type 1 and type 2 diabetes mellitus (DM. Methods: The subjects selected were 49 women with type 1 DM, 24 women with type 2 DM, and 45 healthy women as controls. Each participant was given the nine-item Female Sexual Function Index questionnaire to complete. The metabolic profile was evaluated by body mass index and glycosylated hemoglobin assay. Results: The prevalence of sexual dysfunction (total score ≤30 was significantly higher in the type 1 DM group (25/49, 51%; 95% confidence interval [CI] 18–31 than in the control group (4/45, 9%; 95% CI 3–5; P=0.00006; there were no significant variations in the type 2 DM group (4/24, 17%; 95% CI 3–4 versus the control group (P=0.630, not statistically significant. The mean total score was significantly lower in the type 1 DM group (30.2±6.9 versus the control group (36.5±4.9; P=0.0003, but there was no significant difference between the type 2 DM group and the control group (P=0.773. With regard to specific questionnaire items, the mean values for arousal, lubrication, dyspareunia, and orgasm were significantly lower only in the type 1 DM group versus the control group. The mean values for desire were reduced in type 1 and type 2 DM groups versus control group. Conclusion: Type 1 DM is associated with sexual dysfunction. This may be due to classic neurovascular complications or to the negative impact of the disease on psychosocial factors. Larger and ideally longitudinal studies are necessary to better understand the relationship between DM and sexual dysfunction. Keywords
Full Text Available Several health organizations have classified diabetes mellitus, a metabolic syndrome, as the epidemic of the century, since it affects millions of people worldwide and is one of the top ten causes of death. Type 1 diabetes is considered to be an autoimmune disease, in which autoaggressive T cells infiltrate the islets of Langerhans in the pancreas, leading to the destruction of insulin producing beta cells. The risk of the disease is modulated by genetic factors, mainly genes coding for human leukocyte antigens (HLA. However, the incidence of this disease has increased significantly during the recent decades, which cannot be explained only by genetic factors. Environmental perturbations have also been associated to the development of diabetes. Among these factors, viral triggers have been implicated; particularly enteroviruses, which have been associated to the induction of the disease. Supporting the hypothesis, numerous lines of evidence coming from mouse models and patients with this type of diabetes have shown the association. The present review aims to provide some understanding of how type 1 diabetes occurs and the possible role of enterovirus in this pathology.
Kleinwechter, Helmut; Demandt, Norbert
In Germany in 5.5% of all births diabetes is registered. In patients with type 1 and type 2 diabetes planning pregnancy, preconception counseling, diabetologic care with optimized periconceptional metabolic control and folic acid supplementation are essential for good pregnancy outcome. Gestational diabetes (GDM) should be diagnosed timely and managed according to existing guidelines. GDM is treated with insulin in approximately 20%. In 1-2% of GDM cases a glucokinase gene mutation is present (MODY 2). Pregnancies after bariatric-metabolic surgery are increasing and show high risks. © Georg Thieme Verlag KG Stuttgart · New York.
Deepti P. Deshmukh; Asmita G. Akarte
Background: Musculoskeletal complications of diabetes have been generally ignored and poorly treated as compared to other complications. Hence we carried out this study to find the prevalence of musculoskeletal manifestations in type II diabetes mellitus and its correlation with age, BMI, duration of diabetes, and control of diabetes. Methods: 100 consecutive patients of type II diabetes were studied. Duration of diabetes, control of diabetes, and any musculoskeletal complaints were noted....
Radzevičienė, Lina; Ostrauskas, Rytas
Type 2 diabetes mellitus appears to involve an interaction between susceptible genetic backgrounds and environmental factors including highly calorific diets. As it is important to identify modifiable risk factors that may help reduce the risk of type 2 diabetes mellitus, the aim of the present study was to determine the association between egg consumption and the risk of type 2 diabetes mellitus. A specifically designed questionnaire was used to collect information on possible risk factors of type 2 diabetes mellitus. The odds ratios and 95 % confidence intervals for type 2 diabetes mellitus were calculated by conditional logistic regression. A case-control study in a Lithuanian out-patient clinic was performed in 2001. A total of 234 cases with a newly confirmed diagnosis of type 2 diabetes mellitus and 468 controls free of the disease. Variables such as BMI, family history of diabetes, cigarette smoking, education, morning exercise and plasma TAG level were retained in multivariate logistic regression models as confounders because their inclusion changed the value of the odds ratio by more than 10 % in any exposure category. After adjustment for possible confounders more than twofold increased risk of type 2 diabetes mellitus was determined for individuals consuming 3-4·9 eggs/week (OR = 2·60; 95 % CI 1·34, 5·08) and threefold increased risk of the disease was determined for individuals consuming ≥5 eggs/week (OR = 3·02; 95 % CI 1·14, 7·98) compared with those eating diabetes mellitus.
Full Text Available Chronic hyperglycaemia of Type 2 diabetes mellitus causes long term damage to heart resulting in coronary artery disease (CAD, myocardial infarction (MI, congestive heart failure (CHF, and sudden death from arrhythmias. AIMS: To study the prevalence of different types of arrhythmias in T2DM, particularly in association with Cardiac Autonomic Neuropathy (CAN. METHODS: A cross-sectional study including 100 patients of Type 2 Diabetes Mellitus (T2DM presenting with cardiac arrhythmias, was done at our hospital over 2 years. Detailed history along with physical examination and tests for CAN were done. Routine investigations along with echocardiography, stress test, Holter monitoring were done. RESULTS: Sinus Tachycardia (ST was the commonest arrhythmia, found in 32% of patients. 20% had Complete Heart Block (CHB, 15% had Sinus Bradycardia (SB, and 15% had Atrial Fibrillation (AF. Ventricular Premature Complex (VPC was found in 10% and 3% had Atrial Premature Complex (APC. 3% had first degree AV block, whereas 1% had Paroxysmal Supra Ventricular Tachycardia (PSVT, and another 1% had Ventricular Tachycardia (VT. Poorly controlled diabetes and co-morbidities was associated with higher incidence of arrhythmias. 62% of patients had prolonged QTc, majority of which had CAN. Most of the patients responded to standard therapy.
Kulkarni, Sweta Vilas; Meenatchi, Suruthi; Reeta, R; Ramesh, Ramasamy; Srinivasan, A R; Lenin, C
Type 2 diabetes mellitus has profound implications on the skeleton. Even though bone mineral density is increased in type 2 diabetes mellitus patients, they are more prone for fractures. The weakening of bone tissue in type 2 diabetes mellitus can be due to uncontrolled blood sugar levels leading to high levels of bone turnover markers in blood. The aim of this study is to find the association between glycemic status and bone turnover markers in type 2 diabetes mellitus. This case-control study was carried out in a tertiary health care hospital. Fifty clinically diagnosed type 2 diabetes mellitus patients in the age group between 30 and 50 years were included as cases. Fifty age- and gender-matched healthy nondiabetics were included as controls. Patients with complications and chronic illness were excluded from the study. Depending on glycated hemoglobin (HbA1c) levels, patients were grouped into uncontrolled (HbA1c >7%, n = 36) and controlled (HbA1c diabetics. Based on duration of diabetes, patients were grouped into newly diagnosed, 1-2 years, 3-5 years, and >5 years. Serum osteocalcin (OC), bone alkaline phosphatase (BAP), acid phosphatase (ACP), and HbA1c levels were estimated. OC/BAP and OC/ACP ratio was calculated. Student's t -test, analysis of variance, and Chi-square tests were used for analysis. Receiver operating characteristic (ROC) curve analysis was done for OC/BAP and OC/ACP ratios. Serum OC, HbA1c, and OC/BAP ratio were increased in cases when compared to controls and were statistically significant ( P type 2 diabetes mellitus and was statistically significant ( P = 0.01). In patients with >5-year duration of diabetes, HbA1c level was high and was statistically significant ( P 2). BAP levels were high in uncontrolled diabetics but statistically not significant. ROC curve showed OC/BAP ratio better marker than OC/ACP ratio. Uncontrolled type 2 diabetes mellitus affects bone tissue resulting in variations in bone turnover markers. Bone turnover
Hardt, Philip D; Ewald, Nils
Pancreatic exocrine insufficiency is a frequently observed phenomenon in type 1 and type 2 diabetes mellitus. Alterations of exocrine pancreatic morphology can also be found frequently in diabetic patients. Several hypotheses try to explain these findings, including lack of insulin as a trophic factor for exocrine tissue, changes in secretion and/or action of other islet hormones, and autoimmunity against common endocrine and exocrine antigens. Another explanation might be that diabetes mellitus could also be a consequence of underlying pancreatic diseases (e.g., chronic pancreatitis). Another pathophysiological concept proposes the functional and morphological alterations as a consequence of diabetic neuropathy. This paper discusses the currently available studies on this subject and tries to provide an overview of the current concepts of exocrine pancreatic insufficiency in diabetes mellitus.
Baruah, Manash P; Ammini, Ariachery C; Khurana, Madan L
The pathogenesis of type 1 diabetes mellitus (T1DM) requires a genetic predisposition to particular environmental triggers that may activate mechanisms leading to progressive loss of pancreatic beta cells. We tried to compare the impact of some demographic and environmental factors and breast-feeding on children (aged 18 years) with recent onset diabetes mellitus (≤1 year) with that on age, sex, and socioeconomic status-matched controls. A total of 43 consecutive patients (male, 24, mean age ± SD = 12.58 ± 9.6 years) and equal number of controls without diabetes mellitus or dysglycemia were included in this hospital-based case-control study. A distinct peak in the incidence noted in the early adolescence with segregation in the winter months. Our patients did not differ significantly from the controls with regard to birth order, mode of delivery, parental age, parental education, dietary practices, breast-feeding, and migration in the family. Growth characteristics and nutritional status were also similar. A population study with more power will be better equipped to answer such queries.
Full Text Available BACKGROUND Altered blood levels of adenosine deaminase may help in predicting immunological dysfunction in diabetic individuals. But very few studies exist on ADA activity in type 2 diabetes mellitus. Aim of this study is to compare serum adenosine deaminase activity in type 2 diabetic patients with non-diabetic control. MATERIALS AND METHODS A comparative study design was used in data collection process. The study was conducted in 40 type 2 diabetes mellitus patients attending diabetic clinic or admitted in the medicine ward for metabolic control of diabetes in medical college, Calicut from January 2011 to January 2012. The adenosine deaminase (ADA level in the serum is measured by endpoint method in these patients. The results were expressed as mean and standard deviation. The statistical significance of the differences between the values was assessed by ANOVA. RESULTS Among 40 diabetic patients, mean ADA level in the serum is 38.56, SD±6.72 (min 30, max 53. Mean ADA level in the serum in the control group is 22.04±4.625 (min 13, max 29. CONCLUSION ADA level in the serum is found to be increased indicating its role as an important immunoenzyme marker in the aetiopathology of type 2 diabetes mellitus.
Full Text Available Patients with complications of diabetes such as retinopathy, nephropathy, and cardiovascular complications have increased hospital stay with greater economic burden. Prevention of complications should be started before the onset of type 1 diabetes mellitus (T1DM by working on risk factors and thereafter by intervention upon confirmatory diagnosis which can prevent further damage to β-cells. The actual risk of getting microvascular complications like microalbuminuria and retinopathy progression starts at glycated hemoglobin (HbA1c level of 7%. As per the American Diabetes Association, a new pediatric glycemic control target of HbA1c 20 years as compared to patients <10 years of age. Screening of these complications should be done regularly, and appropriate preventive strategies should be followed. Angiotensin converting enzyme inhibitors and angiotensin II receptor blocker reduce progression from microalbuminuria to macroalbuminuria and increase the regression rate to normoalbuminuria. Diabetic microvascular complications can be controlled with tight glycemic therapy, dyslipidemia management and blood pressure control along with renal function monitoring, lifestyle changes, including smoking cessation and low-protein diet. An integrated and personalized care would reduce the risk of development of microvascular complications in T1DM patients. The child with diabetes who receives limited care is more likely to develop long-term complications at an earlier age. Screening for subclinical complications and early interventions with intensive therapy is the need of the hour.
Uribe-Wiechers, Ana Cecilia; Janka-Zires, Marcela; Almeda-Valdés, Paloma; López-Gutiérrez, Joel; Gómez-Pérez, Francisco J
The development of metabolic syndrome has been described in patients with type 1 diabetes mellitus as the disease progresses over time. The purpose of this study is to assess the relationship between metabolic syndrome, albuminuria, and glomerular filtration rate, as well as to determine the prevalence of metabolic syndrome, in a group of Mexican patients with type 1 diabetes mellitus. We conducted a cross-sectional study that included patients with type 1 diabetes mellitus who were diagnosed over 10 years ago and who are seen at the Diabetes Intensive Control Clinic of the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City. The presence of metabolic syndrome was determined by using the National Cholesterol Education Program-Adult Treatment Panel III (ATP III) criteria. A total of 81 individuals were studied. The prevalence of metabolic syndrome was 18.5% (n = 15). A higher albuminuria was found in subjects with metabolic syndrome (34.9 mg/24 hours; 8.3-169.3) than in those without metabolic syndrome (9.0 mg/24 hours; 5.0-27.0; p = 0.02). Glomerular filtration rate was lower in patients with metabolic syndrome (95.3 ml/minute; [64.9-107.2] vs. 110.2 ml/minute [88.1-120.3]; p = 0.04). After classifying the population according to the number of metabolic syndrome criteria, a progressive increase in albuminuria and a progressive decrease in glomerular filtration rate were found with each additional metabolic syndrome criterion (p = 0.008 and p = 0.032, respectively). After adjusting for age, time from diagnosis, systolic blood pressure, triglycerides, HDL-cholesterol, and treatment with angiotensin receptor blockers or angiotensin converting enzyme inhibitors, we found that age, time from diagnosis, triglycerides, and HDL-cholesterol were independent factors associated with glomerular filtration rate (R2 = 0.286; p diabetes mellitus. Metabolic syndrome was present in 18.5% of this group of Mexican individuals with type 1 diabetes
Full Text Available The purpose of this review was the analysis of literature data on clinical and laboratory criteria for type 2 diabetes mellitus in children. A review of scientific literature was conducted using Pubmed as the search engine by the keywords: diabetes mellitus, type 2 diabetes mellitus, clinical picture, laboratory criteria, risk factors, taking into consideration studies conducted in the last 10 years, citation review of relevant primary and review articles, conference abstracts, personal files, and contact with expert informants. The criterion for the selection of articles for the study was based on their close relevance to the topic, thus, out of 213 analyzed articles, the findings of the researchers covered in 21 articles were crucial. Type 2 mellitus is a multifactorial disease with hereditary predisposition. The majority of patients with type 2 diabetes mellitus indicate the presence of such a disease in the immediate family; in the presence of type 2 diabetes in one of the parents, the risk of its development during the life of the descendant is 40 %. In most cases, severe clinical manifestations are absent, and the diagnosis is established at a routine determination of glycemia level. The disease usually starts at the age of 10 years, with the overwhelming majority of patients having obesity and other components of the metabolic syndrome. Criteria for the diagnosis of type 2 diabetes are proposed by the International Society for Pediatric and Adolescent Diabetes. With a purpose of differential diagnosis of type 1 and type 2 diabetes in the onset of the disease, the level of insulin and C-peptide in the blood is determined both fasting, and during an oral glucose tolerance test.
Diabetes mellitus type 1 is een veelvoorkomende ziekte. Deze ziekte blijkt niet op zichzelf te staan maar is onder andere geassocieerd met coeliakie. Coeliakie wordt behandeld middels een glutenvrij dieet. De diabetespatiënten die aan coeliakie lijden blijken zich niet altijd bij de huisarts met
Asociación de la microalbuminuria con la disfunción ventricular izquierda en personas normotensas con diabetes mellitus tipo 1 Microalbuminuria and its association with left ventricular dysfunction in normotensive subjects presenting with type 1 diabetes mellitus
Manuel Emiliano Licea Puig
Full Text Available ANTECEDENTES: la disfunción ventricular izquierda es una complicación frecuente en las personas con diabetes mellitus 1. OBJETIVO: determinar si la excreción urinaria de albúmina se asocia a la presencia de disfunción ventricular izquierda en personas normotensas con diabetes mellitus 1 de largo tiempo de evolución. MÉTODOS: se realizó un estudio transversal y descriptivo en 80 diabéticos normotensos tipo 1 con 10 años o más de evolución de la diabetes mellitus 1, atendidos consecutivamente en nuestro centro, en edades entre los 15 y los 40 años. Se excluyeron otras enfermedades o condiciones que provoquen por sí mismas disfunción ventricular izquierda y proteinuria. Se estudió: edad, sexo, índice de masa corporal, hábito de fumar, presión arterial, evolución de la diabetes mellitus 1, retinopatía diabética, nefropatía diabética incipiente, glucemia en ayunas y posprandial de 2 h, hemoglobina glucosilada (HbA1, excreción urinaria de albúmina de 24 h, creatinina, electrocardiograma y ecocardiograma modo M bidimensional con Doppler pulsado. RESULTADOS: se comprobó disfunción ventricular izquierda en el 26,3 % y alteraciones estructurales en el 16,2. La frecuencia de nefropatía diabética incipiente fue mayor (pBACKGROUNDS: left ventricular dysfunction is a frequent complication in persons presenting with type 1 diabetes mellitus. OBJECTIVE: to determine if albumin urinary excretion is associated with the presence of left ventricular dysfunction (LVD in normotensive persons presenting with type diabetes mellitus of a long evolution. METHODS: we made a descriptive and cross-sectional study in 80 normotensive type 1 diabetic patients aged between 15 and 40 with a ³10 years of type 1 diabetes mellitus evolution seen in a consecutive way in our service. Other diseases were excluded or those conditions provoking per se left ventricular dysfunction and proteinuria. Study includes: age, sex, body mass index (BMI, smoking
Feldt-Rasmussen, B; Jensen, T; Dieperink, H
Renal function was studied in 18 patients with Type 1 diabetes mellitus. All were participating in the Canadian-European randomized placebo-controlled cyclosporin trial in newly diagnosed Type 1 diabetic patients, nine being randomized to placebo, and nine to cyclosporin A. During treatment for 12...... corrected for differences in blood glucose control it appeared that in three out of nine patients glomerular filtration rate had not completely returned to the reference range of the placebo group. We conclude that the nephrotoxic side-effects of cyclosporin A treatment for 1 year are reversible. There are...
Braham, Rim; Robert, Asirvatham Alwin; Musallam, Maha Ali; Alanazi, Abdulaziz; Swedan, Nawaf Bin; Al Dawish, Mohamed Abdulaziz
AIM To identify reproductive disturbances among adolescent girls and young women with type 1 diabetes mellitus (T1DM) in Saudi Arabia. METHODS This cross sectional study was conducted among 102 female with T1DM, (aged 13-29 years) who attended the Diabetes Clinic at Diabetes Treatment Center, Prince Sultan Military Medical City, Saudi Arabia between April 2015 to March 2016. Clinical history, anthropometric characteristics and reproductive disturbance were collected through a questionnaire. R...
Strang, Aart C.; van Wijk, Diederik F.; Mutsaerts, Henri J. M. M.; Stroes, Erik S. G.; Nederveen, Aart J.; Rotmans, Joris I.; Rabelink, Ton J.; Box, Frieke M. A.
Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type II diabetes mellitus. We therefore compared change in carotid artery wall dimensions in type II diabetes mellitus and non-type II diabetes mellitus patients with a history of a major
Wiemer, N.G.M.; Dubbelman, M.; Hermans, E.A.; Ringens, P.J.; Polak, B.C.P.
Purpose: To investigate the effect of diabetes mellitus (DM) type 1 and type 2 on the internal structure of the lens. Design: Observational cross-sectional study. Participants and Controls: One hundred seven patients with DM type 1, 106 patients with DM type 2, and 75 healthy control subjects.
Ren, Yongcheng; Zhang, Ming; Zhao, Jingzhi; Wang, Chongjian; Luo, Xinping; Zhang, Jiatong; Zhu, Tian; Li, Xi; Yin, Lei; Pang, Chao; Feng, Tianping; Wang, Bingyuan; Zhang, Lu; Li, Linlin; Yang, Xiangyu; Zhang, Hongyan; Hu, Dongsheng
To clarify the association of the hypertriglyceridemic waist phenotype and type 2 diabetes mellitus among adults in China. In the present case-control study, we included 1,685 patients with type 2 diabetes mellitus and 7,141 normal glucose-tolerant controls from the Henan Province of China in 2011. Elevated waist circumference (GW) was defined as ≥90 cm for men and ≥80 cm for women. Hypertriglyceridemia (HT) was defined as >1.7 m mol/L triglycerides (TG) level. The association of hypertriglyceridemic waist phenotype and type 2 diabetes mellitus was investigated by sex, body mass index, physical activity, and family history of diabetes. Cases and controls differed in age, waist circumference (WC), weight, TG level, fasting glucose, body mass index, smoking status, diabetic family history, physical activity and hypertriglyceridemic waist phenotype (P type 2 diabetes mellitus (odds ratio 4.14, 2.42 and 6.23, respectively). Only HTGW was consistently associated with risk of type 2 diabetes mellitus, with or without adjustment. The strongest relationship between HTGW and type 2 diabetes mellitus was for subjects with body mass index 24.0 kg/m(2) (odds ratio 6.54, 95% confidence interval 4.22-10.14) after adjustment for cofounding variables. HTGW was stably and significantly associated with risk of type 2 diabetes mellitus in adult Chinese. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Nindara Citra Aquarista
Full Text Available Diabetes mellitus is the third highest Non-Communicable Diseases (NCDs, which causes death in Indonesia.The incidence of coronary heart disease in diabetes mellitus is high, 65% of people with diabetes mellitus die due to coronary heart disease and stroke. The purpose of this study is to analyze the differences in the characteristics of Diabetes mellitus type 2 in patients with and without coronary heart disease in Haji General Hospital Surabaya year 2016. This research uses observational analysis with cross sectional study design. The subject of the study is the incidence of diabetes Mellitus type 2 with and without coronary heart disease with undergoing outpatient treatment at Haji General Hospital Surabaya year 2016. The Samples were taken by fixed-disease sampling method with 42 people as the samples. The data analysis uses Chi Square test. The results show for the independent variables that have the most significant difference inHaji General Hospital Surabaya year 2016 is smoking behavior (p = 0.00; PR = 7.85; 95% CI = 2.09 to 29.50 and hypertension (p = 0,002; PR = 3.51; 95% CI = 1.42 to 8.67. In conclusion, the smoking behavior and hypertension can lead to complications of coronary heart disease for patients with type in Diabetes Mellitus type 2 in Haji General Hospital year 2016. It needs awareness to check blood pressure regularly and eliminate the smoking habit as the prevention of complications of coronary heart disease for patients with diabetes mellitus type 2. Keywords: diabetes mellitus type 2, coronary hearth disease.
Philip D. Hardt
Full Text Available Pancreatic exocrine insufficiency is a frequently observed phenomenon in type 1 and type 2 diabetes mellitus. Alterations of exocrine pancreatic morphology can also be found frequently in diabetic patients. Several hypotheses try to explain these findings, including lack of insulin as a trophic factor for exocrine tissue, changes in secretion and/or action of other islet hormones, and autoimmunity against common endocrine and exocrine antigens. Another explanation might be that diabetes mellitus could also be a consequence of underlying pancreatic diseases (e.g., chronic pancreatitis. Another pathophysiological concept proposes the functional and morphological alterations as a consequence of diabetic neuropathy. This paper discusses the currently available studies on this subject and tries to provide an overview of the current concepts of exocrine pancreatic insufficiency in diabetes mellitus.
Pimentel Gustavo D
Full Text Available Abstract This review reports the evidence for a relation between long-term coffee intake and risk of type 2 diabetes mellitus. Numerous epidemiological studies have evaluated this association and, at this moment, at least fourteen out of eighteen cohort studies revealed a substantially lower risk of type 2 diabetes mellitus with frequent coffee intake. Moderate coffee intake (≥4 cups of coffee/d of 150 mL or ≥400 mg of caffeine/d has generally been associated with a decrease in the risk of type 2 diabetes mellitus. Besides, results of most studies suggest a dose-response relation, with greater reductions in type 2 diabetes mellitus risk with higher levels of coffee consumption. Several mechanisms underlying this protective effect, as well as the coffee components responsible for this association are suggested. Despite positive findings, it is still premature to recommend an increase in coffee consumption as a public health strategy to prevent type 2 diabetes mellitus. More population-based surveys are necessary to clarify the long-term effects of decaffeinated and caffeinated coffee intake on the risk of type 2 diabetes mellitus.
Smiley, Dawn; Chandra, Prakash; Umpierrez, Guillermo E
Diabetic ketoacidosis (DKA) has been considered a key clinical feature of Type 1 diabetes mellitus; however, increasing evidence indicates that DKA is also a common feature of Type 2 diabetes (T2DM). Many cases of DKA develop under stressful conditions such as trauma or infection but an increasing number of cases without precipitating cause have been reported in children and adults with T2DM. Such patients present with severe hyperglycemia and ketosis as in Type 1 diabetes mellitus but can di...
properties that are suitable for once-daily dosing. Liraglutide has demonstrated lasting improvement of HbA(1c )levels, weight reduction and improved beta-cell function in patients with Type 2 diabetes mellitus. Liraglutide is well tolerated; the adverse events that are most frequently reported being...... transient nausea and diarrhoea. This article reviews the mechanisms of action and efficacy of liraglutide for the treatment of Type 2 diabetes mellitus. This agent is presently in Phase III clinical development.......The incretin hormones are intestinal peptides that enhance insulin secretion following ingestion of nutrients. Liraglutide is a glucagon-like peptide-1 receptor analogue, which is obtained by derivatising glucagon-like peptide-1 with a fatty acid, providing a compound with pharmacokinetic...
Alexander García Cabreja
lipídico son necesarios para prevenir, retrasar o mejorar la lesión renal diabética.INTRODUCTION: Type 1 diabetes mellitus is an autoimmune disease characterized by absolute deficiency of insulin production, glucose-metabolism disturbances, lipid, and proteins. The aim of present research was to know relation between dyslipidemia and diabetic renal injury, expressed by presence of microalbuminuria. METHODS: Fifty two children presenting with Type 1 diabetes mellitus, aged 9-15, and a disease length of 2 years or more. In all we carried out fast lipidogram including triglyceride analysis, total cholesterol, and low- and high-density lipoprotein cholesterol. Microalbuminuria tests were performed by means of radioimmunoassay for urine-human albumin and also glomerular filtration. RESULTS: There was dyslipidemia in 30 patients (57% and decrease of high-density lipoprotein cholesterol in all patients dyslipidemic. We verified an increase of low-density lipoprotein cholesterol in 27 cases (51,6%; total cholesterol was high in 12 (23%, and there was hypertriglyceridemia only in 4 patients (7,6%. Twenty one of 30 dyslipidemic children (70% had microalbuminuria. It was found that patients presenting with dyslipidemia had a greater percentage of microalbuminuria, but this one was not significant. All patients presenting with dyslipidemia there was a decrease of high-density l lipoproteins cholesterol. Dyslipidemia had a positive relation with length of diabetes, but not with sex. CONCLUSIONS: In Type 1 diabetes mellitus, total cholesterol and triglycerides there is a lack of enough information, and it is necessary to perform studies on high-density lipoprotein cholesterol to predict a future renal injury. Glycemia and lipid control is important to prevent, postpone or to improve the diabetic renal injury.
Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders
AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...
Murata, Takashi; Tsuzaki, Kokoro; Nirengi, Shinsuke; Watanabe, Tomokazu; Mizutani, Yukako; Okada, Hayami; Tsukamoto, Masami; Odori, Shinji; Nakagawachi, Reiko; Kawaguchi, Yaeko; Yoshioka, Fumi; Yamada, Kazunori; Shimatsu, Akira; Kotani, Kazuhiko; Satoh-Asahara, Noriko; Sakane, Naoki
The distributer of the anti-glutamic acid decarboxylase antibody assay kit using radioimmunoassay (RIA) recently announced its discontinuation, and proposed an alternative kit using enzyme-linked immunosorbent assay (ELISA). The aim of the present study was to investigate the diagnostic values of the anti-glutamic acid decarboxylase antibody by RIA and ELISA among type 1 diabetes mellitus patients and control participants. A total of 79 type 1 diabetes mellitus patients and 79 age-matched controls were enrolled and assessed using RIA and ELISA. Sensitivity, specificity, positive predictive values and negative predictive values were calculated for cut-off values (RIA = 1.5 U/mL and ELISA = 5.0 U/mL, respectively). Kappa coefficients were used to test for agreements between the RIA and ELISA methods regarding the diagnosis of type 1 diabetes mellitus. The sensitivity, specificity, positive predictive values, and negative predictive values for diagnosing type 1 diabetes mellitus were 57.0, 97.5, 95.7, and 69.4% by RIA, and 60.8, 100.0, 100.0 and 71.8% by ELISA, respectively. The diagnosis of type 1 diabetes mellitus using the RIA and ELISA methods showed substantial agreement with the kappa values of 0.74 for all participants, and of 0.64 for the acute type; however, there was moderate agreement with the kappa value of 0.56 for the slowly progressive type. The present study suggests that both anti-glutamic acid decarboxylase antibody by RIA and ELISA was useful for diagnosing type 1 diabetes mellitus. However, in the slowly progressive type, the degree of agreement of these two kits was poorer compared with those in all participants or in the acute type. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Kapke, Jonathan; Shaheen, Zachary; Kilari, Deepak; Knudson, Paul; Wong, Stuart
With the introduction of immune checkpoint inhibitors into clinical practice, various autoimmune toxicities have been described. Antibodies targeting the receptor:ligand pairing of programmed death receptor-1 (PD-1) and its cognate ligand programmed death-ligand 1 (PD-L1) in rare reports have been associated with autoimmune diabetes mellitus. We report 2 cases of rapid-onset, insulin-dependent, type 1 diabetes mellitus in the setting of administration of nivolumab, a fully human monoclonal an...
Pâmela Bertazo Viêro
Full Text Available Introduction: Diabetes Mellitus (DM is a group of metabolic diseases characterized by hyperglycemia and associated with complications. It is considered a chronic degenerative disease. Objective: This study aimed to identify which areas of human occupation suffered performance changes as a result of vascular and neurological complications of type 1 and 2 diabetes mellitus. Method: This is a quantitative study with exploratory approach. The data collection occurred in a University Hospital located in a city in the central region of Rio Grande do Sul, and used a sociodemographic questionnaire and the Canadian Occupational Performance Measure (COPM. Data were analyzed by Spearman’s rank correlation coefficient using the software Statistical Package for Social Science 15.0 (SPSS. Results: The sample consisted of 10 people with vascular and neurological complications resulting of type 1 and 2 diabetes mellitus, with 80% men and 20% women. The most frequently cited occupational performance problems were in self-care activities (feeding, bathing and mobility, while the most affected productivity tasks were cooking and leisure activities such as walking and socializing. Conclusion: The data alert us to the work of occupational therapists caring for people with diabetes in all health care levels.
Full Text Available Diabetic ketoacidosis (DKA is a frequently encountered complication of diabetes mellitus. DKA is an insulin deficit state and results in moderate to severe hypertriglyceridemia (HTG. HTG is the third leading cause of acute pancreatitis (AP and often goes unnoticed. The triad of DKA, HTG, and AP is rarely seen, and literature on the same is sparse. We report a case of AP which was due to DKA-induced secondary HTG in an adult with previously undiagnosed type 1 diabetes. His HbA1c was significantly raised, and C-peptide level was low, confirming chronic hyperglycemia. He was treated successfully with insulin infusion, intravenous crystalloid, and analgesics.
Conget, I; Aguilera, E; Pellitero, S
We evaluated in a double-blind study the effect of early treatment with the immunomodulatory drug fusidin in patients with newly diagnosed type 1 diabetes mellitus.......We evaluated in a double-blind study the effect of early treatment with the immunomodulatory drug fusidin in patients with newly diagnosed type 1 diabetes mellitus....
Langendam, Miranda; Luijf, Yoeri M; Hooft, Lotty; Devries, J Hans; Mudde, Aart H; Scholten, Rob J P M
Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that would not have been identified with conventional self-monitoring. Two types of CGM systems can be defined: retrospective systems and real-time systems. Real-time systems continuously provide the actual glucose concentration on a display. Currently, the use of CGM is not common practice and its reimbursement status is a point of debate in many countries. To assess the effects of CGM systems compared to conventional self-monitoring of blood glucose (SMBG) in patients with diabetes mellitus type 1. We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for the identification of studies. Last search date was June 8, 2011. Randomised controlled trials (RCTs) comparing retrospective or real-time CGM with conventional self-monitoring of blood glucose levels or with another type of CGM system in patients with type 1 diabetes mellitus. Primary outcomes were glycaemic control, e.g. level of glycosylated haemoglobin A1c (HbA1c) and health-related quality of life. Secondary outcomes were adverse events and complications, CGM derived glycaemic control, death and costs. Two authors independently selected the studies, assessed the risk of bias and performed data-extraction. Although there was clinical and methodological heterogeneity between studies an exploratory meta-analysis was performed on those outcomes the authors felt could be pooled without losing clinical merit. The search identified 1366 references. Twenty-two RCTs meeting the inclusion criteria of this review were identified. The results of the meta-analyses (across all age groups) indicate benefit of CGM for patients starting on CGM sensor augmented insulin pump therapy compared to patients using multiple daily injections of
Joergensen, C; Tarnow, L; Goetze, J P
AIM: To evaluate the effects of therapy with the vitamin D analogue paricalcitol on markers of cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy. METHODS: In a double-blind, randomized placebo-controlled, crossover trial, 48 participants on s...
孙家忠; 徐焱成; 朱宜莲; 鲁红云; 邓浩华; 范幼筠; 孙苏欣; 张颖
Objective To evaluate the role of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and plasma homocysteine levels in patients with type 2 diabetes mellitus and diabetic retinopathy (DR). Methods Total of 208 patients with type 2 diabetes mellitus and 57 controls were recruited into the study. MTHFR genetic C677T polymorphisms were determined by PCR-RFLP. Plasma total homocysteine levels were measured using high-performance liquid chromatography (HPLC) with fluorescence detection. Results The frequencies of MTHFR TT homogeneous type, CT heterogeneous type and allele T (28.18%, 41.82%, 49.09%) were significantly higher in the type 2 diabetes mellitus with diabetic retinopathy group than those without retinopathy (18.37%, 29.59%, 33.16%) and those of controls (17.54%, 28.07%, 31.58%). The presence of the T allele appeared to have a strong association with the development of diabetic retinopathy. The odds ratio was 1.94 with a 95% confidence interval of 1.31-2.88. Moreover, plasma homocysteine levels were remarkably higher in patients with TT or CT genotype than in patients with the CC genotype. Conclusion MTHFR gene C677T mutation associated with a predisposition to increased plasma homocysteine levels may be considered as a genetic risk factor for diabetic microangiopathy (such as DR) in Chinese patients with type 2 diabetes mellitus.
Elias, J; Hoorweg-Nijman, J J G; Balemans, W A
To investigate the clinical relevance and cost-effectiveness of human leukocyte antigen (HLA)-genotyping in the Netherlands as a screening tool for the development of coeliac disease in children with Type 1 diabetes mellitus. A retrospective analysis was performed in 110 children with Type 1 diabetes mellitus diagnosed between January 1996 and January 2013. All children were screened for coeliac disease using coeliac disease-specific antibodies and HLA genotyping was performed in all children. One hundred and ten children were screened for coeliac disease, and coeliac disease could be confirmed in seven. Eighty-six per cent of the children with Type 1 diabetes mellitus had one of the variants of HLA-DQ2.5 and DQ8. HLA genotypes observed in children with Type 1 diabetes mellitus children and coeliac disease were heterozygote DQ2.5, homozygote DQ2.5 and heterozygote DQ2.5/DQ8. HLA genotyping in coeliac disease screening in children with Type 1 diabetes mellitus is more expensive than screening for coeliac disease with antibodies alone (€326 vs. €182 per child). The risk of coeliac disease development in children with Type 1 diabetes mellitus is increased when they are heterozygote DQ2.5/DQ8, homozygote or heterozygote DQ2.5. The implementation of HLA genotyping as a first-line screening tool has to be reconsidered because it is not distinctive or cost-effective. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.
Full Text Available We report a rare case of Bartter's syndrome in a 35-year-old woman with type 2 diabetes mellitus. The patient presented with leg weakness, fatigue, polyuria and polydipsia. Hypokalemia, metabolic alkalosis, and high renin and aldosterone concentrations were present, but the patient was normotensive. Gitelman's syndrome was excluded because of the presence of hypercalciuria, secondary hyperparathyroidism and bilateral nephrocalcinosis. The patient's condition improved upon administration of a prostaglandin synthetase inhibitor (acemetacin, oral potassium chloride and potassium-sparing diuretics. Five months later, the patient discontinued acemetacin because of epigastric discomfort; at the same time, severe hypokalemia and hyperglycemia developed. Glucagon stimulation and water deprivation tests were performed. Type 2 diabetes mellitus with nephrogenic diabetes insipidus was diagnosed. To avoid further gastrointestinal complications, the patient was treated with celecoxib, a selective cyclooxygenase 2 inhibitor. This case serves as a reminder that Bartter's syndrome is associated with various metabolic derangements including nephrogenic diabetes insipidus, nephrocalcinosis and diabetes mellitus. When treating Bartter's syndrome, it is also prudent to remember that the long-term use of nonsteroidal anti-inflammatory drugs and potassium-sparing diuretics may result in serious adverse reactions.
Wang, Chunxia; Fu, Kailiang; Liu, Huaijun; Xing, Fei; Zhang, Songyun
Voxel-based morphometry has been used in the study of alterations in brain structure in type 1 diabetes mellitus patients. These changes are associated with clinical indices. The age at onset, pathogenesis, and treatment of type 1 diabetes mellitus are different from those for type 2 diabetes mellitus. Thus, type 1 and type 2 diabetes mellitus may have different impacts on brain structure. Only a few studies of the alterations in brain structure in type 2 diabetes mellitus patients using voxe...
Yasuda, Kazuki; Miyake, Kazuaki; Horikawa, Yukio
We carried out a multistage genome-wide association study of type 2 diabetes mellitus in Japanese individuals, with a total of 1,612 cases and 1,424 controls and 100,000 SNPs. The most significant association was obtained with SNPs in KCNQ1, and dense mapping within the gene revealed that rs22378...
Ek, J; Andersen, G; Urhammer, S A
This study aimed to investigate if variability in the peroxisome proliferator-activated receptor-gamma coactivator-1 (PGC-1) gene is associated with Type II (non-insulin-dependent) diabetes mellitus.......This study aimed to investigate if variability in the peroxisome proliferator-activated receptor-gamma coactivator-1 (PGC-1) gene is associated with Type II (non-insulin-dependent) diabetes mellitus....
Full Text Available Combined pegylated interferon (PEG-IFN+ribavirin (RBV therapy has been used as a primary treatment for chronic hepatitis C. However, IFN-induced autoimmune disease, including type 1 diabetes mellitus, has been highlighted as one of the problems with this therapy. Here we report the case of a patient who developed type 1 diabetes mellitus during combined PEG-IFN+RBV therapy for hepatitis C but who showed no exacerbation of diabetes despite continued use of IFN. A 63-year-old man with chronic hepatitis C and a nonresponder to previous IFNα treatments, was admitted to our hospital because of excessive thirst, polydipsia, and polyuria 24 weeks after the start of PEG-IFNα+RBV therapy. High levels of blood glucose and glycosylated hemoglobin and low levels of C-peptide and immunoreactive insulin were observed. The serum antiglutamic acid decarboxylase antibody titer was 27,700 U/mL. We diagnosed IFN-induced type 1 diabetes mellitus; however PEG-IFNα+RBV therapy was continued for 48 weeks. Serum HCV remains negative five years after this treatment. Intensive insulin therapy was started immediately after the diagnosis of type 1 diabetes. Although the patient initially required 22 U/day of insulin, the dosage could be gradually reduced after completion of PEG-IFNα+RBV therapy and blood glucose remained well controlled. Prediction of onset of type 1 diabetes mellitus on the basis of baseline measurement of pancreas-associated autoantibodies is difficult. Therefore, it would be advisable to consider the possibility of onset of type 1 diabetes mellitus in all patients receiving IFN+RBV therapy.
"Dead in bed" is a tragic description of a particular type of sudden death in type 1 diabetes mellitus (DM). Patients are typically found dead in the early morning, lying in an undisturbed bed, having been well the previous evening. The incidence of "dead in bed" syndrome is not known but studies suggest figures of between 4.7 and 27.3% of all unexplained deaths in type 1 DM. The pathogenesis is unclear but patients typically have a preceding history of recurrent severe hypoglycaemia. We describe two cases of "dead in bed" syndrome which occurred at our institution within a 12-month period.
Omid Zargari Samani
Full Text Available Type 1 diabetes is a multi-factorial disease that can develop due to the combination of genetic and environmental factors. Viruses, particularly enteroviruses, are major environmental candidates in the pathogenesis of type 1 diabetes, even though the mechanisms of pathogenicity of these viruses and their effects on the immune system have not been understood very well yet. Previous studies show that any imbalance in the population of different lymphocyte subsets could develop autoimmune diseases. Our theory is that enteroviral infection causes an impairment in the distribution of lymphocyte subtypes and consequently results in the diabetes onset in some individuals. Therefore, in this project, we evaluated the distribution of T CD8+ lymphocytes and their subsets in type 1 diabetes patients. This study was conducted to investigate the relationship between enteroviral infection and type 1 diabetes mellitus in an Iranian population, and suggestion a predicting approach for susceptible subjects. Keywords: Type 1 diabetes mellitus, Enterovirus, CD8+T, Flow cytometry, GAD65
Nnedu, Cordelia Chinwe; Gayle, Lynette; Popoola, Sola
The aim of this research was to examine the impact of type 1 diabetes on women's nutritional beliefs and their lifestyle choices both for themselves and for their families. The data sources used were the online databases of OVID, CINAHL, MEDLINE, PsyINFO, PsyARTICLE, ERIC, Health Source Nursing/Academic edition, and the Centers for Disease Control from January 2000 to 2012. The concentration of the search was to identify literature with the key words "nutrition," "lifestyle," or "women with type 1 diabetes." The researchers found 28 data-based research articles that examined women with type 1 diabetes. The articles were individually scrutinized for relevance and limited to English language articles. Data concerning the nutritional beliefs, lifestyle choices, andfamily dynamics among women with DM1 were extracted. The research articles consisted of 19 qualitative studies, 7 quantitative studies, and 2 theory-testing studies. The themefor the studies included, but was not limited to, birth size, eating disorders, complications of diabetes mellitus, theory testing, documentations of effectiveness, estimations of carbohydrates, weight, changes during pregnancy in women with type 1 diabetes mellitus, and their educational preferences. This integrative review described the effects of DM1 on women's nutritional belief and lifestyle choices. Results demonstrated the importance of education and follow-ups; however, future studies are needed to identify factors that contribute to noncompliance and waysfor patients to comprehend the seriousness of complications that can arise from type 1 diabetes mellitus.
The incretin hormones are intestinal peptides that enhance insulin secretion following ingestion of nutrients. Liraglutide is a glucagon-like peptide-1 receptor analogue, which is obtained by derivatising glucagon-like peptide-1 with a fatty acid, providing a compound with pharmacokinetic propert...... transient nausea and diarrhoea. This article reviews the mechanisms of action and efficacy of liraglutide for the treatment of Type 2 diabetes mellitus. This agent is presently in Phase III clinical development....... properties that are suitable for once-daily dosing. Liraglutide has demonstrated lasting improvement of HbA(1c )levels, weight reduction and improved beta-cell function in patients with Type 2 diabetes mellitus. Liraglutide is well tolerated; the adverse events that are most frequently reported being...
da Silva, Natália Chantal Magalhães; Chaves, Érika de Cássia Lopes; de Carvalho, Emilia Campos; Carvalho, Leonardo César; Iunes, Denise Hollanda
Abstract Objective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz. PMID:26444161
Kyvik, K O; Green, A; Svendsen, Anders Jørgen
A case-control study was conducted to study the proposed inverse relationship between breast feeding and incidence of Type 1 diabetes mellitus. All Danish diabetic men born in Copenhagen during 1959-1964 and/or residing there for the first year of life (n = 119) were identified and a search made...... for their post-natal health visitor records. These include data on birth weight, birth length, immunizations, and feeding habits. A total of 77 cases were re-identified. No differences were found with respect to clinical characteristics between these cases and those not identified. For each diabetic subject, two...... control children with date of birth identical to the diabetic cases were drawn from health visitor records. Cases and controls did not differ with respect to maternal age, or birth weight or length. Overall, the statistical analysis failed to confirm the hypothesis of an association between duration...
Bakkar, May M; Haddad, Mera F; Gammoh, Yazan S
Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education ( p diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.
Zhao, Qianping; Laukkanen, Jari A; Li, Qifu; Li, Gang
There is limited information on the association between metabolic syndrome components including body mass index (BMI) and type 2 diabetes mellitus in elderly Chinese population. Therefore, we investigated whether components of metabolic syndrome are associated with type 2 diabetes mellitus in elderly. A total of 479 hospitalized patients (aged 65-95 years) with recently diagnosed type 2 diabetes mellitus were studied retrospectively in a cross-sectional study and compared with 183 subjects with prediabetes and 62 subjects without glucose metabolism abnormalities. BMI (24.69±3.59 versus 23.92±3.08 and 23.56±3.25 kg/m 2 ), blood pressure, cholesterol, triglyceride, liver enzymes and prevalence of fatty liver were higher in patients with type 2 diabetes mellitus as compared with elderly subjects with prediabetes or normal glucose metabolism separately (all P type 2 diabetes mellitus group (all P type 2 diabetes mellitus.
Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin
on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. DESIGN: A comprehensive review of available evidence and data sources on prevalence, risk factors, cost......, complications, treatment, and management of diabetes mellitus type 2 in Nepal was conducted through an online database search for articles published in English between January 2000 and November 2015. Additionally, we performed a manual search of articles and reference lists of published articles for additional...... references. RESULTS: Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities...
Schmitt, Ara J.; Wodrich, David L.; Lazar, Susan
Type 1 diabetes mellitus (T1DM) is a chronic illness that can impact learning and often requires medical management in the school setting. School psychologists must therefore be knowledgeable of special service eligibility criteria associated with T1DM, the health-related services often required of such students, and what health-related services…
Since its discovery almost a century ago, insulin remains the mainstay of treatment of patients with type 1 diabetes mellitus. Although progress in the synthesis of new formulations has been remarkable, the physiological profile of insulin is still different from that observed with preparations available nowadays. In the last decade, the introduction into clinical practice of insulin analogues has allowed significantly improvement in glycemic control and has facilitated the spread of basal/bolus patterns, the most physiological ones until now. Despite the benefits of basal analogues, glycemia often varies considerably when used as a single daily injection and this is why new molecules have been further investigated. Improvement has been achieved especially in terms of duration and rate of hypoglycemia, the main limiting factor of intensive therapy. This article reviews the available data concerning the new basal insulin analogues, degludec, pegylated lispro and glargine U300, and new formulations currently under development. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Yasumizu, R.; Sugiura, K.; Iwai, H.
Non-obese diabetic (NOD) mice provide a model for type 1 diabetes mellitus. We previously showed that allogeneic bone marrow transplantation (ABMT) can prevent and treat insulitis and overt diabetes in NOD mice. However, ABMT alone could not be used to treat overt diabetes in NOD mice whose islets had been completely destroyed. To provide insulin-producing cells, pancreatic tissue from newborn mice was grafted under the renal capsules in combination with ABMT. The aims of concomitant ABMT are as follows. (i) It induces immunological tolerance to the donor-type major histocompatibility complex determinants and permits the host to accept subsequent pancreatic allografts from the bone marrow donor. (ii) ABMT replaces abnormal stem cells with normal stem cells. After transplantation of bone marrow plus newborn pancreas, NOD mice showed reduction of the glycosuria and a normal response in the glucose-tolerance test. Immunohistological study revealed the presence of clustered insulin-containing beta cells in the grafted pancreatic transplants. ABMT may become a viable treatment of established type 1 diabetes mellitus in humans
Chau, Tin Kin; Fong, Daniel Yee Tak; Chan, Sophia Siu Chee; Wong, Janet Yuen Ha; Li, William Ho Cheung; Tan, Kathryn Choon Beng; Leung, Angela Yee Man; Wong, David Chung Ngok; Leung, Doris Yin Ping; Lam, Tai Hing
To investigate the smoking behaviours, perceptions about quitting smoking and factors associated with intention to quit in patients with type 2 diabetes mellitus. Smoking causes type 2 diabetes mellitus. There has been limited research on the needs and concerns of smokers with type 2 diabetes mellitus about quitting smoking. The study used a qualitative design. Patients diagnosed with type 2 diabetes mellitus who had a history of smoking were recruited at the outpatient diabetic clinics of two major local hospitals in Hong Kong for a semi-structured interview (n = 42), guided by the theory of planned behaviour. At data saturation, 22 current smokers and 20 ex-smokers with type 2 diabetes mellitus were recruited. The current smokers reported they had not quit smoking because of satisfaction with present health status, and misconceptions about the association between diabetes and smoking, and the perceived hazards of quitting. In contrast, ex-smokers had a positive opinion about quitting smoking, accepted advice about quitting from health professionals and received more family support than current smokers. Psychological addiction and weight gain after cessation made quitting challenging. Satisfaction with health status, inadequate knowledge about the relationship between type 2 diabetes mellitus and smoking, and misconceptions about quitting smoking resulted in negative attitudes toward quitting by type 2 diabetes mellitus smokers. Smoking peers, psychological addiction and post-cessation weight gain hindered the quitting process. Education on the causal link between smoking, type 2 diabetes mellitus and its complications is important to raise health awareness and counter misconceptions about quitting smoking. Behavioural counselling with weight control strategies should be part of a comprehensive smoking cessation intervention for type 2 diabetes mellitus smokers. © 2015 John Wiley & Sons Ltd.
Hosseinzadeh, Payam; Javanbakht, Mohammad Hassan; Mostafavi, Seyed-Ali; Djalali, Mahmoud; Derakhshanian, Hoda; Hajianfar, Hossein; Bahonar, Ahmad; Djazayery, Abolghassem
Brewer's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. In a randomized double-blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer's yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus.
Conclusions. In patients with diabetes mellitus type 1 and concomitant diabetic nephropathy without hypertension, we can recommend to study these polymorphic variants of genes to determine the risk of preeclampsia.
Type 2 diabetes mellitus (T2DM) prevalence is increasing rapidly around the world. This cross-sectional study was conducted to assess the prevalence and awareness of type 2 diabetes mellitus in Mwanza city, Tanzania. A multistage random sampling technique was used to obtain representative subjects. Information ...
Full Text Available BACKGROUND Diabetic retinopathy is a major cause of blindness in the world with India being set to emerge as the diabetic capital of the world. Visual disability from diabetes is a significant health problem, but its morbidity is largely preventable and treatable. HbA1c (glycosylated haemoglobin is the best indicator of glycaemic control. It has long been known to predict the incidence and progression of diabetic retinopathy. Our aim is to evaluate the correlation of STDR in type 2 diabetes mellitus with HbA1c levels. MATERIALS AND METHODS A cross-sectional study was carried out in the Department of Ophthalmology, Government Medical College, Kozhikode, among 250 randomly selected type 2 Diabetes Mellitus patients and they were grouped into STDR, non-STDR and no diabetic retinopathy based on ophthalmoscopy. HbA1c level was estimated and its correlation was analysed using SPSS software version 17.0. Association of STDR with duration of diabetes and Body Mass Index (BMI were also studied. RESULTS Out of 250 patients studied, mean age was 58.98 with 126 males and 124 females and there was increased incidence of STDR in males. 104 patients with STDR had HbA1c value of more than 8, high incidence of STDR were noted with increasing levels of HbA1c and the correlation was statistically significant (p = 0.02. 74.1% of patients had STDR in the group with duration of diabetes 11 to 15 years, 90.90% in more than 21 years group compared to 43% in the 5 years group. Increase in duration of diabetes was found to be significantly associated with higher incidence of STDR (p = 0.01. Incidence of STDR were more in patients with normal BMI (p = 0.03. CONCLUSION Poor diabetic control as noted by high HbA1c level and longer duration of diabetes were significantly associated with sightthreatening diabetic retinopathy. Patients with STDR and high HbA1c levels have to be referred for appropriate evaluation and treatment at the earliest to prevent blindness.
Full Text Available Context: To evaluate the necessity of ocular screening in Type 1 diabetes mellitus (DM. Aims: This study aims to investigate the diabetes-related ocular changes according to the glycosylated hemoglobin (HbA1c level and duration of diabetes in children and compare the results with nondiabetic healthy children. Settings and Design: Observational cross-sectional study designed by ophthalmology and pediatric endocrinology clinics. Subjects and Methods: Forty-two children with Type 1 DM, 42 healthy gender- and age-matched children as controls were enrolled. All patients underwent ophthalmic and physical examination, with a review of medical history and current medication. HbA1c level, best corrected visual acuity, intraocular pressure (IOP, central corneal thickness (CCT, tear break-up time (BUT, Schirmer test, dilated fundus examination findings, central retinal thickness (CRT, and total macular volume (TMV measurements were noted. Statistical Analysis: Descriptive statistics, Student's t-test, Mann–Whitney U-test, Chi-square test for comparison of the group parameters and correlation analyses (Spearman analysis were performed with SPSS statistical software 17.0 (SPSS Inc., Chicago, IL, USA. Results: Type 1 DM group exhibited significantly reduced Schirmer test, increased IOP and decreased retinal thickness relative to the age-matched control group (P < 0.05 but no statistically significant difference was found for the BUT (P = 0.182 and for the CCT (P = 0.495. The correlations between the age, duration, HbA1c and IOP, BUT, Schirmer test, TMV, CRT measurements did not reach statistical significance. Conclusions: More frequent screening may be needed for complications, including neuropathy-related dry eye syndrome, IOP changes, and diabetic retinopathy in children with Type 1 DM.
Horr, Samuel; Nissen, Steven
Hypertension is a common problem in the diabetic population with estimates suggesting a prevalence exceeding 60%. Comorbid hypertension and diabetes mellitus are associated with high rates of macrovascular and microvascular complications. These two pathologies share overlapping risk factors, importantly central obesity. Treatment of hypertension is unequivocally beneficial and improves all-cause mortality, cardiovascular mortality, major cardiovascular events, and microvascular outcomes including nephropathy and retinopathy. Although controversial, current guidelines recommend a target blood pressure in the diabetic population of diabetes. Management of blood pressure in patients with diabetes includes both lifestyle modifications and pharmacological therapies. This article reviews the evidence for management of hypertension in patients with type 2 diabetes mellitus, and provides a recommended treatment strategy based on the available data. Copyright © 2016 Elsevier Ltd. All rights reserved.
Fernández-Soto, María L; Martín-Leyva, Ana; González-Jiménez, Amalia; García-Rubio, Jesús; Cózar-Ibáñez, Antonio; Zamora-Camacho, Francisco J; Leyva-Martínez, María S; Jiménez-Ríos, Jose A; Escobar-Jiménez, Fernándo
We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25).
Li, Xu; Zhang, Lei; Chen, Haibing; Guo, Kaifeng; Yu, Haoyong; Zhou, Jian; Li, Ming; Li, Qing; Li, Lianxi; Yin, Jun; Liu, Fang; Bao, Yuqian; Han, Junfeng; Jia, Weiping
Recent studies highlight a negative association between total bilirubin concentrations and albuminuria in patients with type 2 diabetes mellitus. Our study evaluated the relationship between bilirubin concentrations and the prevalence of diabetic nephropathy (DN) in Chinese patients with type 1 diabetes mellitus (T1DM). A total of 258 patients with T1DM were recruited and bilirubin concentrations were compared between patients with or without diabetic nephropathy. Multiple stepwise regression analysis was used to examine the relationship between bilirubin concentrations and 24 h urinary microalbumin. Binary logistic regression analysis was performed to assess independent risk factors for diabetic nephropathy. Participants were divided into four groups according to the quartile of total bilirubin concentrations (Q1, 0.20-0.60; Q2, 0.60-0.80; Q3, 0.80-1.00; Q4, 1.00-1.90 mg/dL) and the chi-square test was used to compare the prevalence of DN in patients with T1DM. The median bilirubin level was 0.56 (interquartile: 0.43-0.68 mg/dL) in the DN group, significantly lower than in the non-DN group (0.70 [interquartile: 0.58-0.89 mg/dL], P 1). Spearman's correlational analysis showed bilirubin concentrations were inversely correlated with 24 h urinary microalbumin (r = -0.13, P 1.90% to 2.00%. High bilirubin concentrations are independently and negatively associated with albuminuria and the prevalence of DN in patients with T1DM.
Lauszus, Finn; Al-Far, Hanine M; Tjessem, Ingvild
The ambulatory arterial stiffness index (AASI) and pulse pressure (PP) was analyzed during pregnancy and three months after delivery in type 1 diabetes mellitus (T1DM) compared to non-diabetic, pregnant controls. The study was performed prospectively in 176 women with T1DM and 54 control women...... at a tertiary centre. Blood pressure (BP) was measured using a portable oscillometry monitor and AASI was calculated as 1 minus the regression slope of diastolic BP on systolic BP obtained from 24-hour monitoring. Main outcome measures were AASI and PP associated with diabetes vasculopathy and blood pressure...... measurements during and after pregnancy. We found that AASI and PP were higher in 2nd and 3rd trimester during pregnancy in T1DM compared to post partum and significantly associated with albumin excretion rate. The AASI was positively correlated with night-day ratio during and outside pregnancy in diastolic BP...
Hogan, Andrew E; Gaoatswe, Gadintshware; Lynch, Lydia; Corrigan, Michelle A; Woods, Conor; O'Connell, Jean; O'Shea, Donal
Glucagon-like peptide 1 (GLP-1) is a gut hormone used in the treatment of type 2 diabetes mellitus. There is emerging evidence that GLP-1 has anti-inflammatory activity in humans, with murine studies suggesting an effect on macrophage polarisation. We hypothesised that GLP-1 analogue therapy in individuals with type 2 diabetes mellitus would affect the inflammatory macrophage molecule soluble CD163 (sCD163) and adipocytokine profile. We studied ten obese type 2 diabetes mellitus patients starting GLP-1 analogue therapy at a hospital-based diabetes service. We investigated levels of sCD163, TNF-α, IL-1β, IL-6, adiponectin and leptin by ELISA, before and after 8 weeks of GLP-1 analogue therapy. GLP-1 analogue therapy reduced levels of the inflammatory macrophage activation molecule sCD163 (220 ng/ml vs 171 ng/ml, p < 0.001). This occurred independent of changes in body weight, fructosamine and HbA1c. GLP-1 analogue therapy was associated with a decrease in levels of the inflammatory cytokines TNF-α (264 vs 149 pg/ml, p < 0.05), IL-1β (2,919 vs 748 pg/ml, p < 0.05) and IL-6 (1,379 vs 461 pg/ml p < 0.05) and an increase in levels of the anti-inflammatory adipokine adiponectin (4,480 vs 6,290 pg/ml, p < 0.002). In individuals with type 2 diabetes mellitus, GLP-1 analogue therapy reduces the frequency of inflammatory macrophages. This effect is not dependent on the glycaemic or body weight effects of GLP-1.
T.V. Sorokman; O.V. Makarova; V.G. Ostapchuk
The purpose of this review was the analysis of literature data on clinical and laboratory criteria for type 2 diabetes mellitus in children. A review of scientific literature was conducted using Pubmed as the search engine by the keywords: diabetes mellitus, type 2 diabetes mellitus, clinical picture, laboratory criteria, risk factors, taking into consideration studies conducted in the last 10 years, citation review of relevant primary and review articles, conference abstracts, personal files...
Nieuwesteeg, Anke M; Pouwer, Frans; van Bakel, Hedwig Ja
BACKGROUND: In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e......). METHODS/DESIGN: First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15). Observed behaviors are described into rating scales, with each scale describing characteristics of parent...
Ryninks, Kirsty; Sutton, Eileen; Thomas, Elizabeth; Jago, Russell; Shield, Julian P H; Burren, Christine P
To investigate young people's attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus. Four focus groups with 11-14 and 15-16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis. Four superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and "You can do anything". Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal. Whilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life.
Meeuwisse-Pasterkamp, Susanne H; van der Klauw, Melanie M.; Wolffenbuttel, Bruce HR
Type 2 diabetes mellitus is a disease that affects a rapidly increasing number of patients. Most patients with Type 2 diabetes will develop vascular complications. This may be microvascular disease, such as nephropathy, retinopathy or polyneuropathy, and also macrovascular disease, such as coronary
Soedamah-Muthu, S.S.; Stehouwer, C.D.A.
There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification
Soedamah-Muthu, S.S.; Stehouwer, C.D.A.
There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification
Di Gialleonardo, Valentina; de Vries, Erik F. J.; Di Girolamo, Marco; Quintero, Ana M.; Dierckx, Rudi A. J. O.; Signore, Alberto
Insulin-dependent (type 1) diabetes mellitus is a metabolic disease with a complex multifactorial etiology and a poorly understood pathogenesis. Genetic and environmental factors cause an autoimmune reaction against pancreatic beta-cells, called insulitis, confirmed in pancreatic samples obtained at
Silva-E-Oliveira, Julia; Amélio, Pâmela Marina; Abranches, Isabela Lopes Laguardia; Damasceno, Dênis Derly; Furtado, Fabianne
To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score and was classified as low risk (n=26), slightly elevated risk (n=41), moderate risk (n=27) and high risk (n=32). To measure heart rate variability, a heart-rate monitor Polar S810i® was employed to obtain RR series for each individual, at rest, for 5 minutes, followed by analysis of linear and nonlinear indexes. The groups at higher risk of type 2 diabetes mellitus had significantly lower linear and nonlinear heart rate variability indexes. The individuals at high risk for type 2 diabetes mellitus have lower heart rate variability. Avaliar a variabilidade da frequência cardíaca em adultos com diferentes níveis de risco para diabetes mellitus tipo 2. O grau de risco para diabetes mellitus tipo 2 de 130 participantes (41 homens) foi avaliado pelo questionário Finnish Diabetes Risk Score. Os participantes foram classificados em baixo risco (n=26), risco levemente elevado (n=41), risco moderado (n=27) e alto risco (n=32). Para medir a variabilidade da frequência cardíaca, utilizou-se o frequencímetro Polar S810i® para obter séries de intervalo RR para cada indivíduo, em repouso, durante 5 minutos; posteriormente, realizou-se análise por meio de índices lineares e não-lineares. O grupo com maior risco para diabetes mellitus tipo 2 teve uma diminuição significante nos índices lineares e não-lineares da variabilidade da frequência cardíaca. Os resultados apontam que indivíduos com risco alto para diabetes mellitus tipo 2 tem menor variabilidade da frequência cardíaca. To evaluate heart rate variability among adults with different risk levels for type 2 diabetes mellitus. The risk for type 2 diabetes mellitus was assessed in 130 participants (89 females) based on the questionnaire Finnish Diabetes Risk Score
Boris Il'ich Kuznik; Yuriy Antonovich Vitkovskiy; Marina Yur'evna Zakharova; Natal'ya Nikolaevna Klyuchereva; Ol'ga Sergeevna Rodnina; Aleksey Vladimirovich Solpov
Aims. To assess differences in blood formed elements aggregation activity in patients with type 1 (T1) and type 2 (T2) diabetes mellitus (DM). Materials and methods. We studied blood samples from 88 patients with T1 and T2 DM. Platelet aggregation activity was assessed by means of «Biola» aggregometer; we also determined platelet-lymphocyte and leucocyte-erythrocyte adhesion intensity. Results. We show that spontaneous platelet aggregation is markedly increased in patients with T1...
Gundmi, Shubha; Maiya, Arun G; Bhat, Anil K; Ravishankar, N; Hande, Manjunatha H; Rajagopal, K V
People with type 2 diabetes mellitus frequently show complications in feet and hands. However, the literature has mostly focused on foot complications. The disease can affect the strength and dexterity of the hands, thereby reducing function. This systematic review and meta-analysis focused on identifying the existing evidence on how type 2 diabetes mellitus affects hand strength, dexterity and function. We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane central register of controlled trials for reports of studies of grip and pinch strength as well as hand dexterity and function evaluated by questionnaires comparing patients with type 2 diabetes mellitus and healthy controls that were published between 1990 and 2017. Data are reported as standardized mean difference (SMD) or mean difference (MD) and 95% confidence intervals (CIs). Among 2077 records retrieved, only 7 full-text articles were available for meta-analysis. For both the dominant and non-dominant hand, type 2 diabetes mellitus negatively affected grip strength (SMD: -1.03; 95% CI: -2.24 to 0.18 and -1.37, -3.07 to 0.33) and pinch strength (-1.09, -2.56 to 0.38 and -1.12, -2.73 to 0.49), although not significantly. Dexterity of the dominant hand did not differ between diabetes and control groups but was poorer for the non-dominant hand, although not significantly. Hand function was worse for diabetes than control groups in 2 studies (MD: -8.7; 95% CI: -16.88 to -1.52 and 4.69, 2.03 to 7.35). This systematic review with meta-analysis suggested reduced hand function, specifically grip and pinch strength, for people with type 2 diabetes mellitus versus healthy controls. However, the sample size for all studies was low. Hence, we need studies with adequate sample size and randomized controlled trials to provide statistically significant results. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Type 2 diabetes mellitus (T2DM) is an insulin-insufficient disease characterised ... complications.1–4 Early in the onset of T2DM there is development of relative insulin ..... position statement of the American Diabetes Association (ADA) and.
Full Text Available We recently found that overexpression of angiotensin (Ang-converting enzyme 2, which metabolizes Ang-II to Ang-(1-7 and Ang-I to Ang-(1-9, may prevent diabetes-induced left ventricular remodeling and dysfunction in rats. Our objective was to evaluate the association of plasma Ang-(1-7 level and left ventricular function in patients with type 2 diabetes mellitus.We measured the left ventricular ejection fraction (EF, ratio of early to late left ventricular filling velocity (E/A and ratio of early diastolic mitral inflow to annular velocity (E/Ea by ultrasonography in 110 patients with type 2 diabetes mellitus for more than 5 years. Anthropometric and fasting blood values were obtained from medical records. The plasma Ang-(1-7 level in patients with a poor EF (15 was significantly lower than that in patients with E/Ea ≤15. Ang-(1-7 level was negatively correlated with E/Ea and Log-N-terminal pro-B-type natriuretic peptide and positively with EF and E/A. Stepwise multiple regression analysis revealed that Ang-(1-7, hemoglobin A1c and Ang-II levels as well as duration of diabetes predicted EF; Ang-(1-7 level, fasting blood glucose, low-density lipoprotein cholesterol level and duration of diabetes predicted E/A; and Ang-(1-7 and hemoglobin A1c levels predicted E/Ea.Plasma Ang-(1-7 level is independently associated with left ventricular function in patients with type 2 diabetes mellitus and may be a biomarker for assessing cardiac function in such patients.
Alonso Martín, Daniel E; Roldán Martín, M Belén; Álvarez Gómez, M Ángeles; Yelmo Valverde, Rosa; Martín-Frías, María; Alonso Blanco, Milagros; Barrio Castellanos, Raquel
Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII]). Mean HbA1c levels in the previous year was considered as metabolic control marker. Mean HbA1c levels were similar in both treatment groups, with slightly higher values in children over 12years of age. Patients on CSII had a longer time since disease onset and had poorer results, maybe because the items were more difficult due to the higher level of knowledge required for this treatment modality (P=.005). Caregivers with lower educational levels achieved poorer scores in the survey, but mean HbA1c levels of their children were lower, probably because of their greater involvement in disease care. The level of knowledge of caregivers and/or patients with T1DM was high, and this was associated to good metabolic control. Studies to assess the impact of caregiver knowledge on metabolic control of children are needed. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.
Marina Fedorovna Kalashnikova
Full Text Available Diabetes mellitus is a disease that presents a global medical problem. It is necessary to implement an in-depth analysis of the epidemiological situation of type 2 diabetes mellitus for planning and organizing specialized medical help to patients with type 2 diabetes mellitus. Aim. To rate the basic epidemiological indices of type 2 diabetes mellitus in actual clinical practice using the informational database of national registry of diabetic patients. Materials and methods. Epidemiological analyses were performed in two administrative districts of Moscow. From 1999 to 2011 48978 adult patients with type 2 diabetes mellitus who were aged 18 years and older were registered. We used methods of clinical, analytical and statistical epidemiology with elements of descriptive research. Results. The prevalence rate of type 2 diabetes mellitus was 1590 per hundred thousand, most patients were in the 60?64 and 70?74 age groups, and approximately 80% of patients were older than 55 years. The morbidity rate of type 2 diabetes mellitus was 138,72 per hundred thousand and was found to be higher in women at 1,89. The mortality rate of adult patients with diabetes mellitus was 0,83, mostly in men of all ages. Cardiovascular diseases accounted for most of the registered cases of deaths (34,4%. The average life expectancy appeared to be 75,24?0,45 years, although women lived 6 years longer than men. The average duration of the disease was 10,04?0,34 years. A total of 0,4% of patients underwent hospital treatment and the average length of treatment was 17?18 days. The total number of days of disablement was an average of 307,33?30,13 days (80% of patients were older than 55 years. In the study group, a mean grade of НbА1c
Full Text Available We examined 25 pregnant patients with diabetes mellitus type 1: 20 patients were on intensified one, 5 — on the traditional regimen of insulin therapy. It is found that intensified insulin therapy with self-control provided a good compensation of carbohydrate metabolism and more favorable pregnancy outcomes.
Caire Estévez, J P; González-Ocampo Dorta, S; Sanz Solana, P
The case is presented of a 29-year-old woman who complained of headache over a period of several days, with loss of visual acuity and pain in her left eye. She had a 3-year history of type 1 diabetes mellitus, and was an immigrant from Ecuador. The funduscopic examination revealed a papilledema. The polymerase chain reaction (PCR) study of the cerebrospinal fluid was positive for Mycobacterium tuberculosis (MTB). She showed a marked improvement after treatment with anti-TB drugs. About a third of the world's population has a latent infection of MTB, comorbidity between diabetes mellitus and tuberculosis has been reported, particularly in undeveloped countries. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.
Pregnancy in women with type 1 diabetes mellitus is associated with neonatal morbidity. It is commonly agreed that the morbidity decreases when diabetic control is tightened. The most common methods for the determination of diabetic control are the self-monitoring of blood glucose levels (SMBG) and
Clausen, P; Jacobsen, P; Rossing, K
AIMS: Elevated urinary albumin excretion is associated with macrovascular atherosclerotic complications in Type 1 diabetes mellitus. Adhesion molecules mediate leucocyte adhesion to the endothelium early in the atherosclerotic process. The present study tests the hypothesis that microalbuminuria...... disease in diabetic patients with renal complications. METHODS: Soluble adhesion molecule concentrations were measured by enzyme-linked immunosorbent assays (ELISA) in healthy controls (n = 16) and in 59 Type 1 diabetic patients: group 1-patients with normoalbuminuria (n = 16); group 2-patients...... diabetic patients, but the concentrations were increased by the presence of microalbuminuria and overt nephropathy (P diabetic patients and controls. CONCLUSIONS: Plasma concentration of sICAM-1 is elevated in Type 1...
Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin
references. Results Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack...... on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. Design A comprehensive review of available evidence and data sources on prevalence, risk factors, cost...
Full Text Available Diabetes mellitus can be looked upon as an array of diseases, all of which exhibit common symptoms. While pathogenesis of IDDM (insulin dependant diabetes mellitus is well understood, the same is not true for diabetes mellitus type II. In the latter case, relative contribution of the two factors (insulin resistance or decreased insulin secretion varies individually, being highly increased in peripheral tissues and strictly dependant on insulin for glucose uptake. Moreover, in patients with diabetes mellitus type II, disbalance at the level of regulation of glucose metabolism as well as lipid metabolism has been noted in skeletal muscles. It is normal to assume that in this type of diabetes, these changes are reflected at the level of total activity of enzyme creatine kinase. This experimental work was performed on a group of 80 regular patients of Sarajevo General Hospital. Forty of those patients were classified as patients with diabetes type I and forty as patients with diabetes type II. Each group of patients was carefully chosen and constituted of equal number of males and females. The same was applied for adequate controls. Concentration of glucose was determined for each patient with GOD method, while activity of creatine kinase was determined with CK-NAC activated kit. Statistical analysis of the results was performed with SPSS software for Windows. Obtained results point out highly expressed differences in enzyme activity between two populations examined. Changes in enzyme activity are more expressed in patients with diabetes type II. Positive correlation between concentration of glucose and serum activity of the enzyme is seen in both categories of diabetic patients which is not the case for the patients in control group. At the same time, correlation between age and type of diabetes does exist . This is not followed at the level of enzyme activity or concentration of glucose.
Sejling, A-S; Schouwenberg, B; Faerch, L H
AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus. METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269...... of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort). RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either...... of macrovascular disease and reduced kidney function. CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus....
Siddiqui, M.U.; Ali, I.; Asghar, S.P.; Ahmed, M.R.
Objective: The objective of this study was to determine the frequency of Hypomagnesemia in patients with uncontrolled type II diabetes mellitus. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medicine, PNS Shifa Naval Hospital Karachi, from Jul 2012 to Dec 2012 over a period of six months. Material and Methods: In this study, three hundred and twenty three patients of uncontrolled diabetes mellitus type-II on oral hypoglycemic agents for more than five years, presenting to medical OPD, were recruited. All patients fulfilled inclusion and exclusion criteria. Blood samples of all patients for serum HbA1c and serum magnesium levels were analyzed at the time of enrollment. Statistical analysis was done on SPSS 20. Results: Out of 323 patients, 243 (75.23 percent) were males and 80 (24.76 percent) were females with the age ranging from 40 - 65 years (mean age and SD 54.76 +- 6.43). Hypomagnesemia was found in 117 patients, without any significant difference in men and women (38.45 percent and 35.39 percent respectively). The mean duration of diabetes was 12.5 years (ranging from 5 to 22 years). By frequency test in SPSS-20, the highest frequency of hypomagnesemia (49.42 percent) is seen in (8.6-9.0) HbA1c group while lowest frequency hypomagnesemia (15.38 percent) is seen in (>10.0) HbA1c level group mean standard deviation and p-value calculated by Pearson correlation statistic in SPSS-20 for quantitative variables (HbA1c, Magnesium level). Conclusion: Hypomagnesemia is frequent in poorly controlled type-II diabetes mellitus having increased level of HbA1c. So it may be prudent in clinical practice to periodically monitor plasma magnesium and HbA1c in type-II diabetes mellitus patients. (author)
Pinhas-Hamiel, Orit; Hamiel, Uri; Greenfield, Yuval; Boyko, Valentina; Graph-Barel, Chana; Rachmiel, Marianna; Lerner-Geva, Liat; Reichman, Brian
Intentional insulin omission is a unique inappropriate compensatory behavior that occurs in patients with type 1 diabetes mellitus, mostly in females, who omit or restrict their required insulin doses in order to lose weight. Diagnosis of this underlying disorder is difficult. We aimed to use clinical and laboratory criteria to create an algorithm to assist in the detection of intentional insulin omission. The distribution of HbA1c levels from 287 (181 females) patients with type 1 diabetes were used as reference. Data from 26 patients with type 1 diabetes and intentional insulin omission were analysed. The Weka (Waikato Environment for Knowledge Analysis) machine learning software, decision tree classifier with 10-fold cross validation was used to developed prediction models. Model performance was assessed by cross-validation in a further 43 patients. Adolescents with intentional insulin omission were discriminated by: female sex, HbA1c>9.2%, more than 20% of HbA1c measurements above the 90th percentile, the mean of 3 highest delta HbA1c z-scores>1.28, current age and age at diagnosis. The models developed showed good discrimination (sensitivity and specificity 0.88 and 0.74, respectively). The external test dataset revealed good performance of the model with a sensitivity and specificity of 1.00 and 0.97, respectively. Using data mining methods we developed a clinical prediction model to determine an individual's probability of intentionally omitting insulin. This model provides a decision support system for the detection of intentional insulin omission for weight loss in adolescent females with type 1 diabetes mellitus. Copyright © 2013 Wiley Periodicals, Inc.
Hemmingsen, Bianca; Schroll, Jeppe B; Lund, Søren
Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial.......Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. Whether sulphonylureas show better, equal or worse therapeutic effects in comparison with other antidiabetic interventions for patients with T2DM remains controversial....
Full Text Available Vitamin D has an important role and supposed to be a risk factor in the development of pathogenesis of type 2 diabetes mellitus by affecting either insulin sensitivity or β-cell function, or both. The present study was conducted to evaluate the relation of serum vitamin D3 and type 2 diabetes mellitus. Total 80 individuals were enrolled in this study. Forty newly diagnosed type 2 diabetic individual were enrolled as cases and 40 healthy glucose tolerant subjects were enrolled as controls. Serum vitamin D3 was measured by chemiluminescence microparticle immunoassay. Fasting and 2 hours plasma glucose level were measured by hexokinase method using the Dimension clinical chemistry system. The mean serum vitamin D3 level was significantly low in type 2 diabetes mellitus than in controls (p= 0,007. The individual with vitamin D3 deficiency showed 3.4 times higher chances to develop type 2 diabetes mellitus compare to the individual with normal vitamin D status. Correlation test showed significant (r= -0.351 negative correlation (p=0.026 between serum vitamin D3 and type 2 diabetes mellitus. It can be concluded that vitamin D3 deficiency is related to type 2 diabetes mellitus.
Şahin, Nilfer; Öztop, Didem Behice; Yilmaz, Savaş; Altun, Hatice
The aim of the present study was to identify psychopathology, parental attitudes, perceptions of quality of life, and relationships between these factors in adolescents with type 1 diabetes mellitus (DM). Fifty adolescents (12-18 years old) with type 1 diabetes mellitus and 50 healthy adolescents and their parents were recruited for the study. Clinical interviews with the diabetic adolescents were performed using "Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL)." Both groups completed the "Depression Scale for Children," "State-Trait Anxiety Inventory," and "Health Related Quality of Life Scale for Children," while their parents completed the "Parental Attitude Research Instrument," "The Coping Strategy Indicator," and "Health Related Quality of Life Scale for Children-Parent Form." The psychological disorder ratio in diabetic adolescents was 68%. No significant difference was found regarding perceptions of quality of life between the diabetic group and control group. However, diabetic adolescents with psychological disorder had reduced perception of quality of life than those without psychological disorder. Among parental attitudes, an authoritarian attitude was found to be more common in the diabetic group. It was found that among coping strategies, parents in the diabetic group use avoidance more commonly. In the present study, a high rate of psychopathology was detected among adolescents with type 1 DM. In addition, no clear impairment in quality of life was reported in patients with type 1 DM; however, there was worsening in the perception of quality of life in the presence of psychiatric disorders accompanying diabetes. It was found that parents of diabetic children use inappropriate coping strategies and negative parental attitudes more often than those of healthy controls.
There is a selective review of the literature concerning the coexistence of coeliac disease and type 1 diabetes mellitus. This review focuses on the principles of serological tests towards coeliac disease in patients with type 1 diabetes mellitus and metabolic control measures as a result of a gluten-free diet.
Full Text Available To investigate young people's attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus.Four focus groups with 11-14 and 15-16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis.Four superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and "You can do anything". Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal.Whilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life.
Ryninks, Kirsty; Sutton, Eileen; Thomas, Elizabeth; Jago, Russell; Shield, Julian P. H.; Burren, Christine P.
Aims To investigate young people’s attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus. Methods Four focus groups with 11–14 and 15–16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis. Results Four superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and “You can do anything”. Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal. Conclusions Whilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life. PMID:26465770
Rusdiana; Savira, Maya; Amelia, Rina
The study aimed to evaluate the effect of short-term diabetes self-management education (DSME) on Hba1and Fasting Blood Sugar in type 2 diabetes mellitus patients attending the Primary Health Care (PHC) in Binjai city of North Sumatera, Indonesia. A quasi-experimental (pretest-posttest) study was conducted in 4 PHCs, involving 80 patients with type 2 diabetes mellitus. The patients in received a 3-months intervention, including an 8 week education on self- management of diabetes mellitus and subsequent 4 weeks of practice of the self- management guidelines.The patients received standard advice on diet management. There was a significant reduction in Hba1c levels. The statistical analysis using t-test found that there was a significant difference of Hba1c value between pre and post education among type 2 diabetes mellitus patients (p Diabetes self-management education in PHC of Binjai city can reduce the Hba1c level in type 2 diabetes mellitus patients.
Ooi, Cheow Peng; Yassin, Zaitun; Hamid, Tengku-Aizan
Momordica charantia (bitter gourd) is not only a nutritious vegetable but it is also used in traditional medical practices to treat type 2 diabetes mellitus. Experimental studies with animals and humans suggested that the vegetable has a possible role in glycaemic control. To assess the effects of mormodica charantia for type 2 diabetes mellitus. Several electronic databases were searched, among these were The Cochrane Library (Issue 1, 2012), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to February 2012), combined with handsearches. No language restriction was used. We included randomised controlled trials (RCTs) that compared momordica charantia with placebo or a control intervention, with or without pharmacological or non-pharmacological interventions. Two authors independently extracted data. Risk of bias of the trials was evaluated using the parameters of randomisation, allocation concealment, blinding, completeness of outcome data, selective reporting and other potential sources of bias. A meta-analysis was not performed given the quality of data and the variability of preparations of momordica charantia used in the interventions (no similar preparation was tested twice). Four randomised controlled trials with up to three months duration and investigating 479 participants met the inclusion criteria. Risk of bias of these trials (only two studies were published as a full peer-reviewed publication) was generally high. Two RCTs compared the effects of preparations from different parts of the momordica charantia plant with placebo on glycaemic control in type 2 diabetes mellitus. There was no statistically significant difference in the glycaemic control with momordica charantia preparations compared to placebo. When momordica charantia was compared to metformin or glibenclamide, there was also no significant change in reliable parameters of glycaemic control. No serious adverse effects were reported in any trial. No trial investigated death from any cause
to other autoimmune diseases, the etiology of T1D remains obscure but ..... T1D, type 1 diabetes; AIT, autoimmune thyroiditis; CD, celiac disease; AD, Addison's disease. Table 5. .... (GAD65Ab) in prediabetic adults developing diabetes.
Henriksson, Martin; Jindal, Ramandeep; Sternhufvud, Catarina; Bergenheim, Klas; Sörstadius, Elisabeth; Willis, Michael
Critiques of cost-effectiveness modelling in type 1 diabetes mellitus (T1DM) are scarce and are often undertaken in combination with type 2 diabetes mellitus (T2DM) models. However, T1DM is a separate disease, and it is therefore important to appraise modelling methods in T1DM. This review identified published economic models in T1DM and provided an overview of the characteristics and capabilities of available models, thus enabling a discussion of best-practice modelling approaches in T1DM. A systematic review of Embase(®), MEDLINE(®), MEDLINE(®) In-Process, and NHS EED was conducted to identify available models in T1DM. Key conferences and health technology assessment (HTA) websites were also reviewed. The characteristics of each model (e.g. model structure, simulation method, handling of uncertainty, incorporation of treatment effect, data for risk equations, and validation procedures, based on information in the primary publication) were extracted, with a focus on model capabilities. We identified 13 unique models. Overall, the included studies varied greatly in scope as well as in the quality and quantity of information reported, but six of the models (Archimedes, CDM [Core Diabetes Model], CRC DES [Cardiff Research Consortium Discrete Event Simulation], DCCT [Diabetes Control and Complications Trial], Sheffield, and EAGLE [Economic Assessment of Glycaemic control and Long-term Effects of diabetes]) were the most rigorous and thoroughly reported. Most models were Markov based, and cohort and microsimulation methods were equally common. All of the more comprehensive models employed microsimulation methods. Model structure varied widely, with the more holistic models providing a comprehensive approach to microvascular and macrovascular events, as well as including adverse events. The majority of studies reported a lifetime horizon, used a payer perspective, and had the capability for sensitivity analysis. Several models have been developed that provide useful
Full Text Available The objective — to establish the incidence of diabetic nephropathy (DN depending on duration of type 1 diabetes mellitus (DM, and also the content of cystatin С as a marker of early kidney damage. Materials and methods. Twenty eight patients with type 1 DM were enrolled in prospective study (11 men and 17 women aged 34.8 ± 7.2 years. Clinical and functional examination included the standard evaluation of renal function, and also the study of serum level of cystatin С. Results. In 17 out of 28 patients, the indexes of glomerular filtration rate calculated using the formulas of CKD-ЕРIcreat and CKD-ЕРIcys, indicated the different stages of chronic kidneys disease. Conclusions. Determination of cystatin C level and calculation of glomerular filtration rate using this index allows diagnosing the preclinical stages of kidney dysfunction in patients with type 1 DM in the normal creatinine level in the blood and without decline in glomerular filtration rate calculated using creatinine value. According to a retrospective study, the incidence and severity of DN in patients with type 1 DM increases with disease duration of more than 10 years.
Full Text Available OBJECTIVE The study objective was to examine the effect of glycaemic control and variations on the incidence and progression of diabetic retinopathy (DR among the diabetes mellitus patients visiting Medicine and Ophthalmology OPD Sapthagiri Medical college, Bangalore. MATERIALS AND METHODS 10 patients with type 1 diabetes mellitus, and 70 persons with type 2 diabetes mellitus, visiting the Medicine OPD of Sapthagiri Medical College and referred to Ophthalmology department of the above to detect the Diabetic Retinopathy changes in a diabetes mellitus management programme conducted for 3 months in Bangalore, participated in the study. Patients who were followed up for 6 months the same above were also included in the study. Analyses were conducted to assess the relationship between the risk factors, incidence and progression of Diabetic Retinopathy among Diabetes Mellitus patients and management. MAIN OUTCOME MEASURES To determine the risk factors associated with it, stage of retinopathy diagnosed at presentation, management of it, and final visual outcome. The prevention is by strict glycaemic control, prompt use of anti-diabetic drugs and regular exercises. These included age and gender-adjusted prevalence of diabetes and diabetic retinopathy, 1 and correlation of prevalence with history-based risk factors. RESULTS The three months cumulative incidence of DR was 58 %in type I diabetes mellitus and 42 % among type II Diabetes mellitus. After controlling for known risk factors for DR,1 a high baseline haemoglobin A1c (HbA1c, ethnicity, age, type of diabetes mellitus, duration were associated with the incidence of referable DR in patients with type 1 and type 2 diabetes mellitus. The age- and gender-adjusted prevalence rate of diabetes in urban Bangalore 28.2% (95% confidence interval [CI], and the prevalence of diabetic retinopathy in general population was 3.5% (95% CI. The prevalence of diabetic retinopathy in the population with diabetes
Amiri Dash Atan, Nasrin; Koushki, Mehdi; Motedayen, Morteza; Dousti, Majid; Sayehmiri, Fatemeh; Vafaee, Reza; Norouzinia, Mohsen; Gholami, Reza
The aim of this study was the evaluation of the prevalence of NAFLD in patients with type 2 diabetes mellitus. Non-alcoholic fatty liver disease (NAFLD) is an emerging disease with high prevalence in patients with type 2 diabetes mellitus (T2DM). Many studies have reported the prevalence of NAFLD in type 2 diabetes mellitus patients. However, these results are inconsistent. A Literature search was conducted in PubMed, Scopus, web of science and Science Direct from 2005 to August 2017. The necessary information was extracted. Heterogeneity was evaluated using I 2 statistic. Meta-regression analyses were performed to the estimation of the relationship between the year of study and sample size with the prevalence of NAFLD. Publication bias was assessed by both Begg rank correlation and Egger tests. Subgroup analysis was performed for identification of sources heterogeneity. Seventeen studies involving 10897 type 2 diabetes mellitus patients with NAFLD were included in this meta-analysis. The overall prevalence of NAFLD in type 2 diabetes mellitus patients by random effects models was 54% (95% CI, 45%- 64%). There is a significant heterogeneity across studies with (I 2 = 99%, p> 0.01). The funnel plot as graphically and Begg and Egger as statistically showed no publication bias among studies. Subgroup analysis indicated that the prevalence of NAFLD in type 2 diabetes mellitus patients differed in predictive factors such as lipid profile, BMI, HbA1c, AST, and ALT. This finding in spite of heterogeneity of documents is corresponding to the positive correlation between NAFLD and type 2 diabetes mellitus. The findings indicated that the overall prevalence of NAFLD among type 2 diabetes mellitus patients is significantly higher. It can be concluded that type 2 diabetes mellitus patients should be managed to prevent NAFLD.
Emotional problems such as depression, anxiety and diabetes-specific distress are common in patients with type 2 diabetes mellitus (T2DM) but often remain unrecognized and thus untreated. The present Review focuses on the extent of this problem and discusses whether we should screen for depression......DM have shown that screening for depression does not improve outcomes. On the other hand, collaborative care approaches for depression in patients with type 1 diabetes mellitus (T1DM) or T2DM seem to be effective. Intervention studies for anxiety or diabetes-specific emotional distress are currently...... assessments of emotional well-being in patients with T2DM. However, this recommendation is not based on strong evidence, as the effects of screening (case-finding) on psychological outcomes and diabetes outcomes have not been tested in a randomized controlled study. Results from studies in patients without T2...
Rasmussen, O. W.; Lauszus, Finn F; Loekke, M
Introduction Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared...... telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. Methods Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home...... by video conferences only or standard outpatient treatment. Primary outcomes were HbA1c and blood glucose levels and secondary outcomes were 24-hour blood pressure, cholesterol levels and albuminuria. The video-telephone was a broadband solution installed and serviced by the Danish Telephone Company (TDC...
The immune system is the body's natural defense system against invading pathogens. It protects the body from infection and works to communicate an individual's well-being through a complex network of interconnected cells and cytokines. This system is an associated host defense. An uncontrolled immune system has the potential to trigger negative complications in the host. Type 1 diabetes results from the destruction of pancreatic β-cells by a β-cell-specific autoimmune process. Examples of β-cell autoantigens are insulin, glutamic acid decarboxylase, tyrosine phosphatase, and insulinoma antigen. There are many autoimmune diseases, but type 1 diabetes mellitus is one of the well-characterized autoimmune diseases. The mechanisms involved in the β-cell destruction are still not clear; it is generally believed that β-cell autoantigens, macrophages, dendritic cells, B lymphocytes, and T lymphocytes are involved in the β-cell-specific autoimmune process. It is necessary to determine what exact factors are causing the immune system to become unregulated in such a manner as to promote an autoimmune response. Copyright © 2014 Elsevier B.V. All rights reserved.
Göhr, M; Röpcke, B; Pistor, K; Eggers, C
This paper discusses psychosocial influences of diabetes mellitus type 1 on children and young patients. A group of 21 patients, age 9 to 14 years with Diabetes mellitus type 1 attended a course in "Autogenic Training" for a period of 11 weeks. From the multidimensional questionnaire for children (PFK 9-14, SETZ U. RAUSCHE 1976) 15 dimensions of personality and 5 second rank factors were extracted at the beginning and at the end of training and 5 months later. Additionally HbA1-scores were assessed at the beginning and at the end at a 2 month and a 5 month-follow-up. At the beginning of the course only on one of the 15 scales a significant difference could be observed between experimental group and age related normal population. After training 5 scales and one second rank factor showed significant changes. Significant reduction was observed in: "need for aggressive forms of dominance behaviour" "feeling of submission with respects to other:", "emotional lability" and "tendency for dependence on adults". A significantly increased score was observed in the scale measuring "self confidence regarding one's own meaning, decisions and planning ability". The second rank faktor "neuroticism" was significantly reduced. Against expectations there was no reduction in HbA1 scores. At the end of training HbA1 scores even had increased significantly. But this might have been related to the high frequency of infections during this course. In subjective ratings of training evaluation most of the course members and their parents described fewer problems with attention, less test-anxiety and less aggression and nervousness. The results of this prospective pilot-study are discussed in terms of the psychodynamic influence on diabetes.
Hadzibegovic, I.; Miskic, B.; Prvulovic, D.; Bistrovic, D.; Cosic, V.
Studies of bone mineral density (BMD) in women with type 2 diabetes mellitus have shown conflicting results. We conducted this study to determine whether postmenopausal women with diabetes have higher BMD than non-diabetic women of similar age and to investigate the relationship between BMD and relevant clinical characteristics in these groups of women. We retrospectively analyzed lumbar spine, femoral neck and radius BMD data and other relevant clinical data for 130 postmenopausal women with type 2 diabetes mellitus and 166 non-diabetic women collected during a voluntary screening for osteoporosis in postmenopausal women without a history of low bone mass or osteoporotic fractures. Women with type 2 diabetes mellitus had significantly higher mean lumbar spine BMD (0.903 +-0.165 vs. 0.824+-0.199, respectively, P<0.001) and mean femoral neck BMD (0.870+-0.132 vs. 0.832+-0.134, respectively, P<0.05) than non-diabetic women. In both groups of women, age correlated negatively with BMD levels at all three anatomical sites. Higher body mass index was associated only with higher lumber spine BMD in both groups. Alkaline phosphatase levels showed a negative correlation with BMD at all sites in women with type 2 diabetes mellitus. Postmenopausal women with type 2 diabetes mellitus have higher BMD levels than non-diabetic women with similar clinical characteristics and require a more scrutinized approach in managing low bone mass. (author)
Tatiana Rebouças Moreira
Full Text Available Objective: to evaluate the knowledge on diabetes in children and adolescents and the difficulties regarding the disease. Methods: a quantitative study with 40 patients from 6 to 17 years older who were subjected on a questionnaire based on self-care behaviors proposed by the American Association of Diabetes Educators. Results: the average age was 11.6 years with predominance of the female gender (57.5%, most attending grade school (80.0%, naming the parents as primary caregivers (72.5%. Regarding the knowledge about the disease, the item with the highest percentage of errors was about the pathophysiology of Diabetes Mellitus type 1. On the difficulties related to the treatment, food control and application of insulin had higher frequency. Conclusion:the study revealed a high percentage of correct answers among the participants, suggesting knowledge about the disease. Nevertheless, they reported food control and insulin therapy as the main difficulties related to treatment.
Full Text Available Objective: The aim of the study was to evaluate periodontal health status in patients diagnosed with type 1 diabetes mellitus (DM1 and to establish a correlation between metabolic control and periodontal health status. Materials and Methods: Periodontal health parameters namely plaque index (PI, gingival index (GI, probing pocket depth (PPD and clinical attachment loss (CAL were recorded in 28 patients diagnosed with type 1 diabetes mellitus (DM1 and 20 healthy controls. Diabetes history was recorded based on the information provided by the physician and it included date of diagnosis, duration, age of diagnosis, latest values of glycosylated haemoglobin and existing diabetic complications. Statistical analysis was performed to evaluate the relationship between periodontal parameters and degree of metabolic control, the duration of the disease and the appearance of complications. Results: The periodontal health in the diabetic group was compromised and they had greater bleeding index (P < 0.001, probing pocket depth (P < 0.001 and clinical attachment level (P = 0.001. Patients diagnosed for diabetes for shorter duration of time (4-7 years showed bleeding index-disease severity correlation to be 1.760 0.434. Conclusion: Periodontal disease was more evident in type 1 diabetes mellitus patients and periodontal inflammation is greatly increased in subjects with longer disease course, poor metabolic control and diabetic complications.
Wootton-Gorges, Sandra L.; Glaser, Nicole S.
Type 1 diabetes mellitus (DM) affects about 1 in 500 children and can cause damage to multiple organ systems. In recent years, growing attention has been given to the effects of type 1 DM on the brain. In this article we review important imaging features of the brain in children with type 1 DM, including (1) imaging the child in diabetic ketoacidosis and the child with hypoglycemia, (2) syndromes associated with type 1 DM, and (3) long-term effects of type 1 DM on brain structure. (orig.)
Wootton-Gorges, Sandra L. [University of California, Davis Medical Center, Department of Radiology, UC Davis Children' s Hospital, Sacramento, CA (United States); Glaser, Nicole S. [University of California, Davis Medical Center, Department of Pediatrics, UC Davis Children' s Hospital, Sacramento, CA (United States)
Type 1 diabetes mellitus (DM) affects about 1 in 500 children and can cause damage to multiple organ systems. In recent years, growing attention has been given to the effects of type 1 DM on the brain. In this article we review important imaging features of the brain in children with type 1 DM, including (1) imaging the child in diabetic ketoacidosis and the child with hypoglycemia, (2) syndromes associated with type 1 DM, and (3) long-term effects of type 1 DM on brain structure. (orig.)
van der Schaft, Niels; Brahimaj, Adela; Wen, Ke-Xin; Franco, Oscar H; Dehghan, Abbas
Limited evidence is available about the association between serum uric acid and sub-stages of the spectrum from normoglycaemia to type 2 diabetes mellitus. We aimed to investigate the association between serum uric acid and risk of prediabetes and type 2 diabetes mellitus. Eligible participants of the Rotterdam Study (n = 8,367) were classified into mutually exclusive subgroups of normoglycaemia (n = 7,030) and prediabetes (n = 1,337) at baseline. These subgroups were followed up for incident prediabetes (n = 1,071) and incident type 2 diabetes mellitus (n = 407), respectively. We used Cox proportional hazard models to determine hazard ratios (HRs) for incident prediabetes among individuals with normoglycaemia and incident type 2 diabetes mellitus among individuals with prediabetes. The mean duration of follow-up was 7.5 years for incident prediabetes and 7.2 years for incident type 2 diabetes mellitus. A standard deviation increment in serum uric acid was significantly associated with incident prediabetes among individuals with normoglycaemia (HR 1.10, 95% confidence interval (CI) 1.01; 1.18), but not with incident type 2 diabetes mellitus among individuals with prediabetes (HR 1.07, 95% CI 0.94; 1.21). Exclusion of individuals who used diuretics or individuals with hypertension did not change our results. Serum uric acid was significantly associated with incident prediabetes among normoglycaemic women (HR 1.13, 95% CI 1.02; 1.25) but not among normoglycaemic men (HR 1.08, 95% CI 0.96; 1.21). In contrast, serum uric acid was significantly associated with incident type 2 diabetes mellitus among prediabetic men (HR 1.23, 95% CI 1.01; 1.48) but not among prediabetic women (HR 1.00, 95% CI 0.84; 1.19). Our findings agree with the notion that serum uric acid is more closely related to early-phase mechanisms in the development of type 2 diabetes mellitus than late-phase mechanisms.
Li, X H; Li, T L; Yang, Z; Liu, Z Y; Wei, Y D; Jin, S X; Hong, C; Qin, R L; Li, Y Q; Dorman, J S; Laporte, R E; Wang, K A
To investigate the epidemiological characteristics of childhood type 1 diabetes mellitus in China, newly diagnosed cases of type 1 diabetes with an onset age under 15 years were retrospectively registered by 23 local centers in China following a standardized protocol on the basis of the nationwide registry established by the WHO DiaMond Project China Participating Center, Chinese Academy of Preventive Medicine (CAPM). A population of about 24 million children were covered in the defined areas. A two-sample capture-recapture method was used to estimate case ascertainment. Between 1988 and 1996, 903 diabetic cases were registered in 9 ethnic groups. The overall ascertainment corrected incidence rate (IR) was 0.59 per 100,000 person-year. The IR was 0.52/100,000 (95% CI: 0.50-0.54) for males and 0.66/100,000 (95% CI: 0.64-0.68) for females. The standardized ascertainment corrected IR by the national age-specific population in 1990 was 0.57 per 100,000 person-year. The incidence among various ethnic groups ranged from 0.25/100,000 to 3. 06/100,000. The IRs increased with northern latitude, and the IR of Han population was significantly higher in North China compared with South China (0.67 versus 0.53 per 100,000 respectively, P < 0.01). A correlation model of incidence and calendar time showed that the IR increased significantly between 1988 and 1996 (r = 0.86, P = 0.0027). The relative risk (RR) of type 1 diabetes mellitus for different age-groups estimated by a Poisson regression model showed that taking RR as 1.00 for age-group from 0 to 4 years, the RR for age-group from 5 to 9 year and from 10 to 14 year was 2.30 and 3.60 respectively. The standardized ascertainment corrected IR of childhood type 1 diabetes mellitus in China in much lower than in other countries. The geographic and ethnic variability of the incidence suggests that both genetic and environmental factors play a role in the development of childhood diabetes in China.
Hussain, Gauhar; Rizvi, S Aijaz Abbas; Singhal, Sangeeta; Zubair, Mohammad; Ahmad, Jamal
To correlate serum levels of TGF-β1 with motor and sensory nerve conduction velocities in patients of type 2 diabetes mellitus The study was conducted in diagnosed type 2 diabetes mellitus patients which were divided in patients with clinically detectable peripheral neuropathy of shorter duration (n=37) and longer duration (n=27). They were compared with patients without clinical neuropathy (n=22). Clinical diagnosis was based on neuropathy symptom score (NSS) and Neuropathy disability score (NDS) for signs. Blood samples were collected for baseline investigations and estimation of serum TGF-β1. Nerve conduction velocity was measured in both upper and lower limbs. Median, Ulnar, Common Peroneal and Posterior Tibial nerves were selected for motor nerve conduction study and Median and Sural nerves were selected for sensory nerve conduction study In patients of type 2 diabetes mellitus with clinically detectable and serum TGF-β1 showed positive correlation with nerve conduction velocities High level of TGF-β1 in serum of T2DM patients with neuropathy show possible contribution in development of neuropathy. Due to its independent association this cytokine might be used as biomarker for diabetic peripheral neuropathy. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Rossi, L.; Parvin, S.; Hassan, Z.; Hildebrand, P.; Keller, U.; Ali, L.; Beglinger, C.; Azad Khan, A. K.; Whitcomb, David C.; Gyr, N.
AIMS: In chronic calcific pancreatitis of the tropics, etiology and relationship to developing diabetes mellitus are unknown. Some consider these cases a straightforward secondary type of diabetes, while others suggest selective beta-cell impairment. Testing pancreatic function, we investigated whether selective beta-cell impairment triggers diabetes associated with tropical pancreatitis. METHODS: At a Bangladeshi research institute, 8 chronic tropical pancreatitis and no diabetes mellitus su...
HOOGENBERG, K; DULLAART, RPF
Submaximal exercise provokes an abnormal elevation in albuminuria in type 1 (insulin-dependent) diabetes mellitus. Plasma catecholamines might be involved in this phenomenon by a renal vasoconstrictive effect. Twelve healthy subjects (Controls: albuminuria It is concluded that the exercise-induced
Urzúa M, Alfonso; Chirino, Alejandra; Valladares, Geraldine
Type 2 diabetes mellitus may affect profoundly the quality of life of patients. To assess health related quality of life among patients with Type 2 Diabetes Mellitus. The Diabetes Quality of Life (DQOL) questionnaire was applied to 296 patients with diabetes mellitus aged 63 ± lO years (201 women) seen in primary health care centers. The concern about the future effects of diabetes was the worst evaluated domain. Women perceived a lower health related quality of life than men. There was an inverse correlation between age and satisfaction with treatment, concern about vocational, social and future effects of the disease. Type 2 diabetes affects health related quality of life, especially in some specific domains such as perception of the future.
Kornhauser, C; Malacara, J-M; Macías-Cervantes, M-H; Rivera-Cisneros, A-E
Exercise may be useful to detect patients with diabetes prone to develop persistent microalbuminuria. We studied the relationship between exercise intensity, measured as maximal oxygen consumption (VO(2)max), and microalbuminuria in patients with Type 1 diabetes mellitus patients. We studied 10 patients, age range 10-18 years, with Type 1 diabetes who were normotensive and normoalbuminuric, with less than 10 years since diagnosis. Patients had normal renal function, without infections or clinical evidence of complications. Metabolic control was intensively adjusted in all patients. They underwent three consecutive physical exercise tests, reaching 100, 80 and 60% of the maximal cardiac frequency response. Eight patients had adequate to regular metabolic control. All patients had lower than predicted VO(2)max values. At 60%, only three patients showed microalbuminuria in excess of 20 μg/min, two of them had inadequate metabolic control. Post-exercise microalbuminuria exceeded normal values in nine, seven and three patients when submitted to 100, 80 and 60% of exercise intensity, respectively. Microalbuminuria increased with exercise intensity. Sex, body composition and VO(2)max were the main factors associated with microalbuminuria. The prognostic significance of albuminuria induced by intense exercise in these subjects with Type 1 diabetes is not yet known. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Marina Fedorovna Kalashnikova
Full Text Available Diabetes mellitus is a disease that presents a global medical problem. It is necessary to implement an in-depth analysis of the epidemiological situation of type 2 diabetes mellitus for planning and organizing specialized medical help to patients with type 2 diabetes mellitus.AimTo rate the basic epidemiological indices of type 2 diabetes mellitus in actual clinical practice using the informational database of national registry of diabetic patients.Materials and methodsEpidemiological analyses were performed in two administrative districts of Moscow. From 1999 to 2011 48978 adult patients with type 2 diabetes mellitus who were aged 18 years and older were registered. We used methods of clinical, analytical and statistical epidemiology with elements of descriptive research.ResultsThe prevalence rate of type 2 diabetes mellitus was 1590 per hundred thousand, most patients were in the 60–64 and 70–74 age groups, and approximately 80% of patients were older than 55 years. The morbidity rate of type 2 diabetes mellitus was 138,72 per hundred thousand and was found to be higher in women at 1,89. The mortality rate of adult patients with diabetes mellitus was 0,83, mostly in men of all ages. Cardiovascular diseases accounted for most of the registered cases of deaths (34,4%. The average life expectancy appeared to be 75,24±0,45 years, although women lived 6 years longer than men. The average duration of the disease was 10,04±0,34 years. A total of 0,4% of patients underwent hospital treatment and the average length of treatment was 17–18 days. The total number of days of disablement was an average of 307,33±30,13 days (80% of patients were older than 55 years. In the study group, a mean grade of НbА1c <7% was observed in 56,6% of patients. The prevalence rate of detected chronic complications was considerably lower compared to other epidemiological studies.ConclusionsOur epidemiological analyses revealed a number of features and consistent
Wilson, Charlotte E; Smith, Emma L; Coker, Sian E; Hobbis, Imogen Ca; Acerini, Carlo L
Eating disorders in young people with type 1 diabetes mellitus confer additional health risks beyond those conferred by the disease itself. Risk factors for developing eating disorders are poorly understood. The current study aimed to examine risk factors for eating disturbance in young people with type 1 diabetes mellitus. Both diabetes specific risk factors, such as body mass index (BMI), glycaemic control and diabetes-related conflict, and also more general risk factors such as dysfunctional perfectionism and low self-esteem were assessed. Fifty young people aged 14-16 and their primary caregiver were asked to complete interviews and questionnaires about their eating attitudes and behaviours, dysfunctional perfectionism, self-esteem, family conflict, and general mental health symptoms. Recent weight and height and glycaemic control were extracted from the medical file. Different factors distinguished those young people who displayed eating disorder attitudes from those who did not (higher BMI-z, poorer glycaemic control, and lower self-esteem) and those young people who displayed eating disorder behaviour from those who did not (lower self-esteem and higher diabetes-related family conflict). The results of the current study suggest that there might be different factors associated with eating disorders (ED) attitudes and ED behaviours, but that food/eating-related factors, family factors, and intra-personal factors are all important. Furthermore there are some gender differences in the presence of ED attitudes and behaviours and preliminary evidence that higher body mass indexes (BMIs) impact on girls more than they do on boys. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Gupta, Y; Kapoor, D; Desai, A; Praveen, D; Joshi, R; Rozati, R; Bhatla, N; Prabhakaran, D; Reddy, P; Patel, A; Tandon, N
To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m 2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA 1c value of ≥ 48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA 1c threshold for diabetes may lead to significant under-diagnosis. © 2016 Diabetes UK.
Wang, Xiaojing; Li, Wei; Ma, Liangkun; Ping, Fan; Liu, Juntao; Wu, Xueyan; Mao, Jiangfeng; Wang, Xi; Nie, Min
Emerging evidence has suggested that the genetic background of gestational diabetes mellitus (GDM) was analogous to type 2 diabetes mellitus. In contrast to type 2 diabetes mellitus, the genetic studies for GDM were limited. Accordingly, the aim of the present study was to extensively explore the influence of micro-ribonucleic acid-binding single-nucleotide polymorphisms (SNPs) in type 2 diabetes mellitus candidate loci on GDM susceptibility in Chinese. A total of 839 GDM patients and 900 controls were enrolled. Six micro-ribonucleic acid-binding SNPs were selected from 30 type 2 diabetes mellitus susceptibility loci and genotyped using TaqMan allelic discrimination assays. The minor allele of three SNPs, PAX4 rs712699 (OR 1.366, 95% confidence interval 1.021-1.828, P = 0.036), KCNB1 rs1051295 (OR 1.579, 95% confidence interval 1.172-2.128, P = 0.003) and MFN2 rs1042842 (OR 1.398, 95% confidence interval 1.050-1.862, P = 0.022) were identified to significantly confer higher a risk of GDM in the additive model. The association between rs1051295 and increased fasting plasma glucose (b = 0.006, P = 0.008), 3-h oral glucose tolerance test plasma glucose (b = 0.058, P = 0.025) and homeostatic model assessment of insulin resistance (b = 0.065, P = 0.017) was also shown. Rs1042842 was correlated with higher 3-h oral glucose tolerance test plasma glucose (b = 0.056, P = 0.028). However, no significant correlation between the other included SNPs (LPIN1 rs1050800, VPS26A rs1802295 and NLRP3 rs10802502) and GDM susceptibility were observed. The present findings showed that micro-ribonucleic acid-binding SNPs in type 2 diabetes mellitus candidate loci were also associated with GDM susceptibility, which further highlighted the similar genetic basis underlying GDM and type 2 diabetes mellitus. © 2018 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Gapstur, Susan M; Patel, Alpa V; Diver, W Ryan; Hildebrand, Janet S; Gaudet, Mia M; Jacobs, Eric J; Campbell, Peter T
Despite consistent associations of type II diabetes mellitus with hormonally related cancers such as breast and endometrium, the relation between type II diabetes mellitus and ovarian cancer risk is unclear. Associations of type II diabetes mellitus status, duration, and insulin use with epithelial ovarian cancer overall, and with serous and nonserous histologic subtypes were examined in the Cancer Prevention Study-II Nutrition Cohort, a prospective study of U.S. men and women predominantly aged 50 years and older. Between 1992 and 2007, 524 incident epithelial ovarian cancer cases were identified among 63,440 postmenopausal women. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were computed using extended Cox regression to update diabetes status and bilateral oophorectomy status during follow-up. Type II diabetes mellitus status (RR = 1.05; 95% CI, 0.75-1.46) and duration were not associated with epithelial ovarian cancer risk. Although not statistically significantly different (P(difference) = 0.39), the RR was higher for type II diabetes mellitus with insulin use (RR = 1.28; 95% CI, 0.74-2.24) than for type II diabetes mellitus without insulin use (RR = 0.96; 95% CI, 0.64-1.43). Diabetes seemed to be more strongly associated with nonserous (RR = 1.41; 95% CI, 0.70-2.85) than serous (RR = 0.71; 95% CI, 0.41-1.23) histologic subtypes. Type II diabetes mellitus was not associated with risk of epithelial ovarian cancer, although higher risks with nonserous subtypes and among insulin users cannot be ruled out. Larger studies are needed to clarify associations of type II diabetes mellitus with or without insulin use with risk of ovarian cancer overall and by histologic subtypes. ©2012 AACR.
Claesson, M H; Nicoletti, F; Stosic-Grujicic, S
Type 1 diabetes mellitus (T1D) and inflammatory bowel diseases (IBD) are multifactorial disorders of autoimmune origin.Several microbial agents have been reported to be associated with the development of type 1 diabetes and inflammatory bowel diseases in animal models by different mechanisms...
Full Text Available OBJETIVO: Avaliar a prevalência de diabéticos em uma amostra de pacientes com glaucoma; verificar se existe associação entre diabetes mellitus e glaucoma na amostra estudada; verificar outros fatores de risco associados. MÉTODOS: Foram analisados de forma retrospectiva os prontuários de 50 pacientes com diagnóstico de glaucoma. Os dados registrados foram sexo, idade, raça, história familiar de glaucoma e história pessoal de diabetes mellitus tipo 2. RESULTADOS: Do total de pacientes avaliados, 5 (10% apresentavam diabetes mellitus tipo 2. Destes, 3 eram mulheres e 2 eram homens, com mediana de idade de 81 anos (71-88. A prevalência de diabetes nos pacientes com glaucoma não mostrou diferenças significativas (OR: 1,476; Intervalo de Confiança 95%: 0,4438 a 4,910; p= 0,5352 quando comparada à prevalência de diabetes mellitus tipo 2 na população geral brasileira (7,6%. CONCLUSÃO: Nesta amostra de pacientes com glaucoma, a prevalência de diabetes mellitus tipo 2 foi pouco mais elevada que a da população. Entretanto, nenhuma associação foi encontrada entre diabetes mellitus e glaucoma.PURPOSE: To evaluate prevalence of diabetes mellitus in a group of patients with glaucoma; to verify if there is association between diabetes mellitus and glaucoma; to verify other associated risk factors. METHODS: Fifty(50 glaucoma patients had their medical records analyzed in a retrospective way. Registered data included sex, age, ethnic group, family history of glaucoma and personal history of type 2 diabetes mellitus. RESULTS: Five (10% of all evaluated patients had type 2 diabetes mellitus. 3 of them were female and 2 were male, median age of 81 years old (71-88. Prevalence of diabetes in glaucoma patients did not show significant differences. (OR: 1.476; 95% Confidence Interval: 0.4438 to 4.910; p= 0.5352 when compared to the prevalence of type 2 diabetes mellitus in general brazilian population (7.6%. CONCLUSION: In this group of patients
Polsky, Sarit; Ellis, Samuel L
To summarize recent studies about obesity, insulin resistance, and type 1 diabetes mellitus (T1DM). Overweight and obesity continue to be prevalent among individuals with T1DM. Obesity rates appear to have reached a plateau among children with T1DM in some parts of the world. The risk for development of T1DM is increased by obesity and may occur at an earlier age among obese individuals with a predisposition. Obesity increases the risk for comorbidities among individuals with T1DM, especially metabolic syndrome, and microvascular and macrovascular diseases. Metformin, glucagon-like peptide-1 agonist therapy, sodium glucose cotransporter-2 inhibitor therapy, and bariatric surgery may be beneficial therapies for glucose control, comorbidity management, and obesity among adults with T1DM. Insulin resistance may be improved among obese individuals with T1DM by biguanides (metformin) and glucagon-like peptide-1 agonists (exenatide). We review the last 18 months of literature on obesity, insulin resistance, and T1DM to highlight new epidemiologic results and treatments.
Ferrer-García, Juan Carlos; Granell Vidal, Lina; Muñoz Izquierdo, Amparo; Sánchez Juan, Carlos
Recent studies have demonstrated the cardiovascular benefits of the Mediterranean Diet, enriched with olive oil and nuts. People with diabetes, who have an increased risk of cardiovascular complications, could benefit greatly from following this type of eating pattern. Analysis of vegetable fats intake from nuts and olive oil in patients with 1 Diabetes Mellitus type (DM1). Transverse descriptive study comparing 60 people with type 1 Diabetes Mellitus (DM1) with 60 healthy individuals. We collect the frequency of consumption of vegetable oils and nuts and calculate the contribution of these foods in mono and polyunsaturated fatty acids (oleic acid, linoleic acid and α-linolenic acid). For data collection we designed a food frequency questionnaire specifically. We also collect anthropometric variables, cardiovascular risk factors and diabetes-related variables. Vegetable fat intake from vegetable oils (3.02 ± 1.14 vs 3.07 ± 1.27 portions/day, P = 0.822) and nuts (1.35 ± 2.24 vs 1.60 ± 2.44 portions/week, P = 0.560), was similar in both groups. The DM1 group consumed fewer portions of olive oil daily than the control group (2.55 ± 1.17 vs 3.02 ± 1.34 portions/day, P = 0.046). We detected a significantly lower intake of α-linolenic acid in the control group (1.13 ± 2.06 versus 2.64 ± 4.37 g/day, p = 0.018) while there were not differences in the rest of fatty acids (oleic acid 28.30 ± 18.13 vs 29.53 ± 16.90 g/day, P = 0.703; linoleic 13.70 ± 16.80 vs 15.45 ± 19.90 g/day, P = 0.605). In DM1, it not demonstrated an influence of the intake of vegetable fats and oils from nuts in the anthropometric, metabolic and diabetes-specific variables. In people with DM1, total intake of vegetable oils and nuts do not differ from the general population. However, the consumption of olive oil and the contribution of α-linolenic fatty acid derived from such fats are slightly lower than the general population. Although intake of vegetable oils and nuts in people with DM1
Ali A. Taqi Al-Saffar
Full Text Available Background and objective: As diabetes mellitus a common health problem, it is well known that it can lead to optic neuropathy that affects the optic nerve functions. It is important to monitor the effect of this metabolic disease on the optic nerve that can lead ultimately to decrease visual acuity that can be irreversible. This study aimed to find out the prevalence of diabetic optic nerve diseases and to evaluate the patient characteristics and fundus findings. Methods: Screening examination was done for 2213 patients with type 2 diabetic patients presented to the diabetic center from October 2007 to September 2009. The examination includes visual acuity test using conventional E chart, slit lamp exam, followed by installing short acting Mydriatics (tropicamide 1% eye drops for fundoscopy examination using +76.D or +90 D. Results: Eighty eight patients (approximately 4% had optic nerve problems; 50 females and 38 males. The mean age was 59 years. A total of 58 (116 eyes patients were bilaterally affected, 42 patients with optic papillopathy, 8 patients with anterior ischemic optic neuropathy and profound loss of vision, 8 with glaucomatous cupping and pallor and 30 patients with end stage optic atrophy. A total of 63 (71.5% patients had poor metabolic control. Conclusions: Patients with type 2 diabetes mellitus have 4% prevalence of diabetic optic neuropathy.
Valdés-Ramos, Roxana; Ana Laura, Guadarrama-López; Elina, Martínez-Carrillo Beatriz; Donají, Benítez-Arciniega Alejandra
The present review evaluates the relationship between type 2 diabetes mellitus and individual or combined vitamins. Antioxidant vitamins A, C and E are found decreased in diabetic subjects, possibly due to an increased need to control the excessive oxidative stress produced by abnormalities in glucose metabolism. On the other hand, retinol binding protein exerts a modulating effect, as it has adipokine functions. With respect to the B group vitamins, thiamin, pyridoxine and biotin have been found decreased but the mechanisms are not clear, however supplementation has shown some improvement of the metabolic control in diabetic patients. The absorption of folic acid and vitamin B12 is importantly decreased by the prolongued use of metformin, which is the first choice drug in uncomplicated diabetes, thus these two nutrients have been found deficient in the disease and most probably need to be supplemented regularly. On the other hand, vitamin D is considered a risk factor for the development of diabetes as well as its complications, particularly cardiovascular ones. Although some studies have found an association of vitamin K intake with glucose metabolism further research is needed. Studies on the use of multivitamin supplements have shown unconclusive results. After reviewing the evidence, no real recommendation on the use of vitamin supplements in type 2 diabetes mellitus can be issued, however patients using metformin during prolongued periods may need folic acid and vitamin B12. PMID:25388747
Full Text Available Background/Aim. Diabetic nephropathy (DN as a major microvascular complication of diabetes mellitus (DM include a progressive increase in urinary albumin excretion in association with an increase in blood pressure and to end stage renal failure. Hypertension connected with renin-angiotensin system (RAS hyperactivity and corresponding genotypes, angiotensinogen (AGT, angiotensine-converting enzyme (ACE and angiotensin II type 1 receptor (AT1R, predispose the increasing risk of DN. The aim of this study was to assess the distribution of AGT, ACE and AT1R gene polymorphisms in patients with type 1 DM according to the level of DN and patients clinical characteristics. Methods. The study included 79 type 1 diabetic patients. Inclusion criteria were: age between 20-40, duration of diabetes > 5 years, and no other severe diseases. Clinical characteristics were gained from interviewing the patients. Polymorphism was detected by polymerase chain reaction (PCR and restriction fragment length polymorphism using restriction enzymes Psy I (Tth 111 I and Hae III. Results. The patients with proteinuria compared with normo- and microalbuminuric patients, highly differed in age, diabetes duration, blood pressure level, hypertension, rethynopathy and urinary albumin excretion values (p < 0.001. No statistically significant difference between the groups was found for the ACE and AT1R gene polymorphisms distribution. The presence of TT genotype of the M235T polymorphism was significantly higher in the group with proteinuria (p < 0.05. The patients with hypertension raised nephropathy 5.2 times higher (OR = 5.20, p < 0.05 while carriers of TT allel developed nephropathy 28.38 times higher (OR = 28.389, p < 0.01 than those with MM genotype. Conclusion. Increased association of hypertension and TT angiotensinogen gene polymorphism in patients with diabetes mellitus with proteinuria could be a significant marker of diabetic nephropathy.
Knop, Filip K; Vilsbøll, Tina; Holst, Jens J
This review article focuses on the therapeutic potential of the incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in treating type 2 diabetes mellitus (T2DM). T2DM is characterized by insulin resistance, impaired glucose-induced insulin...... secretion and inappropriately regulated glucagon secretion which in combination eventually result in hyperglycemia and in the longer term microvascular and macrovascular diabetic complications. Traditional treatment modalities--even multidrug approaches--for T2DM are often unsatisfactory at getting patients...
Brandt, Katia G; Silva, Giselia A P; Antunes, Margarida M C
To know the prevalence of celiac disease (CD) in a group of children and adolescents with type I diabetes mellitus. A cross sectional study was conducted at the Instituto Materno Infantil de Pernambuco (IMIP) in March 2000. The sample consisted of 19 children and adolescents with type I diabetes mellitus that had the human anti-tissue transglutaminase antibodies assessed using kits from the Eurospital Laboratory. In case of positive results it was realized small intestine biopsy to confirm the diagnosis. For the calculation of the prevalence of CD it was considered the number of patients with serum positive histological alterations of the mucous membrane of the small intestine compatible with CD. Four patients presented serum positivity for human anti-tissue transglutaminase antibodies with a serum prevalence of 21% (4/19). Out of these four subjects, three who accomplished small intestine biopsy presented histological alterations compatible with CD. The prevalence of CD in this group was 15.8% (3/19). The prevalence of CD in this study group was high, suggesting that those with type I diabetes mellitus should be led as a group of high risk to develop this disease.
Huynh, Jennifer; Yamada, Jessica; Beauharnais, Catherine; Wenger, Julia B; Thadhani, Ravi I; Wexler, Deborah; Roberts, Drucilla J; Bentley-Lewis, Rhonda
During a pregnancy complicated by diabetes, the placenta undergoes a number of functional and structural pathologic changes. However, differences across studies may reflect pathophysiologic differences of diabetes types under investigation. We examined placental pathology from women ages 18-40 years with self-identified race/ethnicity; singleton, live births; and type 1 (T1DM; n = 36), type 2 (T2DM; n = 37), or gestational diabetes mellitus (GDM; n = 126). Clinical data were abstracted from medical records. Placental diagnoses were independently re-reviewed by a perinatal pathologist. Multivariable analyses adjusting for race, gestational weight gain, gestational age, and systolic blood pressure were conducted. Women with T1DM compared with either T2DM or GDM had higher gestational weight gain (mean ± SD, T1DM vs. T2DM: 28.5 ± 12.4 vs. 20.5 ± 13.4 kg, p = 0.03; or GDM: 21.3 ± 12.7 kg, p = 0.009) and insulin use (T2DM: 100.0% vs. 85.3%, p = 0.02; or GDM: 4.0%, p diabetes type, potentially reflecting underlying pathophysiologic mechanisms. Further research on placental pathology and metabolic derangements is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.
Aslan, Ozgur; Demir, Metin; Koseoglu, Mehmet
This study was designed to determine the diagnostic role of urinary kidney injury molecule (KIM)-1 levels in renal damage in patients with type 2 diabetes mellitus according to the urinary albumin/creatinine ratio. Patients with type 2 diabetes mellitus admitted to different polyclinics in our hospital enrolled in the study and were subdivided into three groups according to albumin/creatinine ratio - normalbuminuric (n: 20); microalbuminuric (n: 20); albuminuric (n: 18) - and compared with the control group. Urine albumin was analyzed using the immunoturbidimetric method (Architect C16000, Abbott Diagnostics). uKIM-1 was determined using a commercially available enzyme-linked immunosorbent assay test kit (USCN Life Science, Hankou, Wuhan, China). One-sample Kolmogorov-Smirnov test, Spearman correlation and Kruskal-Wallis non-parametric tests were performed. Post hoc comparisons were made using Bonferroni-corrected Mann-Whitney U tests. The differences between the controls and normalbuminuric, microalbuminuric and albuminuric groups were highly significant for KIM-1. Positive correlation was found between KIM-1 and urine microalbumin-urine microalbumin/creatinine (r = 0.479 P diabetic nephropathy. J. Clin. Lab. Anal. 00:1-6, 2016. © 2016 Wiley Periodicals, Inc.
Qureshi, M.A.; Bhatti, R.
Objective: To study the frequency of ABO blood groups among diabetes mellitus type 2. Results: Comparison of blood groups frequency between the general population and diabetes type 2 patients was carried out in term of percentage. It was noticed that the values were 4.36, 17.15 and 7.34% higher for A, B and AB blood groups respectively in the diabetic patients. On the contrary, the value was 28.94% lower for the blood group O. Conclusion: Present study has supported the hypothesis that diabetes mellitus type 2 and blood groups are interrelated because of the broad genetic immunologic basis in both. It is concluded that the frequency of blood groups B and O is significantly higher and lower respectively in the diabetes mellitus type 2 patients as compared to the general population. (author)
Earle, Sarah; Tariq, Anisah; Komaromy, Carol; Lloyd, Cathy E; Karamat, M Ali; Webb, Jackie; Gill, Paramjit S
Diabetes mellitus is a global health problem and one of the most common medical conditions in pregnancy. A wide range of modifiable risk factors are associated with diabetes mellitus in pregnancy, and it is widely acknowledged that preconception care (PCC) is beneficial for women with pre-existing diabetes mellitus. However, uptake of PCC services is low. To systematically review qualitative research on PCC for women with pre-existing diabetes mellitus of childbearing age, identify facilitators of and barriers to uptake of PCC and establish themes and gaps in knowledge. Through qualitative interviews explore views on the provision of, and facilitators of and barriers to the uptake of, PCC. Mixed methods encompassing a systematic review and qualitative interviews. Two secondary care sites and 11 primary care sites. Women of childbearing age with pre-existing type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) of white British or Pakistani origin. None. A narrative synthesis of the literature using thematic analysis and a thematic analysis of the qualitative interview data using the method of constant comparison. Eighteen qualitative studies were included in the systematic review and a quality appraisal was carried out using relevant criteria for qualitative research appraisal, including a narrative summary of study quality. Twelve interviews with women with pre-existing T1DM or T2DM were carried out. This fell short of the original aim of interviewing 48 women owing to challenges in recruitment, especially in primary care. A synthesis of these data shows that uptake of PCC is influenced by a range of factors, including the complexity of pregnancy planning, the skill and expertise of health professionals who provide care to women with diabetes mellitus, the role of health professionals in the delivery of PCC, and the quality of relationships between women and health professionals. Owing to significant challenges with recruitment of participants
Christensen, Mikkel; Knop, Filip K; Holst, Jens J
Lixisenatide, under development by sanofi-aventis, is a novel human glucagon-like peptide-1 receptor (GLP-1R) agonist for the treatment of type 2 diabetes mellitus (T2DM; non-insulin dependent diabetes). The structure of lixisenatide, based on exendin-4(1-39) modified C-terminally with six Lys...... of the anticipated effects of lixisenatide on glycemic measures and weight; favorable results would place lixisenatide for consideration among other GLP-1R agonists in the treatment armamentarium for T2DM....
Bakker, S F; Pouwer, F; Tushuizen, M E; Hoogma, R P; Mulder, C J; Simsek, S
Type 1 diabetes mellitus and coeliac disease are two chronic illnesses associated with each other. Both diseases and their treatments can seriously impair quality of life. The objective of the present study was to investigate health-related quality of life in adult patients diagnosed with both Type 1 diabetes and coeliac disease and compare this with healthy control subjects and control subjects who have Type 1 diabetes only. A generic measure of health-related quality of life (RAND-36) and a measure of diabetes-specific quality of life (DQOL) questionnaires were sent to patients diagnosed with both Type 1 diabetes and coeliac disease. The control group consisted of patients with Type 1 diabetes without coeliac disease matched for age, gender and socio-economic status. Generic quality of life scores were compared with data from healthy Dutch control subjects. Fifty-seven patients with Type 1 diabetes and coeliac disease were included and no associations between clinical characteristics and quality of life were observed. Women reported a lower quality of life in social functioning, vitality and mental health than men (all P coeliac disease compared with patients with Type 1 diabetes. Compared with healthy control subjects, quality of life in patients with Type 1 diabetes and coeliac disease was significantly lower, particularly social functioning (Cohen's d = 0.76) and general health perception (Cohen's d = 0.86). The additional diagnosis of coeliac disease and treatment by gluten-free diet in adult patients with Type 1 diabetes has a considerable, negative impact on quality of life and diabetes-specific quality of life. Women are particularly affected and social functioning and general health perception is compromised. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.
Full Text Available Diabetes mellitus type 1 is associated with an enhanced apoptosis of different cells and tissues, accelerating occurrence of diabetic microvascular complications. The aim of our study was to determine spontaneous apoptotic potential of the monocyte subsets in juvenile-onset complication-free diabetes mellitus type 1 and to compare them with the corresponding values of the healthy. Moreover, we wanted to assess effects of TNF-R1 blocking agents and those of general TNF-α blocker (Infliximab on spontaneous apoptosis of monocytes. Sixty randomly selected DM1 patients (14.5 ± 3.2 years and 30 healthy (13.5 ± 2.8 years volunteers were enrolled in the study. Our results indicate that three monocyte subsets are distinguishable in the groups of young diabetic patients and the healthy, similarly to in the blood of adults. DM1 patients were characterized by higher values of apoptotic monocytes than the healthy. The manipulation with drugs inhibiting TNF-R1 expression diminished the pool of CD16+ apoptotic monocytes. Infliximab reduced the apoptotic CD16− cells. In conclusion, diabetes mellitus type 1 is associated with greater apoptosis of three monocyte subsets which may contribute to the development of microvascular complications. TNF-α modifiers appear to ameliorate monocyte apoptosis. They may be useful for controlling excessive monocyte apoptosis in diabetic patients.
Wolffenbuttel, B.H.R.; Huijberts, M.S.P.
Disorders of lipid metabolism in 3 patients with diabetes mellitus type 2] [Article in Dutch] Wolffenbuttel BH, Huijberts MS. Academisch Ziekenhuis, afd. Endocrinologie, Postbus 5800, 6202 AZ Maastrict. email@example.com Three patients with diabetes mellitus (type 2) and cardiovascular disease had
Full Text Available Context: Type one diabetes mellitus (T1DM is an autoimmune disorder that is yet the most common type of diabetes in children and adolescents. Several genetic risk factors have been associated with T1DM, auto immune thyroiditis and other autoimmune disorder. Among autoimmune disorders, autoimmune thyroid disease (ATD is the most frequent disorder associated with T1DM. Its prevalence varies depending on age, sex and ethnic origin of the subjects and is considerably higher than the general population and increases with duration of T1DM. The aim of this study was to review the prevalence of ATD in Iranian children with T1DM compared with other countries. Evidence Acquisition: We conducted a review on all papers published on the association between autoimmune thyroiditis and T1DM, which was available on Google Scholar, Scientific Information Database (SID, Magiran and Iran Medex databases up to June 2014. Both Persian and English articles were checked. The searched terms were: diabetes mellitus, autoimmune thyroiditis, prevalence, frequency, Iranian children and adolescents. All papers which were done on patients with age under 20 years old and have used Anti-TPO and Anti-TG to evaluate patients were included. Results: Six papers met all the criteria. A total of 736 participants were included in this review. After review of all the papers, the prevalence of Anti-TPO was reported between 8% and 30% and Anti-TG was reported 6.06% to 23.6% in diabetic children in Iran. Conclusions: Autoimmune thyroid disorders are the most prevalent immunological diseases in patients with type 1 diabetes. All these studies have shown a higher prevalence of the disorder in patients with T1DM compared to the Iranian healthy population. Anti-TPO reported between 8% and 30% and Anti-TG reported 6.06% to 23.6% in diabetic children in Iran that was similar to the studies in other countries.
Uric acid is the final oxidation product of purine metabolism in circulation and has been associated with the occurrence of gout and kidney stones. Type 2 diabetes mellitus and hypertension are two important public health challenges, and both are linked to increased risk of cardiovascular events. Hyperuricemia has recently emerged as an independent risk factor in the development of type 2 diabetes mellitus and hypertension through several proposed mechanisms. Few clinical trials investigated the use of uric acid lowering agents in the management of these two disease entities; however, their results provided encouraging evidence to a potential role for these agents in fighting disease burden. Larger randomized controlled trials are therefore warranted to establish the role of uric acid as a promising target for novel therapeutic interventions in the management of type 2 diabetes mellitus and hypertension.
Xie, Y; Zhang, Y; Qin, W; Lu, S; Ni, C; Zhang, Q
Increasing DTI studies have demonstrated that white matter microstructural abnormalities play an important role in type 2 diabetes mellitus-related cognitive impairment. In this study, the diffusional kurtosis imaging method was used to investigate WM microstructural alterations in patients with type 2 diabetes mellitus and to detect associations between diffusional kurtosis imaging metrics and clinical/cognitive measurements. Diffusional kurtosis imaging and cognitive assessments were performed on 58 patients with type 2 diabetes mellitus and 58 controls. Voxel-based intergroup comparisons of diffusional kurtosis imaging metrics were conducted, and ROI-based intergroup comparisons were further performed. Correlations between the diffusional kurtosis imaging metrics and cognitive/clinical measurements were assessed after controlling for age, sex, and education in both patients and controls. Altered diffusion metrics were observed in the corpus callosum, the bilateral frontal WM, the right superior temporal WM, the left external capsule, and the pons in patients with type 2 diabetes mellitus compared with controls. The splenium of the corpus callosum and the pons had abnormal kurtosis metrics in patients with type 2 diabetes mellitus. Additionally, altered diffusion metrics in the right prefrontal WM were significantly correlated with disease duration and attention task performance in patients with type 2 diabetes mellitus. With both conventional diffusion and additional kurtosis metrics, diffusional kurtosis imaging can provide additional information on WM microstructural abnormalities in patients with type 2 diabetes mellitus. Our results indicate that WM microstructural abnormalities occur before cognitive decline and may be used as neuroimaging markers for predicting the early cognitive impairment in patients with type 2 diabetes mellitus. © 2017 by American Journal of Neuroradiology.
Vardhini Desikan; Izolda Mileva; Jeremy Garlick; Andrew H. Lane; Thomas A. Wilson; Margaret A. McNurlan
Lack of insulin results in a catabolic state in subjects with insulin-dependent diabetes mellitus which is reversed by insulin treatment. Amino acid supply, especially branched chain amino acids such as leucine, enhances protein synthesis in both animal and human studies. This small study was undertaken to assess the acute effect of supplemental leucine on protein metabolism in adolescents with type 1 diabetes. L-[1-13C] Leucine was used to assess whole-body protein metabolism in six adolesc...
Hopmans, Tara-Eileen J P; van Houten, Chantal B; Kasius, Annemieke; Kouznetsova, Ouliana I; Nguyen, Ly A; Rooijmans, Sanne V; Voormolen, Daphne N; van Vliet, Elvira O G; Franx, Arie; Koster, M P H Wendy
To determine the long-term risk of developing type II diabetes (T2D) and cardiovascular disease (CVD) for women with a history of gestational diabetes mellitus. Systematic review and meta-analysis. Two search strategies were used in PubMed and Embase to determine the long-term risks of developing T2D and CVD after a pregnancy complicated by gestational diabetes mellitus. After critical appraisal of the papers found, 11 papers were included, involving a total of 328,423 patients. Absolute and relative risks (RRs) were calculated. Eight studies (n=276,829) reported on the long-term risk of T2D and 4 (n=141,048) on the long-term risk of CVD. Follow-up ranged from 3.5 to 11.5 years for T2D and from 1.2 to 74.0 years for CVD. Women with gestational diabetes had a risk of T2D varying between 9.5% and 37.0% and a risk of CVD of between 0.28% and 15.5%. Women with gestational diabetes were at increased risk of T2D (weighted RR: 13.2; 95% CI: 8.5-20.7) and CVD (weighted RR: 2.0; 95% CI: 1.1-3.7) compared to women without gestational diabetes. Women with prior gestational diabetes mellitus have a significantly increased risk of developing T2D and CVD. It is very important that gestational diabetes is recognised as a cardiovascular risk factor in daily practice. It would be desirable to screen this group of women for the presence of hyperglycaemia and other cardiovascular risk factors. Further research is required to be able to specify the long-term risk of T2D and CVD and to demonstrate whether such screening is cost-effective.
Mavinkurve, M; Quinn, A; O'Gorman, C S
Continuous subcutaneous insulin pump therapy (CSII or pump therapy) is a well-recognised treatment option for Type 1 diabetes mellitus (T1DM) in paediatrics. It is especially suited to children because it optimises control by improving flexibility across age-specific lifestyles. The NICE guidelines (2008) recognise that pump therapy is advantageous and that it should be utilised to deliver best practice. In Ireland, the National Clinical Program for Diabetes will increase the availability and uptake of CSII in children and thus more clinicians are likely to encounter children using CSII therapy. This is a narrative review which discusses the basic principles of pump therapy and focuses on aspects of practical management. Insulin pump management involves some basic yet important principles which optimise the care of diabetes in children. This review addresses the principles of insulin pump management in children which all health care professionals involved in caring for the child with diabetes, shoud be familiar with.
Ruscitti, Piero; Cipriani, Paola; Cantarini, Luca; Liakouli, Vasiliki; Vitale, Antonio; Carubbi, Francesco; Berardicurti, Onorina; Galeazzi, Mauro; Valenti, Marco; Giacomelli, Roberto
Rheumatoid arthritis is an autoimmune arthritis in which two inflammatory cytokines, tumor necrosis factor-α and interleukin-1β, play a critical role in the induction and progression of the disease. Several reports and data from registries have discussed the association between chronic inflammatory diseases and disorders in intermediary metabolism, pointing out that prevalence of peripheral insulin resistance and type 2 diabetes mellitus is increased among patients with rheumatoid arthritis. In addition, several studies have shown that type 2 diabetes mellitus may be considered an interleukin-1β inflammatory-mediated process, and both preclinical and clinical observations have reported the usefulness of interleukin-1 antagonism therapy in this disease. We describe the case of a 58-year-old Caucasian woman and a 74-year-old Caucasian man with rheumatoid arthritis associated with type 2 diabetes mellitus. In these patients, the inhibition of interleukin-1β not only induced remission for rheumatoid arthritis, but successfully controlled their metabolic status. We report the positive effects of the inhibition of interleukin-1 in two patients with rheumatoid arthritis associated with type 2 diabetes mellitus, with both reaching the therapeutic targets of their diseases by using a single biological agent and tapering or discontinuing their antidiabetic therapies. These findings suggest that targeting interleukin-1 might be considered a good therapeutic option for the treatment of rheumatoid arthritis associated with type 2 diabetes mellitus.
Kim, Sun-Young; Jo, Dae-Sun; Hwang, Pyoung Han; Park, Ji Hyun; Park, Sung Kwang; Yi, Ho Keun; Lee, Dae-Yeol
Ghrelin is a novel gut-brain peptide, which exerts somatotropic, orexigenic, and adipogenic effects. Genetic variants of ghrelin have been associated with both obesity and insulin metabolism. In this study, we determined a role of preproghrelin Leu72Met polymorphism on type 2 diabetes mellitus and its relationship to variables studied. Genotypes were assessed by polymerase chain reaction. Frequencies of the Leu72Met polymorphism were found to be 35.4% in the type 2 diabetic patients and 32.5% in the normal controls. The Leu72Met polymorphism was not associated with hypertension, macroangiopathy, retinopathy, serum cholesterol, triglyceride, blood urea nitrogen, HbA(1c), lipoprotein (a), fasting insulin, or 24-hour urinary protein levels in the type 2 diabetic group. However, the Leu72Met polymorphism was clearly associated with serum creatinine levels in the diabetic group, as the Met72 carriers exhibited lower serum creatinine levels than the Met72 noncarriers. Our data indicate that the preproghrelin Leu72Met polymorphism is not associated with type 2 diabetes mellitus. However, the Leu72Met polymorphism is associated with serum creatinine levels. These data suggest that Met72 carrier status may be a predictable marker for diabetic nephropathy or renal impairment in type 2 diabetes mellitus.
Leszek, Jerzy; Trypka, Elzbieta; Tarasov, Vadim V; Ashraf, Ghulam Md; Aliev, Gjumrakch
The brain of patients with Alzheimer disease (AD) showed the evidence of reduced expression of insulin and neuronal insulin receptors, as compared with those of age-matched controls. This event gradually and certainly leads to a breakdown of the entire insulin-signaling pathway, which manifests insulin resistance. This in turn affects brain metabolism and cognitive functions, which are the bestdocumented abnormalities in AD. These observations led Dr. de la Monte and her colleagues to suggest that AD is actually a neuroendocrine disorder that resembles type 2 diabetes mellitus. The truth would be more complex with understanding the role of low-density lipoprotein receptor-related protein 1, Aβ derived diffusible ligands, and advanced glycation end products. However, now it known as "brain diabetes" and is called type 3 diabetes mellitus (T3DM). This review provides an overview of "brain diabetes" focusing on the reason why the phenomenon is called T3DM. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Alam, Uazman; Asghar, Omar; Azmi, Shazli; Malik, Rayaz A
Diabetes mellitus is a heterogeneous group of disorders characterized by hyperglycemia due to an absolute or relative deficit in insulin production or action. The chronic hyperglycemia of diabetes mellitus is associated with end organ damage, dysfunction, and failure, including the retina, kidney, nervous system, heart, and blood vessels. The International Diabetes Federation (IDF) estimated an overall prevalence of diabetes mellitus to be 366 million in 2011, and predicted a rise to 552 million by 2030. The treatment of diabetes mellitus is determined by the etiopathology and is most commonly subdivided in type 1 and type 2 diabetes mellitus. There is a greater propensity towards hyperglycemia in individuals with coexisting genetic predisposition or concomitant drug therapy such as corticosteroids. The screening for diabetes mellitus may either be in the form of a 2hour oral glucose tolerance test, or via HbA1c testing, as recently recommended by the American Diabetes Association (ADA). Strong associations have been shown in observational studies suggesting poor clinical outcomes both with chronic hyperglycemia and acutely in intensive care settings. However, tight glycemic control in this setting is a contentious issue with an increased incidence of hypoglycemia and possible increase in morbidity and mortality. In a critically ill patient a glucose range of 140-180mg/dL (7.8-10.0mmol/L) should be maintained via continuous intravenous insulin infusion.
de Cássia Sparapani, Valéria; Liberatore, Raphael D R; Damião, Elaine B C; de Oliveira Dantas, Isa R; de Camargo, Rosangela A A; Nascimento, Lucila C
Children with type 1 diabetes mellitus (T1DM) need to perform self-management activities at school and in other environments. Learning about their experiences at school is crucial to assist them in this challenging task. Qualitative interviews were conducted with children with T1DM, aged between 7 and 12. A scenario was created and puppets were used during the interviews to help the participating children to communicate about school, daily routines, and experiences in diabetes management. Data were collected over a period of 1 year and analyzed according to content analysis procedures. Nineteen children, 13 boys and 6 girls, at the mean age of 9.8 ± 1.8 years and mean time since diagnosis of 3.3 years, participated in the study. Three themes were identified: lack of information on T1DM, diabetes self-care at school, and support received by the children. The study provides useful information to understand the children's experiences in managing the disease at school. The partnership between school staff, health teams, children with T1DM, and their families need to be enhanced to promote appropriate strategies that improve the management of diabetes in this setting. © 2017, American School Health Association.
Galina Georgievna Petrik
Full Text Available Aim. To identify risk factors of macro-microvascular lesions at different stages of pathological process in patients with type 1 diabetes mellitus andmicrogiopathy of different severity. Materials and methods. Comprehensive analysis of parameters of metabolism, hemogram, platelet and plasma hemostasis in 121 patients (67 menand 54 women of mean age 28.2?10.7 years with type 1 diabetes mellitus and angiopathy of different severity. Results. All patients had hyperglycemia along with dysproteinemia and altered lipid spectrum. Mean platelet volume and aggregation activity increasedwhile activated partial thromboplastic time decreased compared with control subjects regardless of the presence and severity of microangiopathy. Conclusion. Morphological and functional characteristics of platelets and activated partial throm-boplastic time are differently related to metabolicchanges.
Tanase-Nakao, Kanako; Arata, Naoko; Kawasaki, Maki; Yasuhi, Ichiro; Sone, Hirohito; Mori, Rintaro; Ota, Erika
Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time 5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect. © 2017 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.
Bakker, S.; Pouwer, F.; Tushuizen, M.E.; Hoogma, R.P.; Mulder, C.J.; Simsek, S.
Aims Type 1 diabetes mellitus and coeliac disease are two chronic illnesses associated with each other. Both diseases and their treatments can seriously impair quality of life. The objective of the present study was to investigate health-related quality of life in adult patients diagnosed with both
Represas Carrera, Francisco Jesús; Carrera García, Álvaro; Clavería Fontán, Ana
Type 2 Diabetes Mellitus is a chronic disease that represent an important problem of public health. The objective of this study was to describe the sociodemographic, anthropometric, metabolic control, comorbidity and cardiovascular risk characteristics of patients diagnosed with Diabetes Mellitus type 2 in the health area of Vigo. Retrospective observational descriptive study. Between March and September 2016, it did telephone interview and an audit of electronic medical records to 195 patients ≥ 18 years old from the health area of Vigo diagnosed with type 2 Diabetes Mellitus. It selected by random sampling with replacement. It evaluated the cardiovascular risk using the method "United Kingdom Prospective Diabetes Study", the metabolic control with the recommendations of the "American Diabetes Association" 2016, and the comorbidity using the Charlson index. It performed a descriptive and bivariate analysis with R statistical package. The glycemic control was adequate (HbA1c less than 7.0%) in the 61.03% of the patients. The 58.46% had a blood pressure under 140/90mmHg, 52.82% had a total cholesterol under 185mg/dl and 66.15% had a triglyceride level under 150mg/dl. The 49.74% presented a high comorbidity (Charlson larger or the same as 3 points). The risk of suffering and/or dying of heart disease was 37.81%, and 23.50% of suffering and/or dying of a stroke in the next 10 years. Most diabetic patients of the health area of Vigo have a good control of their disease but they present a high index of comorbidity and high cardiovascular risk.
Jan 15, 2010 ... Keywords: causes of death; longevity; type 2 diabetes; Nigeria. Introduction. The incidence and prevalence of diabetes mellitus (DM) has continued ... accounted for the majority of deaths from diabetic ketoacidosis (DKA).
Scott, R; Lintott, C J; Zimmet, P; Campbell, L; Bowen, K; Welborn, T
Individuals with type 2 diabetes mellitus (n = 105; age 36-71 years) on diet therapy alone, and with quite good glycaemic control (mean HbA1c approximately 7.0%) were randomized to receive acarbose (100 mg three times daily) or placebo for 16 weeks, and changes in clinical and metabolic parameters indicative of Syndrome X were monitored. Fasting levels of glucose, glycosylated haemoglobin (HbA1c), true insulin, proinsulin, fibrinogen and lipids were measured four times weekly, and glucose, insulin, proinsulin and triglyceride responses to a standardized 1.6 MJ breakfast were determined at 0, 1 and 2 h post meal. Analysis was on an intention-to-treat basis. Fasting levels of glucose (P fasting glucose and triglyceride levels, lowers HbA1c and limits the glycaemic and insulin response to food in individuals with type 2 diabetes mellitus with Syndrome X. Pharmacological agents that improve the metabolic environment and reduce insulin resistance have the potential to limit the progression of atherogenesis associated with type 2 diabetes mellitus.
Unadike, B.C.; Eregie, A.; Ohwovoriole, A.E.
To determine the prevalence and types of sexual dysfunction (SD) amongst female with Diabetes Mellitus (DM) in Benin City, Nigeria. This is a cross sectional study. A total of 225 female with DM and 225 female without DM who served as controls were studied. Data obtained included age, anthropometric indexes, presence and type of sexual dysfunction. Fifteen (6.6%) subjects with DM had sexual dysfunction and four (1.7%) in the control group had SD with sexual pain disorder being the commonest SD, seen in both groups. Other SD seen was lubrication disorder and sexual arousal disorder. The prevalence of SD in diabetic female was significantly higher than in the control group (6.6% vs. 1.7% p < 0.05). Sexual Dysfunction appears to be relatively uncommon amongst Nigerian women with Diabetes Mellitus. However diabetes care providets should address this issue during consultations with patients and provide treatment as this is a treatable condition. (author)
Lykke, Jacob A; Langhoff-Roos, Jens; Sibai, Baha M
Minimal data exist concerning the relationship between hypertensive pregnancy disorders and various subsequent cardiovascular events and the effect of type 2 diabetes mellitus on these. In a registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first...... pregnancy disorders are strongly associated with subsequent type 2 diabetes mellitus and hypertension, the latter independent of subsequent type 2 diabetes mellitus. The severity, parity, and recurrence of these hypertensive pregnancy disorders increase the risk of subsequent cardiovascular events....... for the development of type 2 diabetes mellitus. The end points were subsequent hypertension, ischemic heart disease, congestive heart failure, thromboembolic event, stroke, and type 2 diabetes mellitus. The risk of subsequent hypertension was increased 5.31-fold (range: 4.90 to 5.75) after gestational hypertension...
Full Text Available Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. So the present study was planned with the goals to determine and compare the cardia-vascular risk factors in the diabetic children with type 1 of diabetes mellitus. Method: This was an analytic, cross sectional study that has been done in two groups (case-control. In this research, 148 children, suffering from the typel diabetes mellitus being supported by the metabolism and endocrine research center, were chosen in the continues case manner and for the control group, 148 children, matched with the study group (according to the age and the sex, at 6-18 years old from the schools in Isfahan city randomly and at 2-6 years from the neiborhoods of the case group. The data-gathering tool was the questionnaires includes lipid profile, blood pressure, weight and height. To analyze the data we used the analytic (t student and logistic regression and descriptive (mean and standard deviation statistic methods and SPSS. Results: Findings revealed that the means of Lipid profile, systolic blood pressure and body mass index had not statistically significant differences in the two groups. But the mean of diastolic blood pressure and the mean arterial blood pressure in the control group were more than the case group and this difference was significant. The mean, 75 and 95 percentiles for cholesterol and LDL in all the age groups, mean, 75 and 95 percentile for triglyceride in all the age groups except the age group of 1-4 years in the diabetic and non diabetic groups were
Ibrahim, I.; Fathy, H.; Tawfik, M.S.; Elesseily, E.S.
The study aimed at evaluating the effect of elevated serum insulin-like growth factor-1( IGF-1), which is a by-product of growth hormone in the body on glycemic control (assessed by measuring HbA1c) and lipid profiles in adolescent patients (aged between 12 and 18 years) suffering from diabetes mellitus Type 1 (childhood onset diabetes mellitus ). Thirty patients with diabetes mellitus type one were enrolled in the study within the age range mentioned (mean age was 15.2 ± 3). These patients had high-normal IGF-1 levels according to the normal standard range for their age group). A second group of thirty patients with diabetes mellitus type 1 with normal IGF-1 levels (mean age was 14.6 ± 2.5) were also enrolled for this study. A third group included thirty age and sex matched healthy controls. HbA1-c was measured in all of the patients involved in the study as well as serum IGF-1. Lipid profiles were as sassed and they included total cholesterol, low density lipoproteins (LDL) High density lipoproteins (HDL) and serum triglycerides. A significant elevation in HbA1c levels was observed in diabetes mellitus type 1 patients with normal levels of IGF-1 as compared to patients with diabetes mellitus type 1 with high normal IGF-1 levels or normal control subjects (mean HbA1c levels for group 2 as compared to groups 1 and 3 were 9.20 ±0.64 vs. 7.01 ±0.56 vs. 5.11 ±0.57 respectively, p<0.01). A significant negative correlation was established between serum IGF levels and HbA1c (r= - 0.46, p=0.0 2). These results required the reassessment of management protocols for patients be longing to Group 2. Serum total cholesterol levels, LDL-C, and triglycerides were significantly higher in the second group as compared to the other groups while HDL levels in the same group were found to be significantly lower. A significant negative correlation was established between serum LDL-C levels and IGF- levels measured in all participants (r= - 0.41, p=0.02). This study concluded that
Moole, Harsha; Moole, Vishnu; Mamidipalli, Adrija; Dharmapuri, Sowmya; Boddireddy, Raghuveer; Taneja, Deepak; Sfeir, Hady; Gajula, Sonia
Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results in low plasma insulin levels by destruction of beta cells of the pancreas. As part of the natural progression of this disease, some patients regain beta cell activity transiently. This period is often referred to as the ‘honeymoon period’ or remission of T1DM. During this period, patients manifest improved glycemic control with reduced or no use of insulin or anti-diabetic medications. The incidence rates of remission and...
F. Sharifi Sh. Sazandeh
Diabetes mellitus (DM) type 2 is one of the most common endocrine disorders affecting more than 135 million people in the world. The etiology of the disease is not fully understood, but recently subclinical hemochromatosis has been considered as one of the probable causes of DM. This study was carried out to examine the relationship between serum ferritin as a marker of iron overload with DM and HbA1c. This study was conducted on 97 patients with type 2 DM who were referred to Zanjan Diabetes...
Mohammed Umar Farooque
Full Text Available BACKGROUND To study the analysis of metabolic parameters in patients with type 2 diabetes mellitus on empagliflozin, which is a SGLT2 inhibitor. MATERIALS AND METHODS This study was a prospective study of 120 patients with uncontrolled type 2 diabetes mellitus who were admitted as outpatients in JLNMCH Hospital, Bhagalpur. This study was conducted from February 2017 to April 2017. Informed consent was taken from each patient who participated in the study and the study protocol was approved by the institutions ethics and review board. Inclusion Criteria- Patients with type 2 diabetes mellitus and HbA1c >8% meeting any one of the criteria- Patients who were on dual therapy (metformin + sulfonylurea/DPP4 inhibitor; patients who were on triple therapy (metformin + sulfonylurea + DPP4 inhibitor; patients who were on insulin and triple oral therapy (metformin + sulfonylurea + DPP4 inhibitor. Exclusion Criteria- Patients who had history of genital mycotic infections, recurrent urinary tract infections, pyelonephritis, acute illness, type 1 diabetes, pregnant or lactating women, those patients who were with an eGFR below 45. RESULTS The mean age, duration of diabetes, weight and HbA1c in the study population was 54.36 ± 0.88 years, 14.2 ± 3.6 years, 76.25 ± 2.11 kgs and 9.66 ± 0.22%, respectively. The changes in weight and HbA1c were statistically significant across all groups. In 5% of the patients, genital pruritus was reported. Mycotic genital infection was seen in none of the patients on examination. All the four groups chose to discontinue the use of empagliflozin as a result of pruritus at follow up. The baseline daily insulin dose was 42 ± 25 units, and at 4 months, it was reduced to 34 ± 20 units. At follow up, the reduction in insulin level was 19.1% when compared to baseline. CONCLUSION This study showed that there was an improvement in glycaemic control and body weight with minimal side effects when SGLT2 inhibitor was added at any
Urbonaite, Brone; Zalinkevicius, Rimas; Green, Anders
-based linear trends of the increase in incidence in various age groups and the annual percentage change for both genders was 2.05 (p = 0.0039) and the greatest regression slope is observed for both genders in the 10-14 yr age group. Regression-based linear trends in type 1 diabetes prevalence indicate an even......AIMS/HYPOTHESIS: Our purpose is to analyze interrelations of the incidence, prevalence and mortality of childhood-onset insulin-dependent diabetes mellitus (type 1) in Lithuania. METHODS: Incidence and prevalence rates were based on the national type 1 diabetes register during 1983-98. The cohort...... study was performed to evaluate the standardized mortality ratios. RESULTS: The average incidence of type 1 diabetes during the 16-yr study period was 7.36 per 100,000/yr. For both males and females the highest incidence of type 1 diabetes was recorded in the 10-14 yr age group. The regression...
Vilsbøll, Tina; Knop, Filip K
Type 2 diabetes mellitus is characterized by insulin resistance, impaired glucose-induced insulin secretion, and inappropriately elevated glucagon levels which eventually result in hyperglycemia. The currently available treatment modalities for type 2 diabetes are often unsatisfactory in getting...... for the treatment of type 2 diabetes has become available in the US (since October 2005) and in Europe (since May 2007): the incretin-based therapies. The incretin-based therapies fall into two different classes: (i) incretin mimetics, i.e. injectable peptide preparations with actions similar to the natural...... patients to glycemic goals, even when used in combination, and therefore many patients develop microvascular and macrovascular diabetic complications. Additionally, these treatment modalities are often limited by inconvenient dosage regimens and safety and tolerability issues, the latter including...
Nieuwesteeg, A.M.; Hartman, E.E.; Pouwer, F.; Emons, W.H.M.; Aanstoot, H.J.; van Mil, E.; van Bakel, H.J.A.
Background In young children with type 1 diabetes mellitus (T1DM), parents have complete responsibility for the diabetes-management. In toddlers and (pre)schoolers, the tasks needed to achieve optimal blood glucose control may interfere with normal developmental processes and could negatively affect
Ukkola, O; Kesäniemi, Y A
The association between the Leu72Met polymorphism of the preproghrelin gene and diabetic complications was examined in patients with type 2 diabetes mellitus. A total of 258 patients with type 2 diabetes mellitus and 522 control subjects were screened. Genotypes were determined by polymerase chain reaction technique. The diagnosis of coronary heart disease was based on clinical and ECG criteria. Laboratory analyses were carried out in the hospital laboratory. No differences in the genotype distributions and allele frequencies of the preproghrelin Leu72Met polymorphism were found between type 2 diabetes mellitus patients and controls. The polymorphism was not associated with macro- or micro-angiopathy or hypertension. However, Leu72Met polymorphism was associated with serum creatinine (P = 0.006) and lipoprotein(a) [Lp(a)] levels (P = 0.006) with Leu72Leu subjects showing the highest values. This association was observed only amongst diabetic group. The Leu72Met polymorphism of the preproghrelin gene was not related to cardiovascular disease in type 2 diabetes mellitus patients. Leu72Met polymorphism was, however, associated with serum creatinine and Lp(a) levels in diabetic patients. The mechanism might be associated with a possible change in ghrelin product and its somatotropic effect.
Zhang, Junxia; Xiang, Lin; Zhang, Bilin; Cheng, Yangyang
To reveal the effect of hyperuricaemia on endothelial function in normoglycaemic first-degree relatives of type 2 diabetes mellitus. In all, 40 first-degree relatives of type 2 diabetes mellitus with hyperuricaemia, 40 first-degree relatives of type 2 diabetes mellitus with normouricaemia and 35 healthy subjects without diabetic family history were recruited in this study. Anthropometric parameters as well as blood pressure, blood lipids, fasting blood glucose, fasting insulin, C-reactive protein, tumour necrosis factor-α and interleukin-6 were measured. Insulin resistance was assessed with homoeostasis model assessment index-insulin resistance index. To assess endothelial function, high-resolution ultrasonography was used for measuring flow- and nitroglycerine-mediated brachial artery vasodilation. When compared with control, flow-mediated dilation was lower in first-degree relatives with or without hyperuricaemia (both p type 2 diabetes mellitus (β = -0.677, p type 2 diabetes mellitus complicated with hyperuricaemia.
Zhu Wei; Yang Yuzhi; Li Xianhou; Feng Kun; Wang Dan
Objective: To investigate the relationship between serum adiponectin concentration and diabetic nephropathy in patients with type 2 diabetes mellitus. Methods: The serum adiponectin concentrations were measured with RIA in 163 patients with type 2 diabetes mellitus and 50 controls. Results: In the diabetic patients, serum adiponectin concentrations were significantly higher in patients with macro albuminuria (n = 54) than those inpatients with microalbuminuria (n = 57) (P 0.05). Adiponectin concentrations were higher in women than in men, but there was no significant difference (P > 0.05). Conclusion: Serum adiponectin concentrations are increased in type 2 diabetic patients with advanced nephropathy. The kidney seems to be involved in the metabolism and excretion of adiponectin. Adiponectin may play important roles in the onset and development of diabetic nephropathy. (authors)
Cognitive impairment in patients with type 2 diabetes mellitus: Perspectives and ... may have a deteriorating effect on mental health including a decline in cognitive ... of Diabetes; Functional Foods and Human Diet; Quality of Life and Wellness ...
Manish K. Verma; D. A. Biswas; Shambhavi Tripathi; N. S. Verma
Background: Cardiac autonomic neuropathy (CAN) is a very common complication of Type II diabetes mellitus patients. Early detection and treatment of CAN is necessary for reduction of mortality and morbidity in type II diabetes patients. Methods: The study included 120 diagnosed cases of type 2 diabetes mellitus with autonomic neuropathy both male and female, with more than 5 years duration of disease. Age group of the study subjects was between 30 and ndash; 70 years. All the 120 diabet...
Kristensen, Peter Lommer; Høi-Hansen, Thomas; Boomsma, Frans
hypoglycemia. High activity in the renin-angiotensin system (RAS) is associated with an increased risk of severe hypoglycemia in patients with type 1 diabetes mellitus. Renin-angiotensin system possibly exerts its mechanism in hypoglycemia via VEGF. We studied the impact of mild hypoglycemia on plasma VEGF...... in patients with type 1 diabetes mellitus and high or low RAS activity and analyzed associations between VEGF levels and cognitive function during hypoglycemia. Eighteen patients with type 1 diabetes mellitus-9 with high and 9 with low RAS activity-underwent a single-blinded, placebo-controlled, crossover...... study with either mild hypoglycemia or stable glycemia. Cognitive function was assessed by the California Cognitive Assessment Package and the Alzheimer Quick Test. Nadir plasma glucose was 2.2 (0.3) mmol/L. During the control study, plasma VEGF did not change. During hypoglycemia, plasma VEGF increased...
Jimenez, Carolyn C; Corcoran, Matthew H; Crawley, James T; Guyton Hornsby, W; Peer, Kimberly S; Philbin, Rick D; Riddell, Michael C
To present recommendations for the certified athletic trainer in the management of type 1 diabetes in the athlete. In managing diabetes, the most important goal is to keep blood glucose levels at or as close to normal levels as possible without causing hypoglycemia. This goal requires the maintenance of a delicate balance among hypoglycemia, euglycemia, and hyperglycemia, which is often more challenging in the athlete due to the demands of physical activity and competition. However, effectively managing blood glucose, lipid, and blood pressure levels is necessary to ensuring the long-term health and well-being of the athlete with diabetes. These recommendations are intended to provide the certified athletic trainer participating in the management of an athlete with type 1 diabetes mellitus with the specific knowledge and problem-solving skills needed. Athletic trainers have more contact with the athlete with diabetes than most members of the diabetes management team do and so must be prepared to assist the athlete as required.
Sildorf, S. M.; Hertel, N T; Thomsen, J.
AIMS: To examine trends in diabetes treatment in Danish children and adolescents with Type 1 diabetes mellitus, comparing treatment intensity with metabolic outcomes in the population, and to describe the challenges of population-based registries in a clinical setting with rapidly changing...... treatment methods. METHODS: This observational study is based on the Danish national population registry of childhood diabetes, which includes 99% of children diagnosed with Type 1 diabetes before the age of 15 years. We included 4527 people diagnosed between 2000 and 2012. Self-monitored blood glucose...... measurements, insulin injections/boluses, treatment method and metabolic control quantifications were analysed and adjusted for the effects of gender and ethnicity, the combined effect of age, visit year and duration, and for the random effects of individual and hospital settings. RESULTS: Treatment...
Vanstone, Meredith; Rewegan, Alex; Brundisini, Francesca; Dejean, Deirdre; Giacomini, Mita
Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. The objective of this analysis was to examine the perceptions of patients with uncontrolled type 1 diabetes on how it affects their lived experience and quality of life. This report synthesizes 31 primary qualitative studies to examine quality of life from the perspectives of adult patients with type 1 diabetes mellitus and their families or partners. We performed a qualitative meta-synthesis to integrate findings across primary research studies. Long- and short-term negative consequences of uncontrolled type 1 diabetes affect all aspects of patients' lives: physical, emotional, practical, and social. The effect on each domain is far-reaching, and effects interact across domains. Uncontrolled blood sugar levels lead to substantial psychological distress, negative moods, cognitive difficulties, irritable or aggressive behaviour, and closely associated problems with relationships, self-image, and confidence. Emotional distress is pervasive and under-addressed by health care providers. Patients live in fear of complications from diabetes over the long term. In the shorter term, they are anxious about the personal, social, and professional consequences of hypoglycemic episodes (e.g., injury, humiliation), and may curtail normal activities such as driving or socializing because they are worried about having an episode. The quality of life for patients' family members is also negatively impacted by uncontrolled type 1 diabetes. Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.
DeFronzo, Ralph A; Ferrannini, Ele; Groop, Leif
Type 2 diabetes mellitus (T2DM) is an expanding global health problem, closely linked to the epidemic of obesity. Individuals with T2DM are at high risk for both microvascular complications (including retinopathy, nephropathy and neuropathy) and macrovascular complications (such as cardiovascular...... that multiple antidiabetic agents, used in combination, will be required to maintain normoglycaemia. The treatment must not only be effective and safe but also improve the quality of life. Several novel medications are in development, but the greatest need is for agents that enhance insulin sensitivity, halt...
Ashraf, S.M.S.; Basir, F.
To evaluate the prevalence of hypertension and diastolic dysfunction (LVDD) with normal ejection fraction in type-2 diabetes mellitus. Two hundred twelve diabetic patients (98 females and 114 males) from January 2005 to June 2006 were enrolled in this study. Their ages ranged from 35 to 65 years with mean age of 55 years. Patients with Diabetes Mellitus Type-2, Hypertension: BP/sup 3/140/90 (with or without medication) Body Mass Index/sub 3/30, Waist-Hip ratio>0.90. Left Ventricular Diastolic Dysfunction (LVDD) and Serum Triglyceride and HDL Cholesterol were included. Out of 212 patients, 104 (49%) were found to be hypertensive (both systolic and diastolic) and 12 patients (5.6%) were found to be suffering from isolated systolic hypertension. Hence total number of hypertensive patients was 116 (54.6%). Thirty two patients were found to be suffering from diastolic dysfunction. Hypertension and Diabetes are interlinked and show how micro and macrovascular complications of diabetes are increased when two conditions occur together. The LVDD is much more prevalent than previously suggested in patients with type-2 diabetes mellitus. Hence LVDD is an early marker of diabetic cardiomyopathy. (author)
El Eter, E. [Physiology Department, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Cardiovascular Research Group, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Physiology Department, Faculty of Medicine, Alexandria University, Alexandria (Egypt); Al-Masri, A.A. [Physiology Department, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia); Cardiovascular Research Group, Faculty of Medicine, King Saud University, Riyadh (Saudi Arabia)
The production of oxygen free radicals in type 2 diabetes mellitus contributes to the development of complications, especially the cardiovascular-related ones. Peroxiredoxins (PRDXs) are antioxidant enzymes that combat oxidative stress. The aim of this study was to investigate the associations between the levels of PRDX isoforms (1, 2, 4, and 6) and cardiovascular risk factors in type 2 diabetes mellitus. Fifty-three patients with type 2 diabetes mellitus (28F/25M) and 25 healthy control subjects (7F/18M) were enrolled. We measured the plasma levels of each PRDX isoform and analyzed their correlations with cardiovascular risk factors. The plasma PRDX1, -2, -4, and -6 levels were higher in the diabetic patients than in the healthy control subjects. PRDX2 and -6 levels were negatively correlated with diastolic blood pressure, fasting blood sugar, and hemoglobin A1c. In contrast, PRDX1 levels were positively correlated with low-density lipoprotein and C-reactive protein levels. PRDX4 levels were negatively correlated with triglycerides. In conclusion, PRDX1, -2, -4, and -6 showed differential correlations with a variety of traditional cardiovascular risk factors. These results should encourage further research into the crosstalk between PRDX isoforms and cardiovascular risk factors.
El Eter, E.; Al-Masri, A.A.
The production of oxygen free radicals in type 2 diabetes mellitus contributes to the development of complications, especially the cardiovascular-related ones. Peroxiredoxins (PRDXs) are antioxidant enzymes that combat oxidative stress. The aim of this study was to investigate the associations between the levels of PRDX isoforms (1, 2, 4, and 6) and cardiovascular risk factors in type 2 diabetes mellitus. Fifty-three patients with type 2 diabetes mellitus (28F/25M) and 25 healthy control subjects (7F/18M) were enrolled. We measured the plasma levels of each PRDX isoform and analyzed their correlations with cardiovascular risk factors. The plasma PRDX1, -2, -4, and -6 levels were higher in the diabetic patients than in the healthy control subjects. PRDX2 and -6 levels were negatively correlated with diastolic blood pressure, fasting blood sugar, and hemoglobin A1c. In contrast, PRDX1 levels were positively correlated with low-density lipoprotein and C-reactive protein levels. PRDX4 levels were negatively correlated with triglycerides. In conclusion, PRDX1, -2, -4, and -6 showed differential correlations with a variety of traditional cardiovascular risk factors. These results should encourage further research into the crosstalk between PRDX isoforms and cardiovascular risk factors
Hypertension is a major worldwide health problem. Its prevalence is 1.5-2 times higher in diabetic population than that in non-diabetic individuals. Its pathogenesis depends on diabetic nephropathy in type 1, whereas may be multifactorial in type 2 diabetes mellitus. In diabetics, angiotensin converting enzyme inhibitors are most widely preferred in the treatment of hypertension because of their numerous desirable effects. In this article, the most recent data are presented on the relationshi...
Holst, Jens Juul; McGill, Maria A
Type 2 diabetes mellitus is associated with a progressive decline in insulin-producing pancreatic ß-cells, an increase in hepatic glucose production, and a decrease in insulin sensitivity. The incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1....... The currently available incretin-based therapies, GLP-1 receptor agonists (incretin mimetics) and dipeptidyl peptidase-4 (DPP-4) inhibitors (CD26 antigen inhibitors) [incretin enhancers], are safe and effective in the treatment of type 2 diabetes. However, they may be unable to halt the progression of type 2...... diabetes, perhaps because they do not increase secretion of endogenous GLP-1. Therapies that directly target intestinal L cells to stimulate secretion of endogenous GLP-1 could possibly prove more effective than treatment with GLP-1 receptor agonists and DPP-4 inhibitors. Potential new approaches...
Jerrell, Jeanette M; Tripathi, Avnish; Rizvi, Ali A; McIntyre, Roger S
Type 2 diabetes mellitus in children and adolescents has become an important public health concern, in parallel with the "epidemic" of overweight/obesity in this age group and a sharp increase in children being prescribed antidepressant or antipsychotic medications. In children and adolescents, the prevalence of being prescribed antidepressant or antipsychotic medications was examined as well as the association of these medications with developing type 2 diabetes mellitus. A retrospective cohort design evaluating South Carolina Medicaid medical and pharmacy claims between January 1, 1996, and December 31, 2006, was employed to identify 4,070 children and adolescents diagnosed initially with type 2 diabetes mellitus, 39% of whom were later reclassified as type 1 (using ICD-9 criteria). The added risk of developing type 2 diabetes mellitus posed by the use of antidepressants or antipsychotics was investigated in this cohort, controlling for individual risk factors and comorbid cardiometabolic conditions. Use of antidepressants or antipsychotics alone, or the 2 in combination, conferred an increased risk (1.3 to 2 times greater) of having diagnosed type 2 diabetes mellitus and several comorbid cardiometabolic conditions (obesity, dyslipidemia, and hypertension). However, psychiatric illnesses generally developed and were treated after the initial development of diabetes. Depression was diagnosed and treated in 10% to 20% of this cohort. While antidepressants and antipsychotics, alone or in combination, are associated with a diagnosis of type 2 diabetes mellitus and its cardiometabolic comorbidities by adolescence, they do not appear to be an explanatory factor in the early onset of type 2 diabetes mellitus in this age group and do not appear to cloud the initial, overlapping clinical picture between type 1 and type 2 diabetes mellitus.
Atik Altınok, Yasemin; Özgür, Suriye; Meseri, Reci; Özen, Samim; Darcan, Şükran; Gökşen, Damla
The aim of this study was to show the reliability and validity of a Turkish version of Diabetes Eating Problem Survey-Revised (DEPS-R) in children and adolescents with type 1 diabetes mellitus. A total of 200 children and adolescents with type 1 diabetes, ages 9-18 years, completed the DEPS-R Turkish version. In addition to tests of validity, confirmatory factor analysis was conducted to investigate the factor structure of the 16-item Turkish version of DEPS-R. The Turkish version of DEPS-R demonstrated satisfactory Cronbach's ∝ (0.847) and was significantly correlated with age (r=0.194; p1), hemoglobin A1c levels (r=0.303; p1), and body mass index-standard deviation score (r=0.412; p1) indicating criterion validity. Median DEPS-R scores of Turkish version for the total samples, females, and males were 11.0, 11.5, and 10.5, respectively. Disturbed eating behaviors and insulin restriction were associated with poor metabolic control. A short, self-administered diabetes-specific screening tool for disordered eating behavior can be used routinely in the clinical care of adolescents with type 1 diabetes. The Turkish version of DEPS-R is a valid screening tool for disordered eating behaviors in type 1 diabetes and it is potentially important to early detect disordered eating behaviors.
Donna M D'Souza
Full Text Available Diabetes mellitus is defined as a group of metabolic diseases that are associated with the presence of a hyperglycemic state due to impairments in insulin function. While the development of each form of diabetes (Type 1 or Type 2 drastically differs, resultant pathologies often overlap. In each diabetic condition a failure to maintain healthy muscle is often observed, and is termed diabetic myopathy. This significant, but often overlooked, complication is believed to contribute to the progression of additional diabetic pathologies due to the vital importance of skeletal muscle for our physical and metabolic well-being. While studies have investigated the link between changes to skeletal muscle metabolic health following diabetes mellitus onset (particularly Type 2 diabetes mellitus, few have examined the negative impact of diabetes mellitus on the growth and reparative capacities of skeletal muscle that often coincides with disease development. Importantly, evidence is accumulating that the muscle progenitor cell population (particularly the muscle satellite cell population is also negatively affected by the diabetic environment, and as such, likely contributes to the declining skeletal muscle health observed in diabetes mellitus. In this review, we summarize the current knowledge surrounding the influence of diabetes mellitus on skeletal muscle growth and repair, with a particular emphasis on the impact of diabetes mellitus on the progenitor cell population of skeletal muscle.
Targher, Giovanni; Lonardo, Amedeo; Byrne, Christopher D
Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70-80% of patients with type 2 diabetes mellitus and up to 30-40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus. NAFLD is also associated with an increased risk of developing microvascular diabetic complications, especially chronic kidney disease. This Review focuses on the strong association between NAFLD and the risk of chronic vascular complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus, thereby promoting an increased awareness of the extra-hepatic implications of this increasingly prevalent and burdensome liver disease. We also discuss the putative underlying mechanisms by which NAFLD contributes to vascular diseases, as well as the emerging role of changes in the gut microbiota (dysbiosis) in the pathogenesis of NAFLD and associated vascular diseases.
Recent estimates suggest that more than 100,000 inhabitants in the Middle East suffer from type 1 diabetes and that about 6000 subjects in the region develop the disease each year. This paper illustrates how epidemiological principles and methods may assist in a rational assessment of the public...... health impact of type 1 diabetes in the Middle East. Making a series of assumptions, it is estimated that the future prevalence of type 1 diabetes in the region will increase slightly, but that the increase may be more pronounced if the disease incidence is increasing and the prognosis improved....... It is recommended that more valid information is established on the basic epidemiological features of type 1 diabetes in the Middle East, as this will provide the basis of more rational planning of the current and future diabetes healthcare in the region....
Nansel, Tonja R; Lipsky, Leah M; Liu, Aiyi; Laffel, Lori M B; Mehta, Sanjeev N
This study examined differences in diet quality by meal type, location, and time of week in youth with type 1 diabetes mellitus. A sample of youth with type 1 diabetes mellitus (n=252; 48% female) age 8 to 18 years (mean±standard deviation=13.2±2.8 years) with diabetes duration ≥1 year (mean±standard deviation=6.3±3.4 years) completed 3-day diet records. Multilevel linear regression models tested for differences in diet quality indicators by meal type, location, and time of week (weekdays vs weekends). Participants showed greater energy intake and poorer diet quality on weekends relative to weekdays, with lower intake of fruit and vegetables, and higher intake of total and saturated fat. Differences in diet quality were seen across meal types, with higher nutrient density at breakfast and dinner than at lunch and snacks. Participants reported the highest whole-grain and lowest fat intake at breakfast, but higher added sugar than at lunch or dinner. Dinner was characterized by the highest fruit intake, lowest added sugar, and lowest glycemic load, but also the highest sodium intake. The poorest nutrient density and highest added sugar occurred during snacks. Diet quality was poorer for meals consumed away from home than those consumed at home for breakfast, dinner, and snacks. Findings regarding lunch meal location were mixed, with higher nutrient density, lower glycemic load, and less added sugar at home lunches, and lower total fat, saturated fat, and sodium at lunches away from home. Findings indicate impacts of meal type, location, and time of week on diet quality, suggesting targets for nutrition education and behavioral interventions. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Aitken-Saavedra, Juan; Rojas-Alcayaga, Gonzalo; Maturana-Ramírez, Andrea; Escobar-Álvarez, Alejandro; Cortes-Coloma, Andrea; Reyes-Rojas, Montserrat; Viera-Sapiain, Valentina; Villablanca-Martínez, Claudia; Morales-Bozo, Irene
Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia.
Han, H. W.; Yan, X. L.; Dong, R. X.; Ban, G.; Li, K.
In this paper, we show surface-enhanced Raman spectra (SERS) of serums from type II diabetes mellitus and diabetic complication (coronary disease, glaucoma and cerebral infarction), and analyze the SERS through the multivariate statistical methods of principal component analysis (PCA). In particular, we find that there exist many adenines in these serums, which maybe come from DNA (RNA) damage. The relative intensity of the band at 725±2 cm-1 assigned to adenine is higher for patients than for the healthy volunteers; therefore, it can be used as an important ‘fingerprint’ in order to diagnose these diseases. It is also shown that serums from type II diabetes mellitus group, diabetic complication group and healthy volunteers group can be discriminated by PCA.
Ashrafian, Hutan; Harling, Leanne; Toma, Tania; Athanasiou, Christina; Nikiteas, Nikolaos; Efthimiou, Evangelos; Darzi, Ara; Athanasiou, Thanos
Type 1 diabetes mellitus (T1DM) has a rising global prevalence. Although it is vastly outnumbered by type 2 diabetes mellitus rates, it remains a persistent worldwide source of morbidity and mortality. Increasingly, its sufferers are afflicted by obesity and its complications. The objective of the study is to quantify the effects of bariatric surgery on T1DM by appraising the primary outcomes of glycosylated haemoglobin (HbA1c), insulin requirements and body mass index (BMI). Secondary outcomes included blood pressure, triglycerides and cholesterol biochemistry. A systematic review of studies reporting pre-operative and post-operative outcomes in T1DM patients undergoing bariatric surgery was done. Data were meta-analysed using random effects modelling. Subgroup analysis and quality scoring were assessed. Bariatric surgery in obese T1DM patients is associated with a significant reduction in insulin requirement (-48.95 units, 95 % CI of -56.27, -41.62), insulin requirement per kilogramme (-0.391, 95 % CI of -0.51, -0.27), HbA1c (-0.933, 95 % CI of -1.604, -0.262) and BMI (-11.04 kg/m(2), 95 % CI of -13.49, -8.59). Surgery is also associated with a statistically significant reduction in systolic and diastolic blood pressure and a significant beneficial rise in HDL. Heterogeneity in these results was high, and study quality was low overall. Bariatric surgery in obese T1DM patients is associated with a significant improvement in insulin requirement and a significant though modest effect on HbA1c. These early results require further substantiation with future studies focusing on higher levels of evidence. This may offer a deeper understanding of diabetogenesis and can contribute to better selection and stratification of diabetic patients for metabolic surgery and future metabolic treatment strategies.
Full Text Available This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation coefficient (rs. The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51 and self-perceived health (excellent (6.5%, very good (42.3%, good (38.7%, fair (11.3% and poor (1.2%. Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7 and sense of coherence (SOC-13: 68.9 (9.7, moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8 and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9. A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = −0.41, p < 0.0001 and well-being (rs = 0.34, p < 0.0001 as well as negative correlations with diabetes distress (rs = −0.51, p < 0.0001 and hypoglycemia worries (rs = −0.27, p = 0.0009. Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales “goal achievement” in SWE-DES (p = 0.0028 and “comprehensibility” in SOC (p = 0.016. Well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this.
Khalid S Aljabri; Somoa A Bokhari; Murtadha J. Khan
A prospective, nonblinded and nonrandomized controlled trial was conducted to test the hypothesis that vitamin D supplementation would improve glycemic control in patients with type 1 diabetes mellitus who have vitamin D deficiency. Patients and 0 Eighty patients with type 1 diabetes mellitus who had 25-hydroxyvitamin D levels less than 50 nmol/L were assigned to receive 4000 IU of vitamin D3. Calcium supplements were provided to ensure a total calcium intake of 1200 mg/d. Glycosylated hemoglobin and 25-hydroxyvitamin D levels were measured at baseline and at 12 weeks.There was a significant difference in mean (SD) glycosylated hemoglobin level (%) between the groups that achieved 25-hydroxyvitamin D levels of 51 nmol/L at 12 weeks (P=.02). There was a significant difference in glycosylated hemoglobin change from baseline between the groups that achieved 25-hydroxyvitamin D levels of 51 nmol/L at 12 weeks (P=.04). There was a significant difference in 25-hydroxyvitamin D level between the groups that achieved glycosylated hemoglobin levels of 9.9 at 12 weeks (P=.001). Patients were more likely to achieve lower glycosylated hemoglobin levels at 12 weeks if they had higher 25-hydroxyvitamin D levels at 12 weeks (r=-0.4, P=.001).There was an observed effect of vitamin D supplementation on glycemic control in vitamin D-replete, type 1 diabetes mellitus patients. Further studies are needed to determine if these findings are applicable (Author).
Heida, Karst Y.; Franx, Arie; van Rijn, Bas B.; Eijkemans, Marinus J. C.; Boer, Jolanda M. A.; Verschuren, Monique W. M.; Oudijk, Martijn A.; Bots, Michiel L.; van der Schouw, Yvonne T.
A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of
Alime Selcuk Tosun
Full Text Available Precautions taken in early stages of diabetes mellitus are more beneficial in terms of quality of life. The risk of Type 2 diabetes mellitus has been shown to be reduced at rates up to 58% or its emergence may be delayed with healthy lifestyle changes in different studies. Transtheoretical model and motivational interview method are especially used to increase the adaptation of individuals to disease management and to change behaviours about diabetes mellitus for decreasing or preventing the harmful effects of diabetes mellitus in studies conducted with individuals with Type 2 diabetes mellitus. Interventions using motivational interview method based on transtheoretical model demonstrated that a general improvement in glycaemic control and in physical activity level can be achieved and significant progress has been made during the stage of change. Motivational interview method based on transtheoretical model is an easy and efficient counselling method to reach behavioural change. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1: 32-41
Microvascular diabetes complications in Wolfram syndrome (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness [DIDMOAD]): an age- and duration-matched comparison with common type 1 diabetes.
Cano, Aline; Molines, Laurent; Valéro, René; Simonin, Gilbert; Paquis-Flucklinger, Véronique; Vialettes, Bernard
Some previous studies suggested that patients suffering from Wolfram syndrome or DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness) might be relatively preserved from diabetic retinopathy and nephropathy. However, these data were not conclusive because either observations were only anecdotic or did not match with control type 1 diabetic populations. A group of 26 French diabetic patients with DIDMOAD was compared with a population of 52 patients with common type 1 diabetes matched for age at diabetes diagnosis (8.62 +/- 1.84 vs. 8.27 +/- 1.30 years; P = NS) and diabetes duration (12.88 +/- 1.58 vs. 12.87 +/- 1.13 years; P = NS) to study the quality of glycemic control and the incidence of microvascular complications. Glycemic control was significantly better in the DIDMOAD group than in the type 1 diabetic group (A1C: 7.72 +/- 0.21 vs. 8.99 +/- 0.25%, respectively; P = 0.002), with significant lower daily insulin requirements (0.71 +/- 0.07 vs. 0.88 +/- 0.04 UI x kg(-1) x day(-1), respectively; P = 0.0325). The prevalence of microvascular complications in the DIDMOAD group was half that observed in the type 1 diabetic group, but the difference was not significant. Diabetes in DIDMOAD patients is more easily controlled despite the presence of other handicaps. This better glycemic control could explain the trend to decreased microvascular diabetes complications observed in previous studies.
Katra, Pernilla; Dereke, Jonatan; Nilsson, Charlotta; Hillman, Magnus
Diabetes mellitus is a group of diseases characterized by chronic hyperglycemia. Women who develops hyperglycemia for the first time during pregnancy receive the diagnosis gestational diabetes mellitus (GDM). Presently, there is no consensus about the diagnostic criteria for GDM. A majority of these women subsequently develop postpartum overt diabetes making it important to identify these patients as early as possible. In this study we investigated if plasma levels of the interleukin-1 receptor antagonist (IL-1Ra), an endogenous inhibitor of IL-1 signaling, can be used as a complementary biomarker for diagnosing GDM and predicting postpartum development of overt diabetes mellitus. Patients participating in this study (n = 227) were diagnosed with their first GDM 2004-2013 at Lund University Hospital, Lund, Sweden. Healthy pregnant volunteers (n = 156) were recruited from women's welfare centers in the same region 2014-2015. Levels of IL-1Ra and C-peptide were analyzed in ethylenediaminetetraacetic acid (EDTA)-plasma or serum using enzyme linked immunosorbent assay (ELISA). GDM patients had significantly lower levels of IL-1Ra than the control group (p = 0.012). In addition, GDM patients that had developed impaired glucose tolerance (IGT) or type 2 diabetes mellitus postpartum had significantly lower levels of IL-1Ra, and significantly higher levels of C-peptide than GDM patients that had not developed diabetes mellitus postpartum (p = 0.023) and (p = 0.0011) respectively. An inverse correlation was found between IL-1Ra and serum C-peptide levels in the control group (rs = -0.31 p = 0.0001). Our results show that IL-1Ra might be included in a future panel of biomarkers, both for diagnosing GDM to complement blood glucose, and also identifying GDM patients that are at risk of developing type 2 diabetes mellitus postpartum. However, the ROC curve analysis provided a sensitivity of 52.2% and specificity of 67.1%, which nonetheless may not be sufficient enough to use IL
Full Text Available Diabetes mellitus is a group of diseases characterized by chronic hyperglycemia. Women who develops hyperglycemia for the first time during pregnancy receive the diagnosis gestational diabetes mellitus (GDM. Presently, there is no consensus about the diagnostic criteria for GDM. A majority of these women subsequently develop postpartum overt diabetes making it important to identify these patients as early as possible. In this study we investigated if plasma levels of the interleukin-1 receptor antagonist (IL-1Ra, an endogenous inhibitor of IL-1 signaling, can be used as a complementary biomarker for diagnosing GDM and predicting postpartum development of overt diabetes mellitus. Patients participating in this study (n = 227 were diagnosed with their first GDM 2004-2013 at Lund University Hospital, Lund, Sweden. Healthy pregnant volunteers (n = 156 were recruited from women's welfare centers in the same region 2014-2015. Levels of IL-1Ra and C-peptide were analyzed in ethylenediaminetetraacetic acid (EDTA-plasma or serum using enzyme linked immunosorbent assay (ELISA. GDM patients had significantly lower levels of IL-1Ra than the control group (p = 0.012. In addition, GDM patients that had developed impaired glucose tolerance (IGT or type 2 diabetes mellitus postpartum had significantly lower levels of IL-1Ra, and significantly higher levels of C-peptide than GDM patients that had not developed diabetes mellitus postpartum (p = 0.023 and (p = 0.0011 respectively. An inverse correlation was found between IL-1Ra and serum C-peptide levels in the control group (rs = -0.31 p = 0.0001. Our results show that IL-1Ra might be included in a future panel of biomarkers, both for diagnosing GDM to complement blood glucose, and also identifying GDM patients that are at risk of developing type 2 diabetes mellitus postpartum. However, the ROC curve analysis provided a sensitivity of 52.2% and specificity of 67.1%, which nonetheless may not be sufficient enough
Full Text Available Vitamin D is a well-known fat-soluble vitamin which is essential in the homeostasis of calcium and phosphorus. Vitamin D deficiency causes skeletal disorders, including rickets, osteomalacia, and osteoporosis. However, recent studies revealing the immunomodulatory effects of vitamin D have opened up a new understanding and possibility in this field. It has been proved that vitamin D is related to a variety of autoimmune diseases. Type 1 diabetes mellitus (T1DM, being generally accepted as autoimmune mediated, is also proposed to be associated with the vitamin D status of the human body. Here, we reviewed briefly the epidemiological correlation between the vitamin D status and prevalence of T1DM, the possible mechanisms underlying this correlation, and clinical trials focusing on the therapeutic prospects of vitamin D in the treatment of T1DM.
Green, A.; Andersen, Per Kragh; Svendsen, A.J.
To provide information of the incidence trends of Type 1 (insulin-dependent) diabetes mellitus we performed a cohort study of a series of Danish male birth cohorts. All male livebirths in Denmark between 1 January 1949 and 31 December 1964, were investigated regarding the development of Type 1...... of 1705 diabetic subjects were identified of whom 23 were not representative of idiopathic Type 1 diabetes. The cumulative rate of Type 1 diabetes development during the first 20 years of life increased from 2.37 to 2.90 per 1000 for the first eight and last eight birth cohorts, respectively. A log...... diabetes during the first 20 years of life using the files of the Danish Conscript Board, supplemented by a search in the Danish National Registry of Deaths. Diagnosis was verified and clinical information obtained from medical records. The material is estimated to be more than 95% complete. A total...
Ewald, Nils; Hardt, Philip D
Diabetes secondary to pancreatic diseases is commonly referred to as pancreatogenic diabetes or type 3c diabetes mellitus. It is a clinically relevant condition with a prevalence of 5%-10% among all diabetic subjects in Western populations. In nearly 80% of all type 3c diabetes mellitus cases, chronic pancreatitis seems to be the underlying disease. The prevalence and clinical importance of diabetes secondary to chronic pancreatitis has certainly been underestimated and underappreciated so far. In contrast to the management of type 1 or type 2 diabetes mellitus, the endocrinopathy in type 3c is very complex. The course of the disease is complicated by additional present comorbidities such as maldigestion and concomitant qualitative malnutrition. General awareness that patients with known and/or clinically overt chronic pancreatitis will develop type 3c diabetes mellitus (up to 90% of all cases) is rather good. However, in a patient first presenting with diabetes mellitus, chronic pancreatitis as a potential causative condition is seldom considered. Thus many patients are misdiagnosed. The failure to correctly diagnose type 3 diabetes mellitus leads to a failure to implement an appropriate medical therapy. In patients with type 3c diabetes mellitus treating exocrine pancreatic insufficiency, preventing or treating a lack of fat-soluble vitamins (especially vitamin D) and restoring impaired fat hydrolysis and incretin secretion are key-features of medical therapy.
Wu, Yanqing; Reece, E Albert; Zhong, Jianxiang; Dong, Daoyin; Shen, Wei-Bin; Harman, Christopher R; Yang, Peixin
Maternal type 1 and 2 diabetes mellitus are strongly associated with high rates of severe structural birth defects, including congenital heart defects. Studies in type 1 diabetic embryopathy animal models have demonstrated that cellular stress-induced apoptosis mediates the teratogenicity of maternal diabetes leading to congenital heart defect formation. However, the mechanisms underlying maternal type 2 diabetes mellitus-induced congenital heart defects remain largely unknown. We aim to determine whether oxidative stress, endoplasmic reticulum stress, and excessive apoptosis are the intracellular molecular mechanisms underlying maternal type 2 diabetes mellitus-induced congenital heart defects. A mouse model of maternal type 2 diabetes mellitus was established by feeding female mice a high-fat diet (60% fat). After 15 weeks on the high-fat diet, the mice showed characteristics of maternal type 2 diabetes mellitus. Control dams were either fed a normal diet (10% fat) or the high-fat diet during pregnancy only. Female mice from the high-fat diet group and the 2 control groups were mated with male mice that were fed a normal diet. At E12.5, embryonic hearts were harvested to determine the levels of lipid peroxides and superoxide, endoplasmic reticulum stress markers, cleaved caspase 3 and 8, and apoptosis. E17.5 embryonic hearts were harvested for the detection of congenital heart defect formation using India ink vessel patterning and histological examination. Maternal type 2 diabetes mellitus significantly induced ventricular septal defects and persistent truncus arteriosus in the developing heart, along with increasing oxidative stress markers, including superoxide and lipid peroxidation; endoplasmic reticulum stress markers, including protein levels of phosphorylated-protein kinase RNA-like endoplasmic reticulum kinase, phosphorylated-IRE1α, phosphorylated-eIF2α, C/EBP homologous protein, and binding immunoglobulin protein; endoplasmic reticulum chaperone gene
Wen, W; Frampton, R; Wright, K; Fattore, S; Shadbolt, B; Perampalam, S
To identify the knowledge and management factors associated with glycaemic control among adults with Type 1 diabetes mellitus treated with insulin pump therapy. A cross-sectional study of adults with Type 1 diabetes mellitus on insulin pump therapy for at least 12 months (n = 50, 18-70 years old) was undertaken between December 2013 and May 2014. A new questionnaire was developed to evaluate participants' knowledge and management related to insulin pump therapy, and were correlated with insulin pump data, HbA1c and frequency of hypoglycaemia. Participants who changed their insulin pump settings when indicated had significantly better glycaemic control than those who did not (P = 0.04). Multivariate logistic regression analysis found that better overall insulin pump therapy management was a significant predictor of better glycaemic control (odds ratio 4.45, 95% confidence interval 1.61-12.3; P = 0.004) after adjusting for potential confounders including age, gender, duration of diabetes and insulin pump therapy. However, overall insulin pump therapy knowledge was not a significant predictor of glycaemic control (P = 0.058). There was no significant association between frequency of hypoglycaemia and insulin pump therapy knowledge or management. We identified some key knowledge and management factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy using a newly designed questionnaire. The pilot study assessed the clinical utility of this evaluation tool, which may facilitate provision of targeted education to insulin pump therapy users to achieve optimal glycaemic control. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.
Agoeng Tjahjani Sarwono
Full Text Available Sialolithiasis is a common disease of the submandibular glands or its duct but rare in parotids of patients, especially in male adults. The accessory of salivary glands are small, unsheathed masses with a small canaliculi. The irritant factors might be due to inflammation of the inner layer of the canaliculi, that often concomitant to saliva stasis. This process leads to development of calculus that it is related to secretive specificity of the submandibular gland. The essential factor for its calcification is the stagnation of secretory matieral rich in calcium. The accumulation of this material would cause swelling, further obstruction and atrophy until there is widespread inflammation that has been termed sialadenitis. Diabetes mellitus is one of the medically compromised diseases. Although there are many assocaiations between diabetes mellitus and oral health, lack of investigation in this area has been done to study salivary gland alterations. Many diabetic patient complained xerostomia, a decreasing salivary flow and enlargement of the parotid gland due to a compensatory mechanism to xerostomia that has been termed sialadenosis. This review article summarized that there is no relationship between sialolithiasis and poorly controlled type 2 diabetes mellitus.
Metz, Thomas O; Qian, Wei-Jun; Jacobs, Jon M; Polpitiya, Ashoka D; Camp, II, David G; Smith, Richard D
A method for identifying persons with increased risk of developing type 2 diabetes mellitus utilizing selected biomarkers described hereafter either alone or in combination. The present invention allows for broad based, reliable, screening of large population bases and provides other advantages, including the formulation of effective strategies for characterizing, archiving, and contrasting data from multiple sample types under varying conditions.
Li, Yuan; Ren, Duofu; Ding, Pingfei; Zhang, Qin; Zhang, Juan; Shi, Wenhui; Wu, Jing; Shi, Xiaoming; Liang, Xiaofeng
To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% (urban:17.1%, rural:28.1%, χ² = 27 195.33, P hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3% (urban:62.0%, rural:36.6%, χ² = 329.31, P hypertension patients and type 2 diabetes mellitus patients were 83.0% (urban:84.7% , rural: 80.7% , χ² = 13.42, P hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.
... diabetes, hypertension, contraceptive use and certain genetic predisposing factors. ... Objectives: Was to assess the degree of atherogenic risk in type 2 DM and ... hundred (100) type 2 diabetes mellitus patients and ninety-two (92) healthy ...
Naqvi, Syeda; Naveed, Shabnam; Ali, Zeeshan; Ahmad, Syed Masroor; Asadullah Khan, Raad; Raj, Honey; Shariff, Shoaib; Rupareliya, Chintan; Zahra, Fatima; Khan, Saba
Dyslipidemia is quite prevalent in non-insulin dependent diabetes mellitus. Maintaining tight glycemic along with lipid control plays an essential role in preventing micro- and macro-vascular complications associated with diabetes. The main purpose of the study was to highlight the relationship between glycosylated hemoglobin (HbA1c) and triglyceride levels. This may in turn help in predicting the triglyceride status of type 2 diabetics and therefore identifying patients at increased risk from cardiovascular events. Hypertriglyceridemia is one of the common risk factors for coronary artery disease in type 2 diabetes mellitus (DM). Careful monitoring of the blood glucose level can be used to predict lipid status and can prevent most of the complications associated with the disease. This is a cross-sectional study using data collected from the outpatient diabetic clinic of Jinnah Postgraduate Medical Centre (JPMC) Karachi, Pakistan. Patients of age 18 years and above were recruited from the clinic. A total of consenting 509 patients of type 2 diabetes mellitus were enrolled over a period of 11 months. For statistical analysis, SPSS Statistics for Windows, Version 17.0 ( IBM Corp, Armonk, New York) was used and Chi-square and Pearson's correlation coefficient was used to find the association between triglyceride and HbA1c. The HbA1c was dichotomized into four groups on the basis of cut-off. Chi-square was used for association between HbA1c with various cut-off values and high triglyceride levels. Odds-ratio and its 95% confidence interval were calculated to estimate the level of risk between high triglyceride levels and HbA1c groups. The p-value triglyceride was evaluated in four different groups of HbA1c, with a cut-off seven, eight, nine and 10 respectively. With HbA1c cut-off value of 7%, 74% patients had high triglycerides and showed a significant association with high triglyceride levels at p index, lifestyle) and health status factors (blood pressure
Eduardo De la Cruz-Cano
Full Text Available Background: Diabetes mellitus and depression are highly prevalent conditions throughout the world and have significant impact on health outcomes. It has been estimated that diabetes mellitus type 2 affects about 246 million people in the world; nevertheless, incidence varies among countries. There is evidence that depression is associated with a poor metabolic control in patients with type 2 diabetes mellitus that present other health problems (such as hypertension and obesity. The aim of this study protocol is to determine if obesity increases the risk for depression in patient with diabetes type 2. Methods: The analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA.The studies suitable for inclusion will be assessed by the Newcastle-Ottawa Scale (NOS to determine their methodological quality. To identify the studies of interest, we will search on PubMed and EBSCO databases. We will use the following keyword combinations: "Diabetes Mellitus type 2 AND obesity AND depression", "depression AND Diabetes Mellitus type 2", "Diabetes Mellitus type 2 AND body mass index cross sectional study", "depression AND obesity cross-sectional study". Causes for exclusion will be publications that studied patients diagnosed with diabetes mellitus type 1; articles that focused on the treatment and complications of diabetes mellitus type 2; publications that have studied other clinical or psychiatric conditions (for instance, seizure disorder or history of schizophrenia, bipolar disorder, psychotic symptoms or dementia. Conclusion: The results of this study will form the basis for a better understanding of the association between obesity and depression in patients with diabetes mellitus type 2, and will allow development of prediction tools and better interventions. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes among population
Gallas, P. Robert J.; Stolk, Ronald P.; Bakker, Karel; Endert, Erik; Wiersinga, Wilmar M.
BACKGROUND: The prevalence of thyroid dysfunction in pregnancy and in the first postpartum year (postpartum thyroid dysfunction (PPTD)) in women with diabetes mellitus type 1 (DM1) is known to be higher than in the general population. To assess prevalence, incidence and risk factors in The
HOSSEINZADEH, Payam; DJAZAYERY, Abolghassem; MOSTAFAVI, Seyed-Ali; JAVANBAKHT, Mohammad Hassan; DERAKHSHANIAN, Hoda; RAHIMIFOROUSHANI, Abbas; DJALALI, Mahmoud
Background This study was conducted to investigate the effects of Brewer?s yeast supplementation on serum lipoproteins and blood pressure in patients with Type 2 diabetes mellitus. Methods: In a randomized double blind clinical trial, 90 adults with type 2 diabetes mellitus were recruited, and divided randomly into 2 groups, trial group received brewer?s yeast (1800 mg/day) and control group received placebo for 12 weeks. Weight, BMI, food consumption (based on 24 hour food recall), fasting s...
Akkermans, Marjolijn D.; Mieke Houdijk, E. C. A.; Bakker, Boudewijn; Clement-de Boers, Agnes; van der Kaay, Daniëlle C. M.; de Vries, Martine C.; Claire Woltering, M.; Mul, Dick; van Goudoever, Johannes B.; Brus, Frank
Children with diabetes mellitus (DM) type 1 may be at risk for iron deficiency (ID) although this has been little studied. ID is either an absolute (depleted iron stores) or a functional (restricted iron stores due to chronic inflammation) deficiency each requiring a different therapeutic approach.
Shafie, Asrul Akmal; Ng, Chin Hui; Tan, Yui Ping; Chaiyakunapruk, Nathorn
Insulin analogues have a pharmacokinetic advantage over human insulin and are increasingly used to treat diabetes mellitus. A summary of their cost effectiveness versus other available treatments was required. Our objective was to systematically review the published cost-effectiveness studies of insulin analogues for the treatment of patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). We searched major databases and health technology assessment agency reports for economic evaluation studies published up until 30 September 2015. Two reviewers performed data extraction and assessed the quality of the data using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) guidelines. Seven of the included studies assessed short-acting insulin analogues, 12 assessed biphasic insulin analogues, 30 assessed long-acting insulin analogues and one assessed a combination of short- and long-acting insulin analogues. Only 17 studies involved patients with T1DM, all were modelling studies and 12 were conducted in Canada. The incremental cost-effectiveness ratios (ICERs) for short-acting insulin analogues ranged from dominant to $US435,913 per quality-adjusted life-year (QALY) gained, the ICERs for biphasic insulin analogues ranged from dominant to $US57,636 per QALY gained and the ICERs for long-acting insulin analogues ranged from dominant to $US599,863 per QALY gained. A total of 15 studies met all the CHEERS guidelines reporting quality criteria. Only 26 % of the studies assessed heterogeneity in their analyses. Current evidence indicates that insulin analogues are cost effective for T1DM; however, evidence for their use in T2DM is not convincing. Additional evidence regarding compliance and efficacy is required to support the broader use of long-acting and biphasic insulin analogues in T2DM. The value of insulin analogues depends strongly on reductions in hypoglycaemia event rates and its efficacy in lowering glycated haemoglobin
Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C
Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.
Menon, P S; Khatwa, U A
Diabetes mellitus is uncommon in infancy and newborn period. The two common forms seen are the transient and permanent forms of diabetes mellitus of the newborn. They have to be differentiated from the transient hyperglycemic states (Blood sugar > 125 mg/dl) seen in newborns who receive parenteral glucose infusions and in those with septicemia and CNS disorders. Transient diabetes mellitus of the newborn (TDNB) is defined as hyperglycemia occurring within the first month of life lasting at least 2 weeks and requiring insulin therapy. Most of these cases resolve spontaneously by 4 months. It has a reported incidence of 1 in 45,000 to 60,000 live births. The most likely etiology is a maturational delay of cAMP mediated insulin release. The clinical features include small for datedness, proneness for birth asphyxia, open-eye alert facies, dehydration, emaciation, polyuria and poydipsia. These children are prone to septicemia and urinary tract infections. They have hyperglycemia, glucosuria, absent or mild ketonuria, low basal insulin, C-peptide and IGF-1 levels. Treatment consists of hydration and judicious administration of insulin with close monitoring. Thirty percent of these children are likely to develop permanent neonatal diabetes. Compared to transient form, permanent diabetes mellitus is uncommon. It is usually due to pancreatic dysgenesis often associated with other malformations and rarely due to type 1 diabetes mellitus. The diagnosis is based on the demonstration of both exocrine and endocrine pancreatic dysfunction. These children are managed as type 1 diabetes mellitus. They are prone to develop the vascular complications of diabetes at an earlier date.
Napoli, Nicola; Chandran, Manju; Pierroz, Dominique D
The risk of fragility fractures is increased in patients with either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM). Although BMD is decreased in T1DM, BMD in T2DM is often normal or even slightly elevated compared with an age-matched control population. However, in both T1DM...... and T2DM, bone turnover is decreased and the bone material properties and microstructure of bone are altered; the latter particularly so when microvascular complications are present. The pathophysiological mechanisms underlying bone fragility in diabetes mellitus are complex, and include hyperglycaemia......-induced hypoglycaemia, certain antidiabetic medications with a direct effect on bone and mineral metabolism (such as thiazolidinediones), as well as an increased propensity for falls, all contribute to the increased fracture risk in patients with diabetes mellitus....
Elaine Buchhom Cintra Damião
Full Text Available OBJETIVO: Compreender como o adolescente com diabetes mellitus tipo I vivencia sua experiência de doença e como lida com esta situação no cotidiano. MÉTODOS: O Interacionismo Simbólico foi utilizado como referencial teórico e a Teoria Fundamentada nos Dados como o referencial metodológico da pesquisa. Participaram do estudo 10 adolescentes com diagnóstico de diabetes mellitus tipo 1 há mais de um ano. RESULTADOS: Foram identificados dois fenômenos explicativos da experiência: não sendo normal ter diabetes e sendo normal ter diabetes. CONCLUSÃO: Os dois fenômenos não são isolados ou excludentes para o mesmo adolescente, parecendo haver períodos ou fases em que os adolescentes identificam-se e vivenciam ora um fenômeno ora outro, com maior ou menor intensidade.OBJETIVO: Comprender como el adolescente con diabetes mellitus tipo I experimenta su enfermedad y como lidia con esta situación en lo cotidiano. MÉTODOS: El Interaccionismo Simbólico fue utilizado como marco teórico y la Teoría Fundamentada en los Datos como el marco metodológico de la investigación. Participaron del estudio 10 adolescentes que tenían diagnóstico de diabetes mellitus tipo 1 hace más de un año. RESULTADOS: Fueron identificados dos fenómenos que explicaban la experiencia: no es normal tener diabetes y es normal tener diabetes. CONCLUSIÓN: Los dos fenómenos no están aislados o se excluyen mutuamente para el mismo adolescente, pareciendo haber períodos o fases en que los adolescentes se identifican y viven una vez un fenómeno y otra vez el otro, con mayor o menor intensidad.PURPOSE: To understand the life experience of teenagers with type 1 diabetes mellitus and how they cope with the disease in daily life. METHODS: The symbolic interactionism was the theoretical perspective guiding the study. Grounded theory served as the method for using the empirical data. Participants consisted of 10 teenagers with type 1 diabetes mellitus over a year
Stuti L. Misra
Full Text Available Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P=0.12 and P=0.33, resp.. Tear lipid thickness (P=0.02, stability (P<0.0001, and quantity (P=0.01 were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P<0.001 and tear film stability was inversely associated with total neuropathy score (r=-0.29, P=0.03. Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.
Perry, Lin; James, Steven; Steinbeck, Katharine; Dunbabin, Janet; Lowe, Julia
Continuous subcutaneous insulin infusion (CSII; insulin pump) use is increasing. However, there is little information about how this technology is used compared with other insulin delivery methods (ie, injections) by young people with type 1 diabetes mellitus in Australia. This study explored young people's attitudes, perceptions, and experiences with diabetes management comparing those using with those not using CSII, and proportions likely to transition to adult services requiring initiation and/or support for CSII use. A survey was undertaken of young people (aged 12 to 18 years) with type 1 diabetes mellitus and their parents/guardians living in Hunter New England, Australia, using a questionnaire designed to collect quantitative, descriptive, and demographic data. Most questions were based on previously developed and validated instruments. In total, 107 respondents returned partially or fully completed questionnaires. Respondents had positive attitudes and perceptions of their self-efficacy and diabetes management, but were moderately disturbed by their diabetes and reported experiencing suboptimal management outcomes. Patterns of associations were demonstrated between knowledge, attitudes, and experiences of diabetes modeled by regression analysis. There were no statistically significant differences in responses between users and nonusers of CSII. Over 40% indicated their intention to use the technology as adults. Opportunities for enhanced diabetes service support were clear, and CSII did not appear to be used to its full potential. Service redesign could enhance support for this young population using all preferred insulin delivery methods and should align to patients' goals and preferences to maximize service and patient gain. © 2017 John Wiley & Sons, Ltd.
Feldt-Rasmussen, B; Nørgaard, K; Jensen, T
Which comes first when developing clinical diabetic nephropathy, the blood pressure rise or the increasing urinary albumin excretion? This issue is discussed based on recent literature of studies in humans with Type 1 (insulin-dependent) diabetes mellitus. We conclude that hypertension has...... a central role in the progression of diabetic nephropathy and has deleterious effects on the life expectancy of patients who already have signs of diabetic renal disease in terms of elevated urinary albumin excretion. However, blood pressure is preceded by small increments of urinary albumin excretion rates......, an indicator of universally increased vascular leakiness, and thus does not seem to be the cause of diabetic nephropathy....
Pamungkas, Rian Adi; Chamroonsawasdi, Kanittha; Vatanasomboon, Paranee
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose moni...
Broe, Rebecca; Rasmussen, Malin Lundberg; Frydkjaer-Olsen, Ulrik
The aim was to investigate the long-term incidence of proliferative diabetic retinopathy (PDR), and progression and regression of diabetic retinopathy (DR) and associated risk factors in young Danish patients with Type 1 diabetes mellitus. In 1987-89, a pediatric cohort involving approximately 75...... % of all children with Type 1 diabetes in Denmark diabetic parameters assessed. Of those, 185 (54.6 %) were evaluated again in 2011 for the same clinical parameters. All retinal images...... were graded using modified early treatment of DR study for 1995 and 2011. In 1995, mean age was 21.0 years and mean diabetes duration 13.5 years. The 16-year incidence of proliferative retinopathy, 2-step progression and 2-step regression of DR was 31.0, 64.4 and 0.0 %, respectively, while...
Aren, Gamze; Sepet, Elif; Ozdemir, Didem; Dinççağ, Nevin; Güvener, Bora; Firatli, Erhan
The aim of this study was to determine whether detectable periodontal destruction and alterations in the salivary status were present with duration of diabetes in children with type 1 insulin-dependent diabetes mellitus (type 1 DM) as compared to healthy controls. Sixteen newly diagnosed children with DM (group 1), 16 children with type 1 DM of long duration (group 2), and 16 healthy children (group 3) participated in the study. Periodontal health was assessed by plaque index, gingival index, bleeding on probing, and periodontal probing depths. The flow rate, pH, buffering capacity, and peroxidase activities of stimulated saliva were determined. The data were analyzed by Kruskall-Wallis, Student t test, and Pearson's correlation analysis. The mean values for fasting blood glucose levels for the diabetic groups were significantly higher than for the controls. The mean values for salivary buffering capacities and salivary pH from the diabetic groups were significantly lower than for the controls. The plaque index values for the diabetic groups were significantly higher than for the controls. The mean gingival index value for group 1 was significantly lower than for group 2. The mean periodontal probing depths for group 1 were similar to those of the non-DM controls, but the mean periodontal probing depths for group 2 were significantly greater than for both the non-DM controls and group 1. Group 1 had significantly greater bleeding on probing scores than did the other groups (P diabetic subjects affects the periodontal probing depths, salivary pH, buffering capacity, and peroxidase activity.
Full Text Available ABSTRACT Objective: To investigate factors that are associated with type 2 diabetes Mellitus in shift workers of a slaughterhouse in Southern Brazil. Methods: This cross-sectional study included 1,194 18- to 50-year-old workers of both sexes. The presence of type 2 diabetes Mellitus was self-reported and confirmed by the use of hypoglycemic drugs or insulin. The independent variables were sex, age, skin color, marital status, education level, family income, leisure time physical activity, smoking, and self-reported health and nutritional status (body mass index and waist circumference. Multivariate analysis was performed from an a priori conceptual model. Results: The prevalence of diabetes was 1.3% (95%CI=0.6-1.9. Type 2 diabetes Mellitus was associated with poor or regular self-reported health (OR=3.72; 95%CI=1.28-10.78 and level II abdominal obesity ³102 for men and ³88 for women (OR=5.76; 95%CI=1.07-29.10. Conclusion: The prevalence of type 2 diabetes Mellitus was low. Moreover, the study evidenced the importance of using waist circumference to surveil and screen for metabolic diseases, such as type 2 diabetes Mellitus, and to monitor the low quality of life in the study individuals given the poor self-perceived health of workers with the said disease.
Donatella Paola Provvisiero
Full Text Available Bisphenol A (BPA is an organic synthetic compound employed to produce plastics and epoxy resins. It is used as a structural component in polycarbonate beverage bottles and as coating for metal surface in food containers and packaging. The adverse effects of BPA on human health are widely disputed. BPA has been recently associated with a wide variety of medical disorders and, in particular, it was identified as potential endocrine-disrupting compound with diabetogenic action. Most of the clinical observational studies in humans reveal a positive link between BPA exposure, evaluated by the measurement of urinary BPA levels, and the risk of developing type 2 diabetes mellitus. Clinical studies on humans and preclinical studies on in vivo, ex vivo, and in vitro models indicate that BPA, mostly at low doses, may have a role in increasing type 2 diabetes mellitus developmental risk, directly acting on pancreatic cells, in which BPA induces the impairment of insulin and glucagon secretion, triggers inhibition of cell growth and apoptosis, and acts on muscle, hepatic, and adipose cell function, triggering an insulin-resistant state. The current review summarizes the available evidences regarding the association between BPA and type 2 diabetes mellitus, focusing on both clinical and preclinical studies.
A research has been carried out to assess the awareness of patients about the importance of diet, the availability of information and to make the diabetes patients with mellitus type 2 realize the urgency of dieting. The first part looks into theoretical sources and statistics about how widespread diabetes mellitus type 2 is and the importance of a healthy diet. The practical part of the research consists of the survey results. The method of quantitative research was applied. The conclusions ...
Shen, Yi; Zhang, Sheng; Wang, Xulin; Wang, Yuanyuan; Zhang, Jian; Qin, Gang; Li, Wenchao; Ding, Kun; Zhang, Lei; Liang, Feng
Because whether hepatitis B virus infection increases the risk of type 2 diabetes mellitus has been a controversial topic, pair-wise and network meta-analyses of published literature were carried out to accurately evaluate the association between different phases of hepatitis B virus infection and the risk of type 2 diabetes mellitus. A comprehensive literature retrieval was conducted from the PubMed, Embase, Cochrane Library and Chinese Database to identify epidemiological studies on the association between hepatitis B virus infection and the risk of type 2 diabetes mellitus that were published from 1999 to 2015. A pair-wise meta-analysis of direct evidence was performed to estimate the pooled odds ratios and 95% confidence intervals. A network meta-analysis was conducted, including the construction of a network plot, inconsistency plot, predictive interval plot, comparison-adjusted funnel plot and rank diagram, to graphically link the direct and indirect comparisons between different hepatitis B virus infective phases. Eighteen publications (n=113 639) describing 32 studies were included in this meta-analysis. In the pair-wise meta-analysis, the pooled odds ratio for type 2 diabetes mellitus in chronic hepatitis B cirrhosis patients was 1.76 (95% confidence interval: 1.44-2.14) when compared with non-cirrhotic chronic hepatitis B patients. In the network meta-analysis, six comparisons of four hepatitis B virus infectious states indicated the following descending order for the risk of type 2 diabetes mellitus: hepatitis B cirrhosis patients, non-cirrhotic chronic hepatitis B patients, hepatitis B virus carriers and non-hepatitis B virus controls. This study suggests that hepatitis B virus infection is not an independent risk factor for type 2 diabetes mellitus, but the development of cirrhosis may increase the incidence of type 2 diabetes mellitus cirrhosis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Joseph, Joshua J; Golden, Sherita H
Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous and immune systems. The HPA axis is a tightly regulated system that represents one of the body's mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting HPA axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus. © 2016 New York Academy of Sciences.
Chen, Zhiye; Sun, Jie; Yang, Yang; Lou, Xin; Wang, Yulin; Wang, Yan; Ma, Lin
The purpose of this study was to explore the brain structural changes in type 2 diabetes and the effect of insulin on the brain using a surface-based cortical thickness analysis. High-resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI were obtained from 11 patients with type 2 diabetes before and after insulin therapy. The cortical thickness over the entire brain was calculated, and cross-sectional and longitudinal surface-based cortical thickness analyses were also performed. Regional cortical thinning was demonstrated in the middle temporal gyrus, posterior cingulate gyrus, precuneus, right lateral occipital gyrus and entorhinal cortex bilaterally for patients with type 2 diabetes mellitus compared with normal controls. Cortical thickening was seen in the middle temporal gyrus, entorhinal cortex and left inferior temporal gyrus bilaterally after patients underwent 1 year of insulin therapy. These findings suggest that insulin therapy may have recovering effects on the brain cortex in type 2 diabetes mellitus. The precise mechanism should be investigated further. Copyright © 2014 Elsevier Ltd. All rights reserved.
Zaidi, S.M.H.; Ghafoor, A.; Randhawa, F.A.
Background: Diabetes is usually accompanied by dyslipidaemia, and among these triglyceride levels are related to the insulin resistance in type 2 diabetes. HbAlc which is an indicator of diabetes control can depict the severity of hypertriglyceridemia. The objective of this study was to determine the correlation between HbAlc and Triglyceride levels in type 2 Diabetes mellitus. Method: A sample of 150 diabetic patients fulfilling the inclusion and exclusion criteria were selected for this cross-sectional study. Patient included were type 2 Diabetes Mellitus with HbAlc >7. Patients with history of cardiovascular disease, taking lipid lowering medications, smoker and history of cerebral stroke were excluded. HbAlc and triglyceride levels were noted .Study patients were further stratified on the basis of severity of HbAlc and Triglyceride values. The correlation between HbAlc and Triglyceride levels were established with Pearson Correlation. Results: Among total number of 150 patients 44 percentage (n=70) were male and 50.3 percentage (n=80) were female. The correlation of HbAlc with Triglyceride as estimated by Pearson Correlation was positive (p=0.033, r=0.033) and statistically significant. Conclusions: In type 2 diabetes mellitus there is a predictable relationship between Triglycerides and HbAlc. (author)
Jáuregui-Renaud, K; Aranda-Moreno, C; Herrera-Rangel, A
The aim of this study was to assess the function of the utricle and horizontal semicircular canals in patients with type 2 diabetes mellitus receiving primary health care, with/without a history of falls. 101 patients with type 2 diabetes mellitus, 34 to 84 years old (26 with and 75 without a history of falls) and 51 healthy volunteers (40-83 years old) accepted to participate. They denied having a history of dizziness, vertigo, unsteadiness, hearing loss, or neurological disorders. None of them were seeking care due to sensory or balance decline. After a clinical evaluation and report of symptoms related to balance using a standardised questionnaire, lateral canal function was assessed by sinusoidal rotation at 0.16 Hz and 1.28 Hz (60°/sec peak velocity), otolith function was assessed by static visual vertical (average of 10 trials) and dynamic visual vertical during unilateral centrifugation (300°/sec at 3.5 cm) and static posturography was performed on hard/ soft surface with eyes open/closed. Compared to healthy volunteers, patients showed decreased responses to unilateral centrifugation, but similar responses to horizontal canal stimuli (independently of age, peripheral neuropathy or a history of falls) (ANCoVA p diabetes mellitus, receiving primary healthcare who are not seeking care due to sensory or balance decline, utricular function may be impaired even in the absence of horizontal canal dysfunction or a history of falls. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.
Kokic, S.; Radman, M.; Capkum, V.; Dovzak-Kokic, D.; Tesanovic, S.
The objective of the study was to estimate the most successful way of treating patients with type 2 diabetes mellitus. A total of 87 patients with type 2 diabetes mellitus were selected for a three-month study. The patients were divided into three groups comprising 29 patients in each group, based upon the treatment regimen. Group 1 (BMI 32.3+-3.6 kg/m2) was treated with glimepiride and metformin; group 2 (BMI 27.9+-3.9) was treated with daily doses of insulin mixture 30/70 and bed-time NPH insulin; and group 3 (BMI 30.02+-4.8) was treated with a combination of three daily doses of lispo and metformin.The groups did not differ significantly in terms of sex and age. Initially, there were significant statistical differences in HbA1c (P=0.035) between the three groups (9, 21%+-1.72%; 9.21%+-1.54%; and 10, 0%+-1.73% respectively). After three months there were no statistically differences in HbA1c (P=0.66) between the groups (8.52+-1.7%; 8.03%+-1.05%; and 8.0%+-0.63%, respectively. Decreases in HbA1c were significant in all groups, but most pronounced in patients treated with lispro and metaformin (17% on average). The study results suggest the need for establishing guidelines on how to treat type 2 diabetics. (author)
The number of type 2 diabetic patients is increasing world-wide and a prediction of prevalence of chronic kidney disease up to 2025 in European diabetic population is alarming. Albuminuria and estimated glomerular filtration rate are cardinal biochemical parameters in diagnostics of diabetic nephropathy. Following diagnostic methods are also used: renal ultrasonography, ophthalmoscopy and in not clarified cases renal biopsy. Long-term optimal glycemic control, efficient antihypertensive treatment by angiotensin converting enzyme inhibitor, or angiotensin receptor blocker and recommended protein intake is a cornerstone of therapy. The research is presently focused on new pathophysiological mechanisms, as analysis of genome, microRNA, kidney injury biomarkers and proteomes.Key words: chronic kidney disease - type 2 diabetes mellitus.
Miranda-Lora, América L; Vilchis-Gil, Jenny; Molina-Díaz, Mario; Flores-Huerta, Samuel; Klünder-Klünder, Miguel
To estimate the heritability, parental transmission and environmental contributions to the phenotypic variation in type 2 diabetes mellitus and metabolic syndrome-related traits in families of Mexican children and adolescents. We performed a cross-sectional study of 184 tri-generational pedigrees with a total of 1160 individuals (99 families with a type 2 diabetes mellitus proband before age 19). The family history of type 2 diabetes mellitus in three generations was obtained by interview. Demographic, anthropometric, biochemical and lifestyle information was corroborated in parents and offspring. We obtained correlations for metabolic traits between relative pairs, and variance component methods were used to determine the heritability and environmental components. The heritability of early-onset of type 2 diabetes mellitus was 0.50 (p1.0e-7). The heritability was greater than 0.5 for hypertension, hypoalphalipoproteinemia, hypercholesterolemia, body mass index, waist circumference, blood pressure, 2-h insulin, and cholesterol (p1). In contrast, we observed a high environmental correlation (>0.50) for blood pressure, HbA1c and HDL-cholesterol after multivariate adjustment (ptype 2 diabetes mellitus and insulin resistance, were significantly correlated only through the mother and others, such as hypertriglyceridemia, were significantly correlated only through the father. This study demonstrates that type 2 diabetes mellitus and metabolic syndrome-related traits are highly heritable among Mexican children and adolescents. Furthermore, several cardiometabolic factors have strong heritability and/or high environmental contributions that highlight the complex architecture of these alterations. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Abstract Stem cell therapy is one of the most promising treatments for the near future. It is expected that this kind of therapy can ameliorate or even reverse some diseases. With regard to type 1 diabetes, studies analyzing the therapeutic effects of stem cells in humans began in 2003 in the Hospital das Clínicas of the Faculty of Medicine of Ribeirão Preto - SP USP, Brazil, and since then other centers in different countries started to randomize patients in their clinical trials. Herein we summarize recent data about beta cell regeneration, different ways of immune intervention and what is being employed in type 1 diabetic patients with regard to stem cell repertoire to promote regeneration and/or preservation of beta cell mass. The Diabetes Control and Complications Trial (DCCT was a 7-year longitudinal study that demonstrated the importance of the intensive insulin therapy when compared to conventional treatment in the development of chronic complications in patients with type 1 diabetes mellitus (T1DM. This study also demonstrated another important issue: there is a reverse relationship between C-peptide levels (endogenous indicator of insulin secretion chronic complications - that is, the higher the C-peptide levels, the lower the incidence of nephropathy, retinopathy and hypoglycemia. From such data, beta cell preservation has become an additional target in the management of T1DM 1.
Objective: This study was undertaken with the aim of investigating adipokine levels in the Type 2 Diabetes Mellitus. Methods: This is a cross sectional study conducted in Lagos University Teaching Hospital (LUTH), a-700 bed tertiary hospital centre in Lagos, Nigeria. 53 diabetic subjects and 27 non-diabetic controls with ...
Lin, Xue; Yang, Penghua; Reece, E Albert; Yang, Peixin
Cardiac hypertrophy is highly prevalent in patients with type 2 diabetes mellitus. Experimental evidence has implied that pregnant women with type 2 diabetes mellitus and their children are at an increased risk of cardiovascular diseases. Our previous mouse model study revealed that maternal type 2 diabetes mellitus induces structural heart defects in their offspring. This study aims to determine whether maternal type 2 diabetes mellitus induces embryonic heart hypertrophy in a murine model of diabetic embryopathy. The type 2 diabetes mellitus embryopathy model was established by feeding 4-week-old female C57BL/6J mice with a high-fat diet for 15 weeks. Cardiac hypertrophy in embryos at embryonic day 17.5 was characterized by measuring heart size and thickness of the right and left ventricle walls and the interventricular septum, as well as the expression of β-myosin heavy chain, atrial natriuretic peptide, insulin-like growth factor-1, desmin, and adrenomedullin. Cardiac remodeling was determined by collagen synthesis and fibronectin synthesis. Fibrosis was evaluated by Masson staining and determining the expression of connective tissue growth factor, osteopontin, and galectin-3 genes. Cell apoptosis also was measured in the developing heart. The thicknesses of the left ventricle walls and the interventricular septum of embryonic hearts exposed to maternal diabetes were significantly thicker than those in the nondiabetic group. Maternal diabetes significantly increased β-myosin heavy chain, atrial natriuretic peptide, insulin-like growth factor-1, and desmin expression, but decreased expression of adrenomedullin. Moreover, collagen synthesis was significantly elevated, whereas fibronectin synthesis was suppressed, in embryonic hearts from diabetic dams, suggesting that cardiac remodeling is a contributing factor to cardiac hypertrophy. The cardiac fibrosis marker, galectin-3, was induced by maternal diabetes. Furthermore, maternal type 2 diabetes mellitus
Insulin-dependent diabetes mellitus or type 1 diabetes is an autoimmune multifactorial disease which has a great socio-economic impact. In Morocco, less is known about the contribution of Human leukocyte antigen (HLA) alleles to type 1 diabetes susceptibility. Our study focused on evaluating the distribution of class II ...
Dakovic, Dragana; Pavlovic, Milos D
The purpose of this study was to evaluate periodontal health in young patients with type 1 diabetes mellitus in Serbia. Periodontal disease was clinically assessed and compared in 187 children and adolescents (6 to 18 years of age) with type 1 diabetes mellitus and 178 control subjects without diabetes. Children and adolescents with type 1 diabetes mellitus had significantly more plaque, gingival inflammation, and periodontal destruction than control subjects. The main risk factors for periodontitis were diabetes (odds ratio [OR] = 2.78; 95% confidence interval [CI]: 1.42 to 5.44), bleeding/plaque ratio (OR = 1.25; 95% CI: 1.06 to 1.48), and age (OR = 1.10; 95% CI: 1.01 to 1.21). In case subjects, the number of teeth affected by periodontal destruction was associated with mean hemoglobin A1c (regression coefficient 0.17; P = 0.026), duration of diabetes (regression coefficient 0.19; P = 0.021), and bleeding/plaque ratio (regression coefficient 0.17; P = 0.021). Compared to children and adolescents without diabetes, periodontal disease is more prevalent and widespread in children and adolescents with type 1 diabetes mellitus and depends on the duration of disease, metabolic control, and the severity of gingival inflammation. Gingival inflammation in young patients with diabetes is more evident and more often results in periodontal destruction.
Jin, Yan-Yan; Liang, Li; Fu, Jun-Fen; Wang, Xiu-Min
To investigate the incident and prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in obese children in the last ten years. The clinical data of hospitalized children with newly diagnosed diabetes mellitus (DM) or obesity between October 2000 and September 2011 were retrospectively studied. A total of 503 newly onset cases were diagnosed as DM in the past ten years, of which 31 were diagnosed as T2DM. The prevalence of T2DM in the second five-year duration increased significantly compared with that in the first five-year duration (0.18‰ vs 0.05‰; P1). The number of cases of type 1 diabetes mellitus (T1DM) and T2DM increased by 1.35 fold and 4.20 fold, respectively in the second five-year duration. A total of 1301 obese patients received oral glucose tolerance tests, and 29 cases were diagnosed with T2DM and 255 cases with prediabetes. Of the 255 cases of prediabetes, 133 had dyslipidemia, 138 had non-alcoholic fatty liver disease and 53 had hypertension. The prevalence rates of T1DM and T2DM increased significantly in the last 5 years. The prevalence of T2DM increased more significantly than T1DM. There was a higher prevalence of prediabetes in obese children. Childhood obesity predicts a higher risk of T2DM and cardiovascular disease in the future.
Davis, Nichola; Forbes, Bernice; Wylie-Rosett, Judith
Weight loss is a key goal in the management of patients with type 2 diabetes mellitus. There are conflicting weight-loss strategies, including low-carbohydrate diets, low glycemic-index diets, low-fat vegan diets, conventional low-fat diets, and high-protein and high-monounsaturated fat diets. There is no evidence to suggest that 1 nutritional strategy is clearly the best. The most successful strategy is one that the patient can adopt and follow in the long term. (c) 2009 Mount Sinai School of Medicine.
Sales-Peres, Silvia Helena de Carvalho; Guedes, Maria de Fatima Santos; Sá, Letícia Marques; Negrato, Carlos Antonio; Lauris, José Roberto Pereira
The aim of this review was to verify data concerning the relationship between the existent lifestyle and glycemic control in patients with Diabetes Mellitus Type 1 (DM1). The methods applied included the literature search strategy, selection of studies by means of inclusion and exclusion strategies, according to the characteristics of the studies. The search was conducted in the Lilacs, Medline, PubMed, Cochrame, SciELO and IBECS databases between in the period between 2005 and 2014. The articles selected were studies in humans, investing lifestyle, physical activities and glycemic levels. Of the 1798 studies initially identified, 11 met the eligibility criteria. Among the studies analyzed, 1 cohort; 1 longitudinal prospective, 1 case control and 8 transversal studies that approached the proposed theme were related. Regular physical activity was the variable that presented greatest relationship with the improvement in glycemic levels. Healthy active life, balanced diet, physical activities and education in diabetes improved the glycemic control of the DM1 patient. The results allowed the authors to conclude that a lifestyle based on physical activities interfered directly in the health of patients with DM1, in addition to contributing the glycemic control.
Legorreta-Herrera, M.; Mosqueda-Romo, N. A.; Hernández-Clemente, F.; Soto-Cruz, I.
We selected diabetes mellitus for this laboratory exercise to provide students with an explicit model for scientific research concerning the association between the R230C polymorphism and susceptibility to type 2 diabetes mellitus, which is highly prevalent in the Mexican population. We used a collaborative project-based learning to engage…
N A Molitvoslovova; G R Galstyan
The interrelationship between diabetes mellitus (DM) and bone disorder is still not fully understood. Whereas type 1 diabetes mellitus (T1DM) is characterized by decrease in bone density, a number of studies failed to discover such phenomenon in type 2 diabetes mel- litus (T2DM), – or even uncovered some evidence for higher density, as measured against groups of control. At the very same time both types of DM are associated with elevated risk of bone fracture, which points out at some deterio...
Patucchi, Emanuele; Fatati, Giuseppe; Puxeddu, Adolfo; Coaccioli, Stefano
To determine the prevalence of fibromyalgia in diabetes mellitus and obesity, 121 consecutive patients have been observed: 27 with obesity (6 males and 21 females; mean age 57 years, range 20-57; mean body mass index [BMI] 34); 88 with type 2 diabetes mellitus (T2DM; 40 males and 48 females; mean age 63 years, range 44-78; mean BMI 28.8; mean glycated haemoglobin [HbA1c] in the last year 8.3%); 6 with type 1 diabetes mellitus (T1DM; 2 males and 4 females; mean age 52 years, range 26-76; mean BMI 24.5; mean HbA1c BMI less that 26 the diagnosis of fibromyalgia was negative. Our data seem to reveal the presence of a significant clinical association between obesity, diabetes mellitus and fibromyalgia.
I L Alimova
Full Text Available Aims. To estimate an impact of glycemic variability on the development of gastroesophageal reflux disease (GERD in adolescents with type 1 diabetes mellitus (T1DM. Materials and methods. We enrolled 33 patients with T1DM aged from 12 to 17 years. 24-h pH-monitoring was performed with ?Gas- troskan 24? system (Istok-Sistema, Fryazino; 24-h continuous glucose monitoring utilized CGMS MMT-7310 (Medtronic Minimed, USA with subsequent night-time analysis. Results. As compared to stable night-time glycemia controls (SD 2.0 mmol/L showed longer period of esophageal acidification (17% [2?58]; p
textabstractType 1 diabetes mellitus (DM1) and autoimmune thyroid disease (AITD) are organ specific autoimmune diseases in which the immune system is directed against the ß cells and the thyrocytes respectively. The etio-pathogenesis of organ-specific or endocrine autoimmune diseases is complex,
Meadows, K A; Abrams, C; Sandbaek, A
AIMS: To adapt the Diabetes Health Profile (DHP-1) for use with English speaking patients with Type 2 diabetes mellitus and to evaluate the psychometric properties of the adapted measure in a UK and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. METHODS: Following...... items (56.25%) were retained following initial item analysis. A three-factor solution accounting for 45.6% and 40.3% of the total explained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activity (BA...
SAKA, Tolga; YILDIZ, Yavuz; DENİZ, Ferhat
Aims: The aim of this study was to evaluate postural stability and functional capacity in recreational athletes with type 1 diabetes mellitus (T1 DM) and to compare them with healthy recreational athletes. Materials and Methods: Sixteen recreational athletes with T1 DM (21.4 ± 2.1 years of age, 174.3 ± 7 cm height, 64.5 ± 10.1 kg weight, 10.9 ± 5.3 body fat percentage [BFP]) and 19 healthy recreational athletes (21.9 ± 2.5 years of age, 173.1 ± 5.2 cm height, 66.1 ± 4 kg weight, 14.4 ± 1.5 B...
Tania Moron Saes Braga
purpose of this study was to identify the special needs of children with diabetes mellitus type 1. The participants were 37 family members of students in treatment in an outpatient center at a state of São Paulo medical school. A semi-structured interview was carried, which was audio recorded and transcribed for analysis. The results showed that all participants informed the school informed about their child's condition, however 29,7% reported that inclusion or access to school was difficult, due to the teacher being uninformed about diabetes control, inadequate school lunches, and preconceptions of peers and school supervisor, or the student's embarrassment. Absenteeism occurred among 70,3% of the students, mainly due to doctor appointments. Special needs were identified by 32,4%, including meals, performance in school tasks and the need to better inform school professionals about the condition. Furthermore, 72,9% reported some kind of support to cope with diabetes had been provided, mainly by health professionals. In order to improve their child's development at school 51,3% presented suggestions such as including appropriate school meals, better preparation of school for dealing with diabetes, i.e. lectures and training for teachers. Our suggestion is that there should be a closer relationship between the school and health services, but the first step towards intersector integration is to identify the needs of students with chronic diseases, such as this study showed, by focusing on diabetes mellitus and its impact on the school.
Hoekstra, J. B.; de Koning, E. J.
In three patients with an unusual presentation of diabetes mellitus, the classification of their diabetes was troublesome. An adolescent male with slightly elevated blood-glucose levels turned out to have excellent glycaemic control on sulphonylurea derivatives only. When he was 40 years of age, his
Chew, Boon How; Vos, Rimke C; Metzendorf, Maria-Inti; Scholten, Rob Jpm; Rutten, Guy Ehm
BACKGROUND: Many adults with type 2 diabetes mellitus (T2DM) experience a psychosocial burden and mental health problems associated with the disease. Diabetes-related distress (DRD) has distinct effects on self-care behaviours and disease control. Improving DRD in adults with T2DM could enhance
Otaigbe, B E; Imafidon, E E
Type 2 diabetes mellitus initially said to be an adult disease is now reported in children and adolescents in the developed countries because of increased incidence of obesity and sedentary habits associated with westernization and lifestyle changes. There is a paucity of reports from Africa. A 9 year old overweight female with a BMI of 28 kg/m(2) and a strong family history of DM in at least two generations presented with polyuria and weight loss. The mother had gestational diabetes and is on oral hypoglycaemics. Fasting blood sugar was 11.9 mmol/l. Urinalysis had +1 of glucose, no ketones. She was managed with diet control and exercise. The patient has remained euglycaemic in the past two months without drugs and is losing weight. Type 2 diabetes mellitus is being reported in an obese Nigerian child with a family history of DM and high socio-economic class. Routine screening of overweight children with a family history of DM is recommended.
Dikanovic, M.; Balen, I.; Jandric, M.; Hozo, I.; Kokic, S.; Titlic, M.; Kadojic, D.
Diabetics have a 3-fold risk for cardiovascular diseases compared with non-diabetics. This study was designed to evaluate cerebral hemodynamic changes related to type 2 diabetes mellitus (DM) with transcranial Doppler ultrasonography (TCD). TCD is a highly sensitive and specific method of quick bedside assessment of cerebrovascular circular circulation hemodynamics. In a prospective study, we compared a group of 100 patients with the diagnosis of type 2 diabetes mellitus (aged 48 to 67 years) and an age-and sex-matched control group of 100 healthy subjects without diabetes mellitus. We measured flow velocities (Vm) and the Gosling pulsatility index (PI) of the middle cerebral artery (MCA).The rate of TCD abnormalities was significantly higher in diabetic patients than in healthy control subjects (55% vs. 11%, P - 5 years, respectively. This study suggests that TCD is a useful marker for the detection of diabetic cerebrovascular changes. The duration and type of diabetes were found to have an impact on the development of pathologic cerebrovascular changes. (author)
Hart, Phil A; Bellin, Melena D; Andersen, Dana K; Bradley, David; Cruz-Monserrate, Zobeida; Forsmark, Christopher E; Goodarzi, Mark O; Habtezion, Aida; Korc, Murray; Kudva, Yogish C; Pandol, Stephen J; Yadav, Dhiraj; Chari, Suresh T
Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps. PMID:28404095
Pedro González Fernández
Full Text Available Los episodios de hipoglucemia severa (HS constituyen un riesgo por ocasionar alteraciones de la función cerebral y del trazado electroencefalográfico (EEG en pacientes con diabetes. El presente estudio tiene como objetivo determinar la frecuencia de alteraciones del EEG después del diagnóstico de diabetes en un grupo de niños y su posible relación con HS, edad, control metabólico y tiempo de evolución de la diabetes. Se estudiaron retrospectivamente 40 niños con edades comprendidas entre 1 y 17 años (media de 12 años con diagnóstico de diabetes mellitus tipo 1 atendidos en el servicio de endocrinología del Hospital Pediátrico Docente "William Soler", en el período comprendido entre abril de 1990 y abril de 1998. Se tomaron los resultados de la hemoglobina glucosilada, así como los episodios referidos de HS. Se realizó EEG al diagnóstico de la diabetes y anualmente. Se clasificaron los EEG anormales de acuerdo con el tipo de trazado. Se encontraron EEG anormales en aproximadamente la mitad de los pacientes (45 % con predominio del trazado con descargas focales, los que fueron significativamente mayor en los pacientes con 2 ó más HS y con una edad menor al diagnóstico de la diabetes. No se encontró relación entre el EEG anormal y el control metabólico ni con el tiempo de evolución de la diabetes. La frecuencia hallada en este estudio enfatiza la importancia de realizar EEG al diagnóstico de DM y posteriormente, sobre todo en aquellos pacientes con HS y edad menor de 6 años.Episodes of severe hypoglycemia (SH constitute a risk because it causes brain function and electroencephalographic recording (EEG disturbances in patients with diabetes. This study was aimed at determining the frequency of EEG alterations after the diagnosis of diabetes in a group of children and their possible relation with SH, age, metabolic control and progression of diabetes. Forty children aged 1 to 17 years (average 12 years diagnosed with type 1
Vanni, Ester; Bugianesi, Elisabetta; Saracco, Giorgio
Chronic hepatitis C is a systemic disease inducing metabolic alterations leading to extrahepatic consequences. In particular, hepatitis C virus (HCV) infection seems to increase the risk of incident type 2 diabetes mellitus in predisposed individuals, independently of liver disease stage. The mechanisms through which hepatitis C induces T2DM involve direct viral effects, insulin resistance, pro-inflammatory cytokines and other immune-mediated processes. Many studies have reported the clinical consequences of type 2 diabetes mellitus on hepatitis C outcome, but very few studies have addressed the issue of microangiopathic complications among patients with hepatitis C only, who develop type 2 diabetes mellitus. Moreover, clinical trials in HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment; recent studies have suggested that this metabolic amelioration might have a clinical impact on type 2 diabetes mellitus-related complications. These observations raise the question as to whether the HCV eradication may also have an impact on the future morbidity and mortality due to type 2 diabetes mellitus. The scope of this review is to summarise the current evidence linking successful antiviral treatment and the prevention of type 2 diabetes mellitus and its complications in hepatitis C-infected patients. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Pizzol,Melissa Manfroi Dal; Esteves,Jorge Freita; Sccoco,Caio Augusto; Roggia,Murilo Felix; Rosa,Carolina Maurente da; Lambert,José Humberto Franco; Canani,Luís Henrique
OBJETIVO: Avaliar a prevalência de catarata e seus fatores de risco em uma população portadora de diabetes mellitus tipo 1 (DM1). MÉTODOS: Estudo de casos e controles de um banco de dados de 181 pacientes (362 olhos) com diagnóstico de diabetes mellitus tipo 1. Os pacientes foram classificados como casos quando apresentavam diagnóstico de catarata. As variáveis estudadas foram a presença ou não de retinopatia diabética, tratamento com panfotocoagulação, presença de hipertensão arterial sistêm...
Full Text Available Lack of insulin results in a catabolic state in subjects with insulin-dependent diabetes mellitus which is reversed by insulin treatment. Amino acid supply, especially branched chain amino acids such as leucine, enhances protein synthesis in both animal and human studies. This small study was undertaken to assess the acute effect of supplemental leucine on protein metabolism in adolescents with type 1 diabetes. L-[1-13C] Leucine was used to assess whole-body protein metabolism in six adolescent females (16–18 yrs with type 1 diabetes during consumption of a basal diet (containing 58 μmoles leucine/kg/h and the basal diet with supplemental leucine (232 μmoles leucine/kg/h. Net leucine balance was significantly higher with supplemental leucine ( μmoles leucine/kg body weight/hr than with the basal diet (, due to reduced protein degradation ( μmoles leucine/kg body weight/hr compared to the basal diet (, .
Gamal Abdulrhman Hassan
Full Text Available An increased incidence of Type 1 diabetes mellitus (T1DM is expected worldwide. Eventually, T1DM is fatal unless treated with insulin. The expansion of interventions to prevent diabetes and the use of alternative treatments to insulin is a dream to be fulfilled. The pathophysiology in T1DM is basically a destruction of beta cells in the pancreas, regardless of which risk factors or causative entities have been present. Individual risk factors can have separate patho-physiological processes to, in turn, cause this beta cell destruction. Currently, autoimmunity is considered the major factor in the pathophysiology of T1DM. In a genetically susceptible individual, viral infection may stimulate the production of antibodies against a viral protein that trigger an autoimmune response against antigenically similar beta cell molecules. Many components of the immune system have been implicated in autoimmunity leading to β-cell destruction, including cytotoxic and helper T-cells, B-cells, macrophages, and dendritic cells. The inflammatory process in early diabetes is thought to be initiated and propagated by the effect of Th1-secreted cytokines (e.g. g interferon and suppressed by Th2-secreted antiinflammatory cytokines (interleukins. Structure and function of β-cell may be modulated by using Th1/Th2-secreted cytokines. Several experimental and clinical trials of applying GAD65, Hsp60, peptide-MHC, pepetide-277 immunization, anti-CD3 infusion, and interleukins to modulate immune response in T1DM were done. Applying such trials in patients with prediabetes, will most likely be the future key in preventing Type 1 autoimmune diabetes.
Type 2 diabetes mellitus (T2DM) develops over many years, providing an opportunity to consider early prognostic tools that guide interventions to thwart disease. Advancements in analytical chemistry enable quantitation of hundreds of metabolites in biofluids and tissues (metabolomics), providing in...
Moon, Joon Ho; Kwak, Soo Heon; Jang, Hak C.
Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes. PMID:28049284
Full Text Available Purpose: To explore how perceptions of self-efficacy, health locus of control and outcome expectancy impact the adherence of adults with type 2 diabetes mellitus in Saudi Arabiato self-care activities. Methods: A descriptive correlation design was used to analyse self-report questionnaires completed by a convenience sample of Arabic-speaking individuals (n = 30 with type 2 diabetes mellitus from King Abdulaziz Medical City in Riyadh. Results: More than half (53% of participants reported high self-efficacy, and the majority (77% valued health and believed that effective diabetes management was important. Although the vast majority (93% of participants believed that their doctor influenced their diabetes management, 90% and 80% also acknowledged themselves and God, respectively, as the health locus of control. Participants who perceived that they or their doctors were in control of their health condition were more likely to adhere to self-care activities, such as follow a specific diet and perform foot care (p < 0.05. Furthermore, female participants reported significantly greater adherence to medication than male participants (6.91 ± 0.29 vs 5.14 ± 2.44; p = 0.02, and unmarried participants reported greater adherence to exercise than married participants (4.15 ± 2.22 vs 1.60 ± 1.43; p = 0.001. Finally, self-efficacy had a significant, positive correlation with participants' adherence to exercise (r = 0.491; p = 0.006 and performing their foot care (r = 0.586; p = 0.001. Conclusion: Patients' perceptions of their health should be considered by healthcare providers to maximize adherence to effective self-care management. Keywords: Health locus of control, Saudi Arabia, Self-care activities, Type 2 diabetes mellitus
Diego Augusto Malucelli
Full Text Available Diabetes mellitus (DM é uma doença crônica causada pela não produção e uso inadequado de insulina. Enfermidade crônico-degenerativa. Complicações crônicas do DM, no sistema auditivo, podem causar atrofia do gânglio espiral, degeneração da bainha de mielina do VIII par craniano, diminuição de fibras nervosas na lâmina espiral ou espessamento das paredes capilares da estria vascular e das pequenas artérias. OBJETIVO: Verificar os limiares auditivos em indivíduos portadores de DM tipo 1. MATERIAL E MÉTODOS: Estudo clínico envolvendo 60 indivíduos, divididos em Grupo Estudo (GE e Grupo Controle (GC, indivíduos diabéticos e não diabéticos. Realizada anamnese, exame físico, otorrinolaringológico e exame audiométrico. RESULTADOS:Quanto aos limiares de audibilidade, no GE, houve diferença estatisticamente significante nas frequências 250, 500, 10.000, 11.200, 12.500, 14.000 e 16.000 Hz em ambas as orelhas e médias das orelhas. Na comparação dos GE e GC, houve diferença estatisticamente significativa com maior probabilidade de ocorrência de hipoacusia em alguma frequência independente da orelha testada no GE. CONCLUSÕES: Houve diferenças estatisticamente significativas nos achados audiológicos no GE quando comparado com GC, justificando avaliação audiológica completa em pacientes diabéticos tipo 1, incluindo audiometria de altas frequências.Diabetes mellitus (DM is a chronic degenerative disease that impairs normal insulin production and use. DM chronic auditory complications may include spiral ganglion atrophy, degeneration of the vestibulocochlear nerve myelin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries. OBJECTIVE: This paper aims to verify the hearing thresholds of individuals with type 1 DM. MATERIALS AND METHODS: Sixty patients were enrolled in this trial and divided into case and control groups featuring
Improvement of the quality of diabetes control and decrease in the concentrations of AGE-products in patients with type 1 and insulin-treated type 2 diabetes mellitus: results from a 10 year-prospective, population-based survey on the quality of diabetes care in Germany (JEVIN).
Schiel, Ralf; Franke, S; Appel, T; Voigt, U; Ross, I S; Kientsch-Engel, R; Müller, U A; Stein, G
Advanced glycation end (AGE)-products are a complex group of compounds that have been implicated in diabetes related long-term complications. Up to the present only few data exist about serum levels of the AGE-proteins N-epsilon-Carboxymethyllysine (CML) and pentosidine in patients with diabetes mellitus. In the present 10-year, population-based trial of a selection-free cohort of patients with insulin-treated diabetes mellitus, serum CML and pentosidine levels were examined in correlation to the patients' quality of diabetes control and the prevalence of diabetes related long-term complications. Following the reunification of Germany in 1989 the health care system was decentralised. Up to 1994/95 the relative HbA1c (HbA1c/mean normal) of patients with type 1 diabetes increased (1.65 +/- 0.35 versus 1.52 +/- 0.31, p = 0.002). For patients with type 2 diabetes it remained constant (1.75 +/- 0.4 versus 1.78 +/- 0.31, p = 0.669). During the following period (from 1994/95 to 1999/2000) specialised diabetes care, structured treatment and teaching programmes (TTP), intensified insulin therapy and blood glucose self-monitoring for all patients were broadly implemented. This was accompanied by a substantial improvement in the relative HbA1c of both, patients with type 1 (1.48 +/- 0.3, pproduct CML in the sera of patients with type 1 and insulin-treated type 2 diabetes decreased (type 1: 1994/95: 1158.1 +/- 410.0 ng/ml versus 1999/2000: 938.5 +/- 422.4 ng/ml, pimprovement in patients' quality of diabetes control but also a decrease in the concentration of AGE-products. In patients with diabetes mellitus the AGE-products seem to be mainly influenced by the quality of diabetes control. The decline in renal function leads to increased serum pentosidine levels in patients with insulin-treated diabetes mellitus. Thus it seems that in patients with reduced renal function, higher levels may either play a causal role in the development and progression of nephropathy or they are an
Full Text Available Background: The onset of Type 2 diabetes has been associated with low grade systemic inflammation. The inflammatory status has been studied by measuring acute phase reactant proteins like hsCRP, α1- antitrypsin, α1-acid glycoprotein, ceruloplasmin, fibrinogen. Most of these acute phase reactants form α1 and α2 bands on electropherogram of serum proteins. The aim of this study was to evaluate inflammatory status in controlled and uncontrolled type 2 diabetes using cellulose acetate electrophoresis and to find the impact of glycemic status as indicated by HbA1c on inflammation process. Materials and Methods: Serum protein electrophoresis was done on serum samples of 60 cases of Diabetes [controlled and uncontrolled] using cellulose acetate paper technique. The electropherogram obtained was stained with Ponseu S and then quantitated using densitometer. Glycemic status was studied by HbA1c analysis. The density of α1and α2 bands in electropherogram were correlated with HbA1c level. Result: A significant increase in the percentage of α1 and α2 band proteins (0.765 and 0.716, p<0.001 were found with the increasing level of HbA1c. With cutoff of HbA1c 7% (American Diabetic Association recommended, the α1 and α2 serum proteins concentration are significantly higher (p<0.001 in uncontrolled diabetes mellitus compared to controlled diabetes mellitus Conclusion: Cellulose acetate electrophoresis of serum proteins show early phase acute inflammatory status in uncontrolled type 2 diabetes mellitus. The process of systemic inflammation worsens with uncontrolled glycemia as indicated by HbA1c. Inflammatory status should be studied adjunct to glycemic status. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6024 JPN 2012; 2(3: 211-214
Hart, HE; Bilo, HJG; Redekop, WK; Stolk, RP; Meyboom-de Jong, B
The objective of this study was to assess health related quality of life (QOL) in patients with type I diabetes mellitus (DMT1) and to compare their QOL with the QOL of persons of comparable age in the general population. Furthermore we wanted to investigate which factors mostly influence QOL. In a
Full Text Available AIM: To investigate the correlation between systemic complications and diabetic retinopathy in the patients with type 2 diabetes mellitus.METHODS: Seven hundred and two hospitalized patients with type 2 diabetes were included. All patients were divided into two groups according to with or without retinopathy: NDR group and DR group. DR group was divided into group non-proliferative diabetic retinopathy(NPDRand group proliferative diabetic retinopathy(PDR. The relation between DR and other complications of diabetes, including diabetic macrovascular complications, diabetic nephropathy(DN, diabetic peripheral neuropathy(DPN, peripheral vascular disease of diabetes mellitus(PVD, diabetic foot(DF, diabetic ketoacidosis(DKA, was analyzed.RESULTS: The development of DR was related to hypertension, hyperlipemia, carotid atherosclerosis and plaque, lower extremity arteriosclerosis and plaque, DN, DPN, DF and PVD. PDR was closely associated with hypertension and DPN. CONCLUSION: The prevalence of DR increased in the diabetic patients with systemic complications, especially, the increase of prevalence of PDR in the patients with hypertension and DPN. Vascular endothelial injury and microcirculatory disturbance are the common pathologic base for DR and other complications. Therefore, it is important to carry out the regular fundus examination in the diabetic patients, especially in those with systemic complication, in order to decrease the rate of blindness.
Chen, Siting; Zuo, Xuyang; Li, Yuan; Jiang, Tian; Zhang, Nan; Dai, Fang; Chen, Qiaoer; Zhang, Qiu
The aim of the present research was to study the ghrelin level, executive function and their possible association in patients with type 2 diabetes mellitus. A total of 370 people were recruited between March 2015 and March 2016 in this study. Among them, 212 participants were patients with type 2 diabetes mellitus and 158 participants were included as the control group. Their blood sample was analyzed for the level of ghrelin and other clinical indexes. Cognitive function was measured by the Montreal Cognitive Assessment, and executive function was evaluated by the Wisconsin Card Sorting Test. In the type 2 diabetes mellitus group, age, years of education, duration of diabetes, fasting blood glucose, glycated hemoglobin, hypertension and waist-to-hip ratio were correlated with total Montreal Cognitive Assessment scores. No association was found between ghrelin level and total Montreal Cognitive Assessment score in patients with type 2 diabetes mellitus. However, ghrelin was found to be a significant predictor for executive function impairment measured by the Wisconsin Card Sorting Test in patients with type 2 diabetes mellitus. The level of serum ghrelin might be a biomarker of executive function and become a strong predictor of executive function impairment in patients with type 2 diabetes mellitus. Ghrelin might have a potential protective effect against cognitive function impairment in type 2 diabetes patients. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
Erkolahti, Ritva; Ilonen, Tuula
A total of 69 adolescents, 21 with diabetes mellitus type-1 (DM), 24 with rheumatoid arthritis (RA), and 24 controls matched for sex, age, social background, and living environment, were compared by means of their school grades and the Offer Self-Image Questionnaire. The ages of the children at the time of the diagnosis of the disease and its…
Background: The prevalence of Type 2 diabetes mellitus (T2 DM) in children and ... had none of the risk factors while 272(30.9%) had at least one risk factor. Using the American Diabetes Association criteria for identification of those at risk for ...
Keles, Nursen; Dogan, Burcu; Kalcik, Macit; Caliskan, Mustafa; Keles, Necibe Nur; Aksu, Feyza; Bulut, Mustafa; Kostek, Osman; Isbilen, Banu; Yilmaz, Yusuf; Oguz, Aytekin
Klotho deficiency is associated with several metabolic disorders. Two dimensional (2D) longitudinal strain (LS) of left ventricle (LV), carotid artery intima-media thickness (CIMT), flow-mediated dilation (FMD) of brachial artery and epicardial fat thickness (EFT) have been reported to be early predictors of atherosclerosis. We aimed to investigate the relationship between serum Klotho levels and these early predictors of atherosclerosis in patients with type 1 diabetes mellitus (DM). The study included 45 type 1 diabetic patients and 35 controls. Serum Klotho levels were determined by ELISA method. The patient group was also divided into two subgroups according to serum Klotho levels: high (HK) and low Klotho (LK) groups. EFT, CIMT and FMD were measured according to appropriate recommendations. Speckle tracking analysis was performed using the Echopac software. The patient group had significantly lower serum Klotho (p=0.001), FMD (p1) and LS of LV (p1) values, but larger EFT (p1) and CIMT (p1) values than controls. LK subgroup had also significantly lower FMD (p1) and LS of LV (p1) but larger EFT (p=0.002) and CIMT (p1) values than HK subgroup. Serum Klotho may have a protective effect against atherosclerosis and endothelial dysfunction in type 1 DM. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Mycobacterium avium subspecies paratuberculosis (MAP is a versatile pathogen with a broad host range. Its association with type-1 diabetes mellitus (T1DM has been recently proposed. Rapid identification of infectious agents such as MAP in diabetic patients at the level of clinics might be helpful in deciphering the role of chronic bacterial infection in the development of autoimmune diseases such as T1DM.We describe use of an ELISA method to identify live circulating MAP through the detection of a cell envelope protein, MptD by a specific M13 phage--fMptD. We also used another ELISA format to detect immune response to MptD peptide. Both the methods were tested with blood plasma obtained from T1DM, type-2 diabetes (T2DM patients and non-diabetic controls. Our results demonstrate MptD and fMptD ELISA assays to be accurate and sensitive to detect MAP bacilli in a large fraction (47.3% of T1DM patients as compared to non-diabetic controls (12.6% and those with confirmed T2DM (7.7%. Comparative analysis of ELISA assays performed here with 3 other MAP antigen preparations, namely HbHA, Gsd and whole cell MAP lysates confirmed comparable sensitivity of the MptD peptide and the fMptD based ELISA assays. Moreover, we were successful in demonstrating positive bacterial culture in two of the clinical specimen derived from T1DM patients.The MptD peptide/fMptD based ELISA or similar tests could be suggested as rapid and specific field level diagnostic tests for the identification of MAP in diabetic patients and for finding the explanations towards the occurrence of type-1 or type-2 diabetes in the light of an active infectious trigger.
Carranza-Leon, B Gisella; Puzziferri, Nancy; Adams-Huet, Beverley; Jabbour, Ibrahim; Lingvay, Ildiko
To evaluate the long-term remission rates of type 2 diabetes mellitus and associated comorbidities after gastric bypass surgery in a complete cohort, in a real-life clinic setting. A retrospective study of all consecutive patients with type 2 diabetes mellitus who underwent gastric bypass at a Veterans Affairs Medical Center from 2003 to 2010. The main outcome was remission of type 2 diabetes mellitus defined as HbA1c diabetic medication usage. Secondary outcomes were remission of hypertension and hyperlipidemia, weight loss, and long-term complications four years post-gastric bypass. Eighty-four patients with type 2 diabetes mellitus underwent gastric bypass. Four-year follow-up data were available for 92% (77/84) of patients. The patients (73% male; mean age 54 years) had a mean body mass index of 49 kg/m 2 ± 8.3. Hypertension and hyperlipidemia prevalence were 92% and 85%, respectively. The mean total body weight decrease over four years was 35 kg ± 21. Remission of type 2 diabetes mellitus occurred in 15% at 6 months and 49% four years after surgery. Diabetes remission was more likely (OR 3.2; 95% confidence interval 1.2-9.7) in patients not using insulin at baseline. Remission rates were 12% (9/74) for hypertension and 16% (11/68) for hyperlipidemia. Long-term surgical complications included reoperation (11%), incisional hernia (10%) and anastomotic ulcer (10%). Forty-four percent of patients had one or more nutritional complications. The metabolic effects of gastric bypass are significant and durable for at least four years, even in a predominantly male cohort and real-life clinical setting. Published by Elsevier B.V.
So Young Park
Full Text Available BackgroundDespite the established benefits of diabetes camps for the continuing education of children with type 1 diabetes mellitus, little is known about the long-term metabolic benefits of diabetes camps for middle-aged and elderly people with type 2 diabetes mellitus (T2DM, especially in terms of glycosylated hemoglobin (HbA1c variability.MethodsThe 1-year mean and variability of HbA1c before and after the diabetes camp was compared between the participants of the diabetes camp (n=57; median age 65 years [range, 50 to 86 years]; median diabetes duration 14 years [range, 1 to 48 years]. Additional case-control analysis compared the metabolic outcomes of the participants of the diabetes camp and their propensity score-matched controls who underwent conventional diabetes education (n=93.ResultsThe levels of HbA1c during the first year after the diabetes camp were comparable to those of the matched controls (P=0.341. In an analysis of all participants of the diabetes camp, the 1-year mean±standard deviation (SD of HbA1c decreased (P=0.010 and P=0.041 after the diabetes camp, whereas the adjusted SD and coefficient of variance (CV of HbA1c did not decrease. The adjusted SD and CV significantly decreased after the diabetes camp in participants whose 1-year mean HbA1c was ≥6.5% before the diabetes camp (n=40 and those with a duration of diabetes less than 15 years (n=32.ConclusionThe 1-year mean and SD of HbA1c decreased after the diabetes camp, with significant reduction in the adjusted SD and CV in those with higher baseline HbA1c and a shorter duration of diabetes.
Pérez-Navarro, Lucia Monserrat; Fuentes-Domínguez, Francisco Javier; Zenteno-Cuevas, Roberto
To determine the factors associated with the presence of pulmonary tuberculosis in patients with type 2 diabetes mellitus and the effect in the development of drug and multi-drug resistance, in a population with tuberculosis from the southeast of Mexico. This is a case-control study including 409 individuals, 146 with the binomial tuberculosis-type 2 diabetes mellitus and 263 individuals with tuberculosis. Demographic, epidemiological and outcome variables were collected. Risks were calculated. The factors associated with the presence of type 2 diabetes mellitus were age ≥35years, (OR=9.7; CI: 5.2-17.8), previous contact with a person infected with tuberculosis (OR=1.7; CI: 1.1-3.1). Body mass index ≥25 kg/m(2) (OR=2.2; CI: 1.1-4.3), and inherited family history of diabetes (OR=5.4; CI: 3.2-9.2). It was also found that patients with tuberculosis-type 2 diabetes mellitus presented a 4.7-fold (CI: 1.4-11.3) and 3.5-fold (CI: 1.1-11.1) higher risk of developing drug- and multidrug resistance tuberculosis, respectively. By last, individuals with tuberculosis-type 2 diabetes had a 2.3-fold (CI: 1.5-4.1) greater chance of persisting as tuberculosis-positive by the second month of treatment, delaying the resolution of the tuberculosis infection. Type 2 diabetes exerts a strong influence on the presentation and evolution of tuberculosis within the analyzed population and displays remarkable particularities, necessitating the development of dedicated tuberculosis-diabetes surveillance systems that consider the particular epidemiological characteristics of the population affected. Copyright © 2015 Elsevier Inc. All rights reserved.
Conclusion: Autoimmune destruction of pancreatic β-cells is an important cause of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years. These patients usually have a low insulin reserve and severe ketoacidosis upon diagnosis. A high index of suspicion in the presence of classic symptoms of diabetes in young children is important to prevent complications.
Full Text Available Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin for the treatment of type 2 diabetes mellitus in Asian population.Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used.Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian. It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid compared to the effects observed in studies with Caucasian population, with comparable safety profile.Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12Key words: exenatide, incretin, liraglutide, sitagliptin, type-2 diabetes, vildagliptin
Mahmud, Farid H; Murray, Joseph A; Kudva, Yogish C; Zinsmeister, Alan R; Dierkhising, Ross A; Lahr, Brian D; Dyck, Peter J; Kyle, Robert A; El-Youssef, Mounif; Burgart, Lawrence J; Van Dyke, Carol T; Brogan, Deanna L; Melton, L Joseph
To estimate the prevalence of cellac disease (CD) in pediatric and adult type 1 diabetes melitus in a defined population and to describe clinical features and HLA class II genotypes predictive of CD in screened patients with type 1 diabetes. All residents of Olmsted County, Minnesota, with type 1 diabetes mellitus on the prevalence date January 1, 2001, were identified with the use of an established medical records linkage system (Rochester Epidemiology Project) and defined clinical criteria. Consenting patients underwent serologic screening with endomyslal antibody and tissue transglutaminase antibody testing and Intestinal biopsies to confirm the diagnosis of CD. A subset of screened patients also underwent HLA class II genotyping. Quality-of-life screening (Medical Outcomes Study 36-Item Short-Form Health Survey) was completed in a subset of patients at the time of serologic screening. Overall, 392 Olmsted County residents with type 1 diabetes on January 1, 2001, were Identified. A total of 158 patients with type 1 diabetes were tested, representing 40% (158/392) of the enumerated diabetic population, and 11 had biopsy-proven CD for an estimated point prevalence of 7.0% (95% confidence Interval, 3.5%-12.1%). Most CD-positive diabetic patients were asymptomatic and expressed an at-risk CD haplotype with at least one of but not both HLA DQ2 or DQ8. Celiac disease Is not rare In North American patients with type 1 diabetes, and most CD-positive diabetic patients are asymptomatic Irrespective of age at screening.
Ahmed, K.; Muhammad, Z.; Qayum, I.
Diabetes mellitus (DM) is a clinical syndrome characterized by hyperglycaemia due to absolute or relative insulin deficiency. The aim of this study was to evaluate the frequency of skin manifestations in patients with diabetes mellitus of this area. This descriptive study was conducted in medical out patient door of District Headquarter Hospital Battgram from January 2008 to July 2008. A total of 350 diabetic (types 1 and 2) patients over 15 years of age attending the medical OPD of DHQ Hospital were examined in detail for skin manifestations of the disease. Three hundred and fifty diabetic (type-1 and type-2) patients (193 females and 157 males) enrolled in this study. Mean age of the patients was 54+-8.53 years. Duration of diabetes was between 1-12 years; 320 patients had type-2 and 30 patients had type-1 diabetes mellitus. Patients with uncontrolled disease were 327 and 23 patients showed adequate glycaemic control. Seventy-six percent of patients had cutaneous manifestations. The skin manifestations observed were: skin infections 30.9%, foot gangrene and ulcers 12.9%, pruritus 7.1%, vitiligo 5.7%, yellow skin 4.2%, diabetic dermopathy 4.2%, skin tags 3.7%, acanthosis nigricans 2.9%, eruptive xanthomas 2.6%, necrobiosis lipoidica diabeticorum 1.4%, diabetic bullae 0.6%, and pigmented purpuras in 0.3% patients. Cutaneous manifestations were quite Common in the diabetics of this area. (author)
Kamata, Yuji; Takano, Koji; Kishihara, Eriko; Watanabe, Michiko; Ichikawa, Raishi; Shichiri, Masayoshi
Patients with type 1 diabetes often develop diabetic ketoacidosis (DKA). Reportedly, DKA in type 2 diabetes has higher mortality despite its limited occurrence. The exact clinical characteristics and therapeutic modalities yielding successful outcomes in DKA type 2 diabetes remain unknown. This retrospective study compared the clinical features and detailed treatment of consecutive type 1 and type 2 diabetes patients hospitalized with DKA between January 2001 and December 2014. We report on 127 patients with type 1 and 74 patients with type 2 diabetes whose DKA was successfully treated. The most frequent precipitating cause for DKA was infectious disease for patients with type 1 diabetes and consumption of sugar-containing beverages for those with type 2 diabetes. Type 2 diabetes patients showed higher mean plasma glucose levels than those with type 1 diabetes (48.4±21.6, vs. 37.1±16.4mmol/l, P1) and higher serum creatinine, blood urea nitrogen, and hemoglobin levels, which normalized after DKA resolution. Compared with type 1 diabetes patients, those with type 2 diabetes required distinctly higher daily total insulin dosage (35.9±37.0U, vs. 20.2±23.3U, P1), larger replacement fluid volumes (4.17±2.69L, vs. 2.29±1.57L, P1) and greater potassium supplementation (23.9±36.5mEq, vs. 11.2±17.9mEq, P1) to resolve DKA and reduce plasma glucose level to ≤16.7mmol/l. DKA patients with type 2 diabetes required management with a modified treatment protocol to resolve their profound hyperglycemia and dehydration compared with those with type 1 diabetes. Copyright © 2016 Elsevier Inc. All rights reserved.
Bentley-Lewis, Rhonda; Dawson, Deanna L; Wenger, Julia B; Thadhani, Ravi I; Roberts, Drucilla J
We examined placental histomorphometry in gestational diabetes mellitus (GDM) for factors associated with race/ethnicity and subsequent type 2 diabetes mellitus (T2DM). We identified 124 placentas from singleton, full-term live births whose mothers had clinically defined GDM and self-reported race/ethnicity. Clinical and placental diagnoses were abstracted from medical records. Forty-eight white and 76 nonwhite women were followed for 4.1 years (median, range 0.0-8.9 years). White women developed less T2DM (12.5% vs 35.5%; P = .005) but had higher systolic (mean ± SD, 116 ± 13 vs 109 ± 11 mm Hg; P < .001) and diastolic (71 ± 9 vs 68 ± 7 mm Hg; P = .02) blood pressure, more smoking (35.4% vs 10.5%; P = .004), and more chorangiosis (52.1% vs 30.3%; P = .02) than nonwhite women. Although more nonwhite women developed T2DM, more white women had chorangiosis, possibly secondary to the higher percentage of smokers among them. Further study is necessary to elucidate the relationship among chorangiosis, subsequent maternal T2DM, and race.
Bao, Wei; Yeung, Edwina; Tobias, Deirdre K
AIMS/HYPOTHESIS: Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. METHODS: We included 1,695 women who had...... incident GDM between 1991 and 2001, as part of the Diabetes & Women's Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM...... pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. RESULTS: We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m(2) increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI...
Gawron, Wojciech; Pośpiech, Lucyna; Orendorz-Fraczkowska, Krystyna; Noczyńska, Anna
Diabetic neuropathy encompasses various disturbances concerning somatic and autonomic nervous system and has significant impact on prognosis and course of diabetes mellitus. The aim of the work is an evaluation of vestibulo-spinal reflexes in children and young adults suffering from diabetes mellitus type 1. Material--95 children and young adults aged from 6 to 28 years with diabetes mellitus type 1 diagnosed. The control group consisted of 44 otoneurologically healthy subjects aged from 6 to 28 years. After detailed medical history collection and physical ENT examination stato-posturography was performed in each case. Posturographer PE 62 Model 04 was applied in the studies. Static posturography as well as dynamic one (one leg standing test) was performed in each case. 6 patients belonging to diabetic group complained about vertigo or dizziness. There were worse stabilograms parameters in diabetic group in comparison to control one, statistically significant in younger children. There were better stabilogram parameters in diabetic patients with longer history of the disease. The parameters analysed were significantly worse in the subgroup with not compensated diabetes. The parameters were slightly better in relation to the presence of hypoglycaemic incidents. No apparent differences in stabilograms parameters were present in relation to the presence of diabetic complications. Diabetes mellitus type 1 with slight or without complications does not have significant influence on vestibulo-spinal reflexes and posture stability of the patients. Balance organ disturbances in diabetes mellitus type 1 in children and young adults despite their presence have subclinical course. Perhaps one should consider monitoring of those disturbances in the course of the disease.
Ito, Wulf D; Lund, Natalie; Sager, Hendrik; Becker, Wiebke; Wenzel, Ulrich
Diabetes mellitus type II and arterial hypertension are major risk factors for peripheral arterial disease and have been considered to reduce collateral growth (arteriogenesis). Collateral growth proceeds through different stages. Vascular proliferation and macrophage accumulation are hallmarks of early collateral growth. We here compare the impact of arterial hypertension and diabetes mellitus type II on collateral proliferation (Brdu incorporation) and macrophage accumulation (ED 2 staining) as well as collateral vessel function (collateral conductance) in a rat model of peripheral vascular disease (femoral artery occlusion), diabetes mellitus type II (Zucker fatty diabetic rats and Zucker lean rat controls) and arterial hypertension (induced via clip placement around the right renal arteriy). We furthermore tested the impact of monocyte chemoattractant protein-1 (MCP‑1) on collateral proliferation and macrophage accumulation in these models Diabetic animals showed reduced vascular proliferation and macrophage accumulation, which however did not translate into a change of collateral conductance. Hypertensive animals on the contrary had reduced collateral conductances without altered macrophage accumulation and only a marginal reduction in collateral proliferation. Infusion of MCP‑1 only enhanced vascular proliferation in diabetic animals. These findings illustrate that impaired monocyte/macrophage recruitment is responsible for reduced collateral growth under diabetic conditions but not in arterial hypertension suggesting that diabetes mellitus in particular affects early stages of collateral growth whereas hypertension has its impact on later remodeling stages. Successful pro-arteriogenic treatment strategies in a patient population that presents with diabetes mellitus and arterial hypertension need to address different stages of collateral growth and thus different molecular and cellular targets simultaneously.
Full Text Available Superoxide dismutase is an antioxidant enzyme that is involved in defence mechanisms against oxidative stress. Cu/Zn SOD is a variant that is located in exon3/intron3 boundary. The aim of the present study was to investigate whether the Cu/Zn SOD (+35A/C gene polymorphism is associated with the susceptibility to type 2 diabetes mellitus among south Indian population. The study included patients with type 2 diabetes mellitus (n=100 and healthy controls (n=75. DNA was isolated from the blood and genotyping of Cu/Zn SOD gene polymorphism was done by polymerase chain reaction based restriction fragment length polymorphism method. Occurrence of different genotypes and normal (A and mutant (C allele frequencies were determined. The frequency of the three genotypes of the total subjects was as follows: homozygous wild-type A/A (95%, heterozygous genotype A/C (3%, and homozygous mutant C/C (2%. The mutant (C allele and the mutant genotypes (AC/CC were found to be completely absent among the patients with type 2 diabetes mellitus. Absence of mutant genotype (CC shows that the Cu/Zn SOD gene polymorphism may not be associated with the susceptibility to type 2 diabetes mellitus among south Indian population.
Wodrich, David L.
In an analog study, 122 continuing education and preservice teachers rated potential sources of one of two students' classroom problems. One student's behavior, described in a cumulative folder and a videotaped teacher/school psychologist conference, matched the symptoms of epilepsy, the other matched the symptoms of type 1 diabetes mellitus.…
Picconi, Fabiana; Parravano, Mariacristina; Ylli, Dorina; Pasqualetti, Patrizio; Coluzzi, Sara; Giordani, Ilaria; Malandrucco, Ilaria; Lauro, Davide; Scarinci, Fabio; Giorno, Paola; Varano, Monica; Frontoni, Simona
Recent studies have identified neuroretinal abnormalities in persons affected by diabetes mellitus, before the onset of microvascular alterations. However, the role of glycemic variability (GV) on early retinal neurodegeneration is still not clarified. To explore the relationship between glycemic control and neuroretinal characteristics, 37 persons with Type 1 diabetes mellitus (Type 1 DM) divided into two groups with no signs (noRD) and with mild non-proliferative diabetic retinopathy (NPDR) compared to 13 healthy control participants (C) were recruited. All persons underwent an optical coherence tomography with automatic segmentation of all neuroretinal layers. Measurements of mean of nasal (N)/temporal (T)/superior (S)/inferior (I) macular quadrants for individual layer were also calculated. Metabolic control was evaluated by glycated hemoglobin (HbA1c), and indexes of GV were calculated from continuous glucose monitoring. The difference among the three groups in terms of RNFL thickness was significantly dependent on quadrant (F(6;132) = 2.315; p = 0.037). This interaction was due to a specific difference in RNFL-N thickness, where both Type 1 DM groups showed a similar reduction versus C (-3.9 for noDR and -4.9 for NPDR), without any relevant difference between them (-1.0). Inner nuclear layer (INL) was increased in all quadrants in the two Type 1 DM groups compared to C (mean difference = 7.73; 95% CI: 0.32-15.14, p = 0.043; mean difference = 7.74; 95% CI: 0.33-15.15, p = 0.043, respectively). A negative correlation between RNFL-N and low blood glucose index (r = -0.382, p = 0.034) and positive correlation between INL and continuous overall net glycemic action -1, -2, -4 h (r = 0.40, p = 0.025; r = 0.39, p = 0.031; r = 0.41, p = 0.021, respectively) were observed in Type 1 DM patients. The triglycerides were positively and significantly correlated to INL (r = 0.48, p = 0.011), in Type 1 DM subjects. GV and triglycerides
Rønningen, Ida Charlotte
Digital games do not only serve entertainment purposes, but can also benefit as useful tools for learning. Games that have an explicit and carefully thought-out educational intention has appeared as very productive within health care, and have been used more frequently as part of treatment among children with Type 1 Diabetes Mellitus. Insulin-depended diabetes has no known cure at the present time, hence, individuals living with the disease are fully depended on their self-treatment competenc...
van Dijk, Peter R.
Continuous intraperitoneal insulin infusion (CIPII) with an implantable pump is a last-resort treatment option for selected patients with type 1 diabetes mellitus (T1DM). As compared to the most commonly used forms of insulin administration -injections and an externally placed pump- which deliver insulin in the subcutaneous (SC) tissue, CIPII delivers the insulin in the intraperitoneal space. CIPII using an implantable pump is an unique treatment which has been available for more than 30 year...
Hart, Phil A; Bellin, Melena D; Andersen, Dana K; Bradley, David; Cruz-Monserrate, Zobeida; Forsmark, Christopher E; Goodarzi, Mark O; Habtezion, Aida; Korc, Murray; Kudva, Yogish C; Pandol, Stephen J; Yadav, Dhiraj; Chari, Suresh T
Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hussein, Rasha M
Patients with type 2 diabetes mellitus develop many complications including osteopenia, which is associated with high fracture risk. Osteocalcin is a non collagenous protein derived from the osteoblasts. Recently, it was found that osteocalcin enhances the pancreatic beta cell proliferation, insulin secretion and protection against type 2 diabetes. Investigation of the association of serum osteocalcin and other bone turnover markers with blood glucose level and diabetes mellitus duration in type 2 diabetic patients. Twenty diagnosed type 2 diabetic patients together with 20 healthy controls were enrolled in this study. Serum osteocalcin, alkaline phosphatase activity and calcium concentrations were measured by commercial ELISA kits. The results showed that type 2 diabetic patients exhibited a significantly lower serum osteocalcin and calcium (p=0.0001 and 0.002 respectively) and a higher alkaline phosphatase (p=0.008) compared to the controls. Multiple linear regression analysis revealed that serum osteocalcin was inversely associated with fasting blood glucose and Diabetes Mellitus duration (β=- 0.018; p=0.007 and β=- 0.085; p=0.014 respectively) in Type 2 diabetic patients. In addition, alkaline phosphatase was positively associated (β=0.828; p=0.015) while serum calcium was negatively associated (β=- 0.046; p=0.048) with Diabetes Mellitus duration. These results refer to the strong association between diabetes and bone turnover markers and call for monitoring of diabetes-associated osteopenia in type 2 diabetic patients. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Reusch, Jane E B; Bridenstine, Mark; Regensteiner, Judith G
Limitations in physical fitness, a consistent finding in individuals with both type I and type 2 diabetes mellitus, correlate strongly with cardiovascular and all-cause mortality. These limitations may significantly contribute to the persistent excess cardiovascular mortality affecting this group. Exercise impairments in VO2 peak and VO2 kinetics manifest early on in diabetes, even with good glycemic control and in the absence of clinically apparent complications. Subclinical cardiac dysfunction is often present but does not fully explain the observed defect in exercise capacity in persons with diabetes. In part, the cardiac limitations are secondary to decreased perfusion with exercise challenge. This is a reversible defect. Similarly, in the skeletal muscle, impairments in nutritive blood flow correlate with slowed (or inefficient) exercise kinetics and decreased exercise capacity. Several correlations highlight the likelihood of endothelial-specific impairments as mediators of exercise dysfunction in diabetes, including insulin resistance, endothelial dysfunction, decreased myocardial perfusion, slowed tissue hemoglobin oxygen saturation, and impairment in mitochondrial function. Both exercise training and therapies targeted at improving insulin sensitivity and endothelial function improve physical fitness in subjects with type 2 diabetes. Optimization of exercise functions in people with diabetes has implications for diabetes prevention and reductions in mortality risk. Understanding the molecular details of endothelial dysfunction in diabetes may provide specific therapeutic targets for the remediation of this defect. Rat models to test this hypothesis are under study.
Type 1 diabetes mellitus is caused by the autoimmune destruction of pancreatic beta (β) cells, resulting in severe insulin deficiency. Islet transplantation is a β-cell replacement therapeutic option that aims to restore glycemic control in patients with type 1 diabetes. The objective of this study was to determine the clinical effectiveness of islet transplantation in patients with type 1 diabetes, with or without kidney disease. We conducted a systematic review of the literature on islet transplantation for type 1 diabetes, including relevant health technology assessments, systematic reviews, meta-analyses, and observational studies. We used a two-step process: first, we searched for systematic reviews and health technology assessments; second, we searched primary studies to update the chosen health technology assessment. The Assessment of Multiple Systematic Reviews measurement tool was used to examine the methodological quality of the systematic reviews and health technology assessments. We assessed the quality of the body of evidence and the risk of bias according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. Our searched yielded 1,354 citations. One health technology assessment, 11 additional observational studies to update the health technology assessment, one registry report, and four guidelines were included; the observational studies examined islet transplantation alone, islet-after-kidney transplantation, and simultaneous islet-kidney transplantation. In general, low to very low quality of evidence exists for islet transplantation in patients with type 1 diabetes with difficult-to-control blood glucose levels, with or without kidney disease, for these outcomes: health-related quality of life, secondary complications of diabetes, glycemic control, and adverse events. However, high quality of evidence exists for the specific glycemic control outcome of insulin independence compared with
García, Santiago Durán; Sanz, Santiago Durán; Sanz, Alejandro Durán
In this article, we review the results that can be expected after significant weight loss in patients with type