The relationship between glycaemic variability and cardiovascular autonomic dysfunction in patients with type 1 diabetes: A systematic review

Background: Time-in-range is a key glycaemic metric, and comparisons of management technologies for this outcome are critical to guide device selection. Purpose: We conducted a systematic review and network meta-analysis to compare and rank technologies for time in glycaemic ranges. Data sources: We searched All Evidenced Based Medicine Reviews, CINAHL, EMBASE, MEDLINE, MEDLINE In-Process and other non-indexed citations, PROSPERO, PsycINFO, PubMed, and Web of Science until 24 April, 2019. Study selection: We included randomised controlled trials >2 weeks duration comparing technologies for management of type 1 diabetes in adults (>18 years of age), excluding pregnant women. Data extraction: Data were extracted using a predefined template. Outcomes were percent time with sensor glucose levels 3.9–10.0mmol/l (70–180mg/dL), >10.0mmol/L (180mg/dL), and <3.9mmol/L (70mg/dL). Data synthesis: We identified 16,772 publications, of which 14 eligible studies compared eight technologies comprising 1,043 participants. Closed loop systems lead to greater percent time-in-range than any other management strategy and was 17.85 (95% predictive interval [PrI] 7.56–28.14) higher than usual care of multiple daily injections with capillary glucose testing. Closed loop systems ranked best for percent time-in-range or above range utilising surface under the cumulative ranking curve (SUCRA–98.5 and 93.5 respectively). Closed loop systems also ranked highly for time below range (SUCRA–62.2). Limitations: Overall risk of bias ratings were moderate for all outcomes. Certainty of evidence was very low. Conclusions: In the first integrated comparison of multiple management strategies considering time-in-range, we found that the efficacy of closed loop systems appeared better than all other approaches.

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A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

10.2337/figshare.12808301 ◽

2020 ◽

Author(s):

Ananta Addala ◽

Marie Auzanneau ◽

Kellee Miller ◽

Werner Maier ◽

Nicole Foster ◽

...

Keyword(s):

Type 1 Diabetes ◽

Technology Use ◽

Hemoglobin A1c ◽

Diabetes Technology ◽

Design And Methods ◽

Relationship Of ◽

The Relationship ◽

Pediatric Type 1 Diabetes

Objective: As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. Research Design and Methods: Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. Results: HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant. Conclusions: Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry.

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PREDICTION OF OCCURRENCE AND THE RELATIONSHIP OF AUTOIMMUNE DISEASES IN CHILDREN WITH TYPE 1 DIABETES

European Science Review ◽

10.29013/esr-19-5.6-41-43 ◽

2019 ◽

pp. 41-43

Author(s):

A. A. Sadirkhodjaeva ◽

D. T. Ashurova

Keyword(s):

Type 1 Diabetes ◽

Autoimmune Diseases ◽

Relationship Of ◽

The Relationship

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The virome in early life and childhood and development of islet autoimmunity and type 1 diabetes: A systematic review and meta‐analysis of observational studies

Reviews in Medical Virology ◽

10.1002/rmv.2209 ◽

2020 ◽

Author(s):

Clare L. Faulkner ◽

Yi Xuan Luo ◽

Sonia Isaacs ◽

William D. Rawlinson ◽

Maria E. Craig ◽

...

Keyword(s):

Systematic Review ◽

Type 1 Diabetes ◽

Early Life ◽

Observational Studies ◽

Meta Analysis ◽

Islet Autoimmunity

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Prevalence of Metabolic Syndrome in Children and Adolescents with Type 1 Diabetes Mellitus and Possibilities of Prevention and Treatment: A Systematic Review

Nutrients ◽

10.3390/nu13061782 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1782

Author(s):

Monika Grabia ◽

Renata Markiewicz-Żukowska ◽

Katarzyna Socha

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Type 1 Diabetes ◽

Children And Adolescents ◽

Treatment Options ◽

Overweight And Obesity ◽

Excess Body Weight ◽

Healthy Population ◽

Prevention And Treatment

Overweight and obesity are an increasingly common problem, not only among the healthy population, but also in adolescents with type 1 diabetes (T1DM). Excess body weight is related to many cardiometabolic complications as well as a high risk of metabolic syndrome (MetS). The purpose of this systematic review is to provide a concise and critical overview of the prevalence of MetS in children and adolescents with T1DM and, ultimately, to discuss prevention and treatment options. The study was conducted in accordance with PRISMA guidelines. This review shows that, apart from the growing percentage of overweight and obese children and adolescents with T1DM (on average 20.1% and 9.5%, respectively), the problem of the increasing incidence of MetS (range from 3.2 to 29.9%, depending on the criteria used) is one of the most important phenomena of our time. One of the methods of prevention and treatment is a combined approach: changing eating habits and lifestyle, but there are also reports about the beneficial effects of the gut microflora.

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