Emerging Aspects of the Body Composition, Bone Marrow Adipose Tissue and Skeletal Phenotypes in Type 1 Diabetes Mellitus

AbstractThe aim of this study was to assess dietary intake, nutritional status, body composition, and physical activity level in a group of Chilean children and adolescents with Type 1 diabetes mellitus (T1DM), compare these parameters with the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD), and determine the relationships between dietary intake, body composition, and diabetes control.A total of 30 patients with T1DM (aged 15.2±4.0 years) were included. Dietary intake was assessed using a 92-item quantitative food frequency questionnaire. Body composition was determined using dual-energy X-ray densitometry. Physical activity was assessed by means of a survey.The energy intake of these patients was derived from 21.4% protein, 48% carbohydrates, and 31.2% fat. The glycosylated hemoglobin (HbA1c) was significantly correlated with fat as grams per day (r: 0.363, p<0.05) and calories per day (r: 0.364, p<0.05). The mean body fat percentage in females was 31.2% and 20.2% in males (p < 0.01) and the mean amount of physical activity was 4.5±2.7 h per week.The study patients had a higher protein intake than recommended by ISPAD. Dietary carbohydrate intake was rather low, and dietary fat intake was the same as the limits recommended by ISPAD. Diabetic control was significantly correlated with protein, carbohydrates, fat, and sodium intake. The girls in the study had a higher percentage of body fat than the standard recommendations for their age. The level of physical activity was adequate.

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Heart geometry in climacteric syndrome on the background of type 1 diabetes mellitus

INTERNATIONAL JOURNAL OF ENDOCRINOLOGY ◽

10.22141/2224-0721.17.4.2021.237343 ◽

2021 ◽

Vol 17 (4) ◽

pp. 304-307

Author(s):

O.A. Goncharova

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Left Ventricle ◽

Type 1 Diabetes Mellitus ◽

Postmenopausal Women ◽

Wall Thickness ◽

Estrogen Deficiency ◽

The Body ◽

Perimenopausal Women

Background. The climacteric period in women with type 1 diabetes mellitus (DM1) initiates an additional damaging effect on the existing cardinal pathology associated with DM. The purpose was to establish the features of geometric remodeling of the left ventricle (LV) of the heart in women with DM1 during the climacteric period. Materials and methods. The study involved 60 women with type 1 diabetes at the age of 48.74 ± 0.65 years, including 41 perimenopausal and 19 postmenopausal ones. The control group consisted of 20 women without diabetes mellitus at the age of 50.02 ± 0.71 years. According to echocardiography, taking into account the stage of menopause, the indicators of the end-diastolic volume (EDV) and size (EDS), the posterior wall thickness of the LV (LVPWT) and the interventricular septum (IVST) were analyzed. The frequency of various types of geometric remodeling of the left ventricle of the heart was analyzed using the Penn Convention formula; for this, the LV myocardial mass index (LVMI) was calculated according to the formulas LVMI = 1.04 [(EDS + LVPWT + IVST)3 – EDS3] – 13.6 (LVMI = ratio LVMI to the plane of the body surface (A) in m2; AM2 = 1 + Weight + Δh / 100, where Δh is the difference between the height of a woman and 160 cm) and the relative wall thickness of the LV (LVRWT) LVRWT = 2LVPWT / EDS. Based on these data, the frequency of various types of geometric remodeling was established: normal geometry, concentric remodeling, concentric or eccentric LV hypertrophy. Results. The data obtained indicate that postmenopausal women present a significant decrease in the frequency of normal heart geometry compared to perimenopausal women (26.4 versus 75.6 %, p < 0.001) and the frequency of concentric LV remodeling 3.5 times increases (26.3 versus 7.3 %, respectively). Concentric hypertrophy and eccentric LV hypertrophy prevailed 2.5 times in postmenopausal women (31.6 versus 12.1 % and 12.7 versus 4.9 %). Conclusions. In perimenopausal women with type 1 diabetes mellitus, in almost a quarter of cases, geometric remodeling of the left ventricle of the heart takes place. In postmenopausal women with estrogen deficiency, the frequency of pathological forms of heart geometry exceeds 75 %. The strategy of therapy for cardiac pathology in menopausal women against the background of DM1 should take into account the pathogenetic mechanisms of pathology associated with impaired carbohydrate metabolism and atherogenic measurements against the background of estrogen deficiency as well as limit polypharmacy.

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Control of Blood Glucose Level for Type 1 Diabetes Mellitus using Improved Hovorka Equations: Comparison between Clinical and In-Silico Works

10.1101/2020.10.09.332809 ◽

2020 ◽

Author(s):

Nur’Amanina Mohd Sohadi ◽

Ayub Md Som ◽

Noor Shafina Mohd Nor ◽

Nur Farhana Mohd Yusof ◽

Sherif Abdulbari Ali ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Blood Glucose ◽

Blood Glucose Level ◽

Type 1 Diabetes Mellitus ◽

Glucose Level ◽

In Silico ◽

Artificial Pancreas ◽

The Body

AbstractBackgroundType 1 diabetes mellitus (T1DM) occurs due to inability of the body to produce sufficient amount of insulin to regulate blood glucose level (BGL) at normoglycemic range between 4.0 to 7.0 mmol/L. Thus, T1DM patients require to do self-monitoring blood glucose (SMBG) via finger pricks and depend on exogenous insulin injection to maintain their BGL which is very painful and exasperating. Ongoing works on artificial pancreas device nowadays focus primarily on a computer algorithm which is programmed into the controller device. This study aims to simulate so-called improved equations from the Hovorka model using actual patients’ data through in-silico works and compare its findings with the clinical works.MethodsThe study mainly focuses on computer simulation in MATLAB using improved Hovorka equations in order to control the BGL in T1DM. The improved equations can be found in three subsystems namely; glucose, insulin and insulin action subsystems. CHO intakes were varied during breakfast, lunch and dinner times for three consecutive days. Simulated data are compared with the actual patients’ data from the clinical works.ResultsResult revealed that when the patient took 36.0g CHO during breakfast and lunch, the insulin administered was 0.1U/min in order to maintain the blood glucose level (BGL) in the safe range after meal; while during dinner time, 0.083U/min to 0.1 U/min of insulins were administered in order to regulate 45.0g CHO taken during meal. The basal insulin was also injected at 0.066U/min upon waking up time in the early morning. The BGL was able to remain at normal range after each meal during in-silico works compared to clinical works.ConclusionsThis study proved that the improved Hovorka equations via in-silico works can be employed to model the effect of meal disruptions on T1DM patients, as it demonstrated better control as compared to the clinical works.

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