Type 1 Diabetes Mellitus is an Independent Risk Factor for Pulmonary Fibrosis

Objective. Data on microvascular complications in children and adolescents with type 1 diabetes mellitus (T1DM) in Sudan are scarce. This study was aimed at determining the prevalence of diabetic nephropathy (DN) and retinopathy (DR) and their relationship to certain risk factors in children with T1DM attending the Sudan Childhood Diabetes Centre. Design and Methods. A clinic-based cross-sectional study of 100 patients with T1DM aged 10-18 years. Patients with disease duration exceeding 5 years if the onset of diabetes was prepubertal and 2 years if it was postpubertal were included. Relevant sociodemographic, clinical, and biochemical information was obtained. Blood pressure was measured. The patients were screened for DN and DR using urinary microalbumin estimation and fundus photography, respectively. Results. The frequency of microalbuminuria and diabetic retinopathy was 36% and 33%, respectively. Eleven percent had both retinopathy and microalbuminuria. Seven percent of the patients were found to be hypertensive. Patients with diabetic retinopathy had significantly higher HbA1c levels ( p = 0.009 ) and longer diabetes duration ( p = 0.02 ) than patients without retinopathy. Logistic regression showed that high HbA1c (odds ratio (OR) 0.83, confidence interval (CI) 0.68-1.00, p = 0.04 ), but not age, duration, ethnic group, BMI, blood pressure, and presence of nephropathy, was an independent risk factor for retinopathy. Likewise, high blood pressure (OR 6.89, CI 1.17-40.52, p = 0.03 ), but not age, duration, ethnic group, BMI, HbA1c, and presence of retinopathy, was a predictor for nephropathy. Conclusion. High prevalence of incipient DN and early stages of DR were observed in this study. Longer diabetes duration and higher HbA1c were associated with the presence of diabetic retinopathy. High blood pressure was a risk factor for DN. So regular screening for these complications and optimization of glycemic control are needed.

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Faculty Opinions recommendation of Range of risk factor levels: control, mortality, and cardiovascular outcomes in type 1 diabetes mellitus.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727521391.793538499 ◽

2017 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Risk Factor ◽

Type 1 Diabetes Mellitus ◽

Cardiovascular Outcomes

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Melioidosis in a patient with type 1 diabetes mellitus on an insulin pump

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-18-0062 ◽

2018 ◽

Vol 2018 ◽

Author(s):

Melissa Katz ◽

Simon Smith ◽

Luke Conway ◽

Ashim Sinha

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Risk Factor ◽

Type 1 Diabetes Mellitus ◽

Insulin Pump ◽

Psoas Abscess ◽

Blood Cultures ◽

List Type ◽

Northern Australia

Summary Diabetes mellitus is a well-recognised risk factor for melioidosis, the disease caused by Burkholderia pseudomallei, which is endemic in northern Australia and Southeast Asia. We present the initial diagnostic dilemma of a febrile patient from northern Australia with type 1 diabetes mellitus and negative blood cultures. After a 6-week history of fevers and undifferentiated abdominal pain, MRI of her spine revealed a psoas abscess. She underwent drainage of the abscess which cultured B. pseudomallei. She completed 6 weeks of intravenous (IV) ceftazidime and oral trimethoprim/sulphamethoxazole (TMP/SMX) followed by a 12-week course of oral TMP/SMX. We postulate that the likely route of infection was inoculation via her skin, the integrity of which was compromised from her insulin pump insertion sites and an underlying dermatological condition. Learning points: Diabetes mellitus is the strongest risk factor for developing melioidosis. Atypical infections need to be considered in individuals with diabetes mellitus who are febrile, even if blood cultures are negative. There is heterogeneity in the clinical presentation of melioidosis due to variable organ involvement. Consider melioidosis in febrile patients who have travelled to northern Australia, Asia and other endemic areas.

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Young children (12 yr) with type 1 diabetes mellitus have low rate of partial remission: diabetic ketoacidosis is an important risk factor

Pediatric Diabetes ◽

10.1111/j.1399-5448.2008.00376.x ◽

2008 ◽

Vol 9 (3pt1) ◽

pp. 197-201 ◽

Cited By ~ 59

Author(s):

Sasigarn A Bowden ◽

Mary M Duck ◽

Robert P Hoffman

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Risk Factor ◽

Young Children ◽

Type 1 Diabetes Mellitus ◽

Diabetic Ketoacidosis ◽

Partial Remission ◽

Important Risk Factor ◽

Low Rate

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Is Glucose-6-Phosphate Dehydrogenase Deficiency a Risk Factor for Proliferative Diabetic Retinopathy in Male Patients with Type 1 Diabetes Mellitus in Basrah?

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i1.07 ◽

2017 ◽

Vol 05 (01) ◽

pp. 15173-15179

Author(s):

Hussein Ali Nwayyir MD ◽

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Risk Factor ◽

Type 1 Diabetes Mellitus ◽

Proliferative Diabetic Retinopathy ◽

Dehydrogenase Deficiency ◽

Male Patients ◽

Glucose 6 Phosphate Dehydrogenase

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Socioeconomic deprivation and development of diabetic retinopathy in patients with type 1 diabetes mellitus

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001387 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001387

Author(s):

Pablo Alvarez-Ramos ◽

Soledad Jimenez-Carmona ◽

Pedro Alemany-Marquez ◽

Juan Antonio Cordoba-Doña ◽

Manuel Aguilar-Diosdado

Keyword(s):

Diabetes Mellitus ◽

Socioeconomic Status ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Risk Factor ◽

Diabetic Nephropathy ◽

Type 1 Diabetes Mellitus ◽

Smoking Habit ◽

Socioeconomic Level

IntroductionVery little is known about the influence of socioeconomic status on type 1 diabetes mellitus (T1DM) complications. Our aim was to determine whether socioeconomic level is a risk factor for the development of diabetic retinopathy (DR) in patients with T1DM.Research design and methodsA cohort of 150 patients with T1DM were studied prospectively over 9 years. Socioeconomic status was assessed using a neighborhood-level measure based on an index of deprivation. The contribution of other variables such as hypertension, dyslipidemia, diabetic nephropathy and smoking habit was evaluated. Cox proportional hazards models were used to quantify the associations.ResultsThe incidence of DR was 21.6 cases per 1000 patient-years. Multivariable analyses showed that for each percentage point increase in glycated hemoglobin (HbA1c), the risk of developing DR increased by 58% (HR 1.58, 95% CI 1.19 to 2.10).Patients with T1DM onset >18 years of age and resident in areas of lower socioeconomic levels presented with almost triple the risk of developing DR (HR 2.95, 95% CI 1.08 to 8.00) compared with those with onset <18 years of age and resident in less deprived areas. We did not find significant relationships with other variables studied such as hypertension, dyslipidemia, diabetic nephropathy and smoking habit.ConclusionsLow socioeconomic level is a risk factor, independent of glycemic control, in the development of DR in patients with T1DM when the onset of diabetes is in adulthood. This finding indicates that socioeconomic status and age of onset need to be considered in population screening for DR in patients with T1DM.

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