Type 1 diabetes mellitus and associated risk factors in patients with or without CHD: a case–control study

2017 ◽  
Vol 27 (9) ◽  
pp. 1670-1677
Author(s):  
Anna Björk ◽  
Ann-Marie Svensson ◽  
Mir Nabi Pirouzi Fard ◽  
Peter Eriksson ◽  
Mikael Dellborg
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Stress Strain ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Co Morbidity ◽  
Associated Risk Factors

AbstractBackgroundApproximately 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.MethodsWe 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.ResultsA 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, p<0.001), longer duration of diabetes (22.4 versus 18.1 years, p<0.001), 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.ConclusionsFrom 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.

scholarly journals Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus: the Danish Cohort of Pediatric Diabetes 1987 (DCPD1987)

Diabetologia ◽  
2014 ◽  
Vol 57 (10) ◽  
pp. 2215-2221 ◽  
Author(s):  
Rebecca Broe ◽  
Malin L. Rasmussen ◽  
Ulrik Frydkjaer-Olsen ◽  
Birthe S. Olsen ◽  
Henrik B. Mortensen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Pediatric Diabetes ◽  
Danish Cohort

scholarly journals Pregnancy and delivery in a patient with a 40-year history of type 1 diabetes mellitus and antiphospholipid syndrome

2018 ◽  
Vol 67 (6) ◽  
pp. 93-99
Author(s):  
Roman V. Kapustin ◽  
Natalia V. Borovik ◽  
Ekaterina V. Musina ◽  
Olga N. Arzhanova ◽  
Maria I. Yarmolinskaya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Antiphospholipid Syndrome ◽  
Perinatal Outcomes ◽  
Increased Risk ◽  
Pregnancy And Delivery ◽  
Perinatal Center ◽  
History Of

Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.

scholarly journals Risk of Urticaria in Children with Type 1 Diabetes Mellitus: A Nationwide Cohort Study

2019 ◽  
Vol 17 (1) ◽  
pp. 176
Author(s):  
Shih-Yi Lin ◽  
Cheng-Li Lin ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
Chung-Y. Hsu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Hazard Ratio ◽  
Control Group ◽  
Case Group ◽  
Research Database ◽  
Increased Risk ◽  
Type 1 Dm

Type 1 diabetes mellitus (T1DM) has been linked to many autoimmune problems. The association between T1DM and urticaria warrants investigation. Data were extracted from the National Health Insurance Research Database (NHIRD) of Taiwan. Participants with T1DM were recruited as the case group, and that group was matched by sex and age at a ratio of 1:4 to the control group comprising those without T1DM. The study period was 1998–2011. All participants were followed up to the diagnosis of urticaria, withdrawal from the insurance program, death, or the end of the study. A multivariable Cox proportional hazard model was used to calculate the adjusted and crude hazard ratios for urticaria. A total of 5895 participants (1179 in the case group and 4716 in the control group) were followed up in the study. The total incidence rate of urticaria in patients with type 1 DM was 26.6 per 1000 person-years, and that in controls was 6.85 per 1000 person-years. Compared with the control group, the hazard ratio of urticaria in the case group was 2.84 (95% CI = 2.27–3.56). Compared with age-matched participants without T1DM, patients with type 1 DM aged <18 years had a 3.62-fold higher risk of urticaria (95% CI = 2.85–4.59). The hazard ratio in patients with an adjusted Diabetes Complications Severity Index (aDCSI) score of 1.01–2.00 per year was 2.57 (95% CI = 1.18–5.57), and that in patients with an aDCSI score of >2.00 per year was 4.47 (95% CI = 2.68–7.47). T1DM patients aged <18 years had an increased risk of urticaria, but a similar phenomenon was not observed among T1DM patients older than 18 years.

Clustering of microvascular complications in Type 1 diabetes mellitus

2018 ◽  
Vol 32 (4) ◽  
pp. 393-399 ◽  
Author(s):  
Lasse Bjerg ◽  
Adam Hulman ◽  
Morten Charles ◽  
Marit Eika Jørgensen ◽  
Daniel Rinse Witte
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications

scholarly journals An exploration of Glo-3A antibody levels in children at increased risk for type 1 diabetes mellitus

2009 ◽  
Vol 10 (8) ◽  
pp. 563-572 ◽  
Author(s):  
M Simpson ◽  
M Mojibian ◽  
K Barriga ◽  
FW Scott ◽  
A Fasano ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Increased Risk ◽  
Antibody Levels

Nocturnal blood pressure is associated with the progression of microvascular complications and hypertension in patients with type 1 diabetes mellitus

2016 ◽  
Vol 30 (7) ◽  
pp. 1326-1332 ◽  
Author(s):  
Isabel Mateo-Gavira ◽  
Francisco J. Vílchez-López ◽  
María V. García-Palacios ◽  
Florentino Carral-San Laureano ◽  
Soledad Jiménez-Carmona ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Nocturnal Blood Pressure

scholarly journals A 20-year prospective follow-up study to evaluate the development of retinopathy and nephropathy after the onset of type 1 diabetes mellitus: Contribution of glycemic control and metabolic memory

2017 ◽  
Vol 89 (10) ◽  
pp. 17-21 ◽  
Author(s):  
L L Bolotskaya ◽  
E G Bessmertnaya ◽  
M V Shestakova ◽  
M Sh Shamkhalova ◽  
L V Nikankina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Metabolic Memory ◽  
Follow Up Study ◽  
Study Results ◽  
The Mean

Aim. To assess the time course of changes in the level of glycated hemoglobin (HbA1c) for 20 years after the onset of type 1 diabetes mellitus (T1DM) and to compare its correlation with the development of microvascular complications, such as diabetic retinopathy (DR) and diabetic nephropathy (DN). Subjects and methods. A total of 187 children with new-onset T1DM were registered in Moscow in 1994. During the 20-year follow-up study, these patients underwent regular check-ups at the Endocrinology Research Center, Ministry of Health of the Russian Federation, which included assessment of physical data, HbA1c 2-4 times a year, biochemical blood and albuminuria tests (once per year), and ophthalmologic examination (twice a year). A total of 155 people fully completed the 20-years follow-up study. Results. During the 20-year follow-up period after the onset of T1DM, 86 of the 155 patients developed microvascular complications: DR and DN in 86 (55.5%) and 24 (15.5%) cases, respectively; while DR concurrent with DN were noted in 20 patients. By the time of their last visit, 69 (44.5%) patients had no evidence suggesting the presence of microvascular complications. The level of HbA1c at the onset of the disease in patients who later developed the complications was higher than in those without complications (10.2±0.6 and 8.5±0.2%, respectively (p = 0.003). The statistically significant differences in HbA1c levels between the groups persisted during subsequent 15 years of follow-up, averaging 9.2±1.5, 9.7±0.9, and 8.1±0.7% after 5, 10, and 15 years, respectively, in the complication group and 7.1±0.3, 8.1±0.4, and 7.2±0.2% in the non-complication group (p < 0.01). Over the last 5 years of the follow-up, the mean HbA1c level between the groups was not significantly different, which at the end of the 20-year follow-up period was 7.8±0.3 and 7.4±0.6%, respectively (p > 0.05). The mean duration of T1DM, in which DR developed, was 9.6±6.2, 11.0±2.0, and 13.6±4.6 years for the non-proliferative, pre-proliferative, and proliferative stages, respectively. That of T1DM, in which DN developed, was 11.8±0.6 years for microalbuminuria and 16.1±1.3 years for macroalbuminuria. Conclusion. The 20-year clinical follow-up of patients who had fallen ill with T1DM in childhood showed that diabetic microangiopathies developed with the long-term preservation of poor blood glucose control (BGC) starting at the onset of the disease. At the same time, the complications progressed to more severe stages, despite a clear trend toward better BGC. This may be suggestive of the negative metabolic memory phenomenon, which necessitates stable BGC, starting at the onset of the disease, for the prevention of microvascular complications.

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