Volume rendered 3D OCTA assessment of macular ischemia in patients with type 1 diabetes and without diabetic retinopathy

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.

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Association of the polymorphous marker G6230A of the CTLA4 gene with type 1 diabetes mellitus in the patients of Russian descent

Problems of Endocrinology ◽

10.14341/probl201258414-17 ◽

2012 ◽

Vol 58 (4) ◽

pp. 14-17

Author(s):

O I Kopylova ◽

T L Kuraeva ◽

E Iu Lavrikova ◽

E V Titovich ◽

A G Nikitin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Healthy Subjects ◽

Molecular Mechanisms ◽

Control Group ◽

Diabetic Patients ◽

Potential Candidate ◽

Ctla4 Gene

The risk of devolvement of type 1 diabetes mellitus (DM1) remains a challenging problem because neither etiology of the disease nor its prognosis and genetic predisposition to this condition are clearly understood. The development of any autoimmune process starts from the disturbance of subtle molecular mechanisms involved in the regulation of the immune system. Therefore, the genes controlling the function of its major components are at the same time the potential candidate genes encoding for the predisposition to DM1. Their association with the disease was studied by means of comparative analysis of the frequency distribution of alleles and genotypes of the polymorphous rs3087243 (G6230A) marker of the CTLA4 gene encoding for antigen-4 of cytotoxic T-lymphocytes. The present study included 257 patients presenting with type 1 diabetes mellitus and 526 healthy subjects. Genotypes were identified by the "real time" amplification technique. The AA genotype was found to occur less frequently in the diabetic patients than in the control group (11.3% and 22.1% respectively). In contrast, the frequency of the GG genotype was higher in the patients with DM1 than in the healthy subjects (44.7% and 37.5% respectively). It is concluded that the polymorphous rs3087243 marker of the CTLA4 gene is significantly associated with the predisposition to the development of type 1 diabetes mellitus in the patients of Russian descent.

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Limited Joint Mobility Progression in Type 1 Diabetes: A 15-Year Follow-Up Study

International Journal of Endocrinology ◽

10.1155/2018/1897058 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Javier Labad ◽

Antoni Rozadilla ◽

Paula Garcia-Sancho ◽

Joan M. Nolla ◽

Eduard Montanya

Keyword(s):

Type 1 Diabetes ◽

Healthy Subjects ◽

Diabetic Patients ◽

Joint Mobility ◽

Limited Joint Mobility ◽

Patients With Diabetes ◽

Type 1 Diabetic Patients ◽

Baseline Examination

Objective. To assess the evolution of joint mobility over a period of 15 years in type 1 diabetic patients and healthy controls and to determine whether microalbuminuria is associated with a different evolution of joint mobility. Methods. Joint mobility of hand and wrist was determined in 63 patients with type 1 diabetes and 63 healthy subjects. Fifteen years later, 37 (58.7%) diabetic patients and 16 (25.4%) healthy subjects were studied again. Joint mobility was assessed with the Prayer sign and by measuring the angle of maximal flexion of the fifth and third metacarpophalangeal (MCP) joints and wrist. Patients with diabetes were visited 2–4 times every year with regular assessment of glycated hemoglobin (HbA1c), urinary albumin excretion (UAE), and ophthalmoscopy. Results. Fifteen years after the initial exam, diabetic patients showed reduced flexion of the fifth MCP joint (82.6 ± 5.8 versus 76.0 ± 6.4 degrees, p<0.001) and wrist (75.9 ± 8.1 versus 73.2 ± 7.4 degrees, p=0.015) compared to baseline examination. Joint mobility did not change significantly in healthy subjects. Patients with microalbuminuria showed greater reduction in hand joint mobility than diabetic patients with normal UAE or than healthy subjects (p<0.001). Conclusions. In type 1 diabetic patients, the severity of LJM progresses with time, and the progression is enhanced in patients with microalbuminuria.

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Day-to-Day Variations in Fasting Plasma Glucose Do Not Influence Gastric Emptying in Subjects With Type 1 Diabetes

10.2337/figshare.13020413 ◽

2020 ◽

Author(s):

Lea Aigner ◽

Björn Becker ◽

Sonja Gerken ◽

Daniel R. Quast ◽

Juris J. Meier ◽

...

Keyword(s):

Type 1 Diabetes ◽

Gastric Emptying ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Healthy Subjects ◽

Diabetic Patients ◽

Cross Sectional ◽

Chronic Hyperglycemia ◽

Fasting Plasma

Objective: Acute experimental variations in glycemia decelerate (hyperglycemia) or accelerate (hypoglycemia) gastric emptying. Whether spontaneous variations in fasting plasma glucose (FPG) have a similar influence on gastric emptying is yet unclear. Research design and methods: Gastric emptying of a mixed meal was prospectively studied three times in 20 patients with type 1 diabetes and 10 healthy subjects with normal glucose tolerance using a 13C-CO2 octanoate breath test with Wagner-Nelson analysis. The velocity of gastric emptying was related to fasting plasma glucose (FPG) measured before the test (grouped as low, intermediate, or high). In addition, gastric emptying data from 255 patients with type 1 diabetes studied for clinical indications were compared by tertiles of baseline FPG. Results: Despite marked variations in FPG (by 4.8 (3.4; 6.2) mmol/l), gastric emptying did not differ between the three prospective examinations in patients with type 1 diabetes (D T1/2 between highest and lowest FPG: 1 [95 % CI: -35; 37] min; p = 0.90). The coefficient of variation for T1/2 determined three times was 21.0 %. Similar results at much lower variations in FPG were found in healthy subjects. In the cross-sectional analysis, gastric emptying did not differ between the tertiles of FPG (D T1/2 between highest and lowest FPG: 7 [95 % CI: - 10; 23] min; p = 0.66), when FPG varied by 7.2 (6.7; 7.8) mmol/l. However, higher HbA1c was significantly related to slower gastric emptying. Conclusions: Day-to-day variations in FPG not induced by therapeutic measures do not influence gastric emptying significantly. These findings are in contrast with those obtained after rapidly clamping plasma glucose in the hyper- or hypoglycemic concentrations range and challenge the clinical importance of short-term glucose fluctuations for gastric emptying in type 1-diabetic patients. Rather, chronic hyperglycemia is associated with slowed gastric emptying.

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Urinary excretion of type IV collagen as an early marker of renal fibrosis in patients with diabetes mellitus

Diabetes Mellitus ◽

10.14341/2072-0351-5813 ◽

2011 ◽

Vol 14 (4) ◽

pp. 29-31 ◽

Cited By ~ 2

Author(s):

Irina Arkad'evna Bondar' ◽

Vadim Valer'evich Klimontov ◽

Ekaterina Mikhailovna Parfent'eva ◽

Vyacheslav Vital'evich Romanov ◽

Alexander Petrovich Nadeev

Keyword(s):

Type 1 Diabetes ◽

Urinary Excretion ◽

Renal Fibrosis ◽

Type Iv Collagen ◽

Diagnostic Value ◽

Control Group ◽

Type Iv ◽

Patients With Diabetes

Aim. To determine the diagnostic value of urinary excretion of type IV collagen in patients with type 1 diabetes with different stages of nephropathy.Methods. Urinary type IV collagen was determined in 60 patients with type 1 diabetes (23 with normal albuminuria, 28 with microalbuminuriaand 9 with macroalbuminuria) by an enzyme immunoassay. 10 healthy individuals were acted as the control group. Renal biopsy was performedin 22 patients. Deposits of type IV collagen were revealed by 11 individuals by immunohistochemistry. Results. The urinary excretion of type IV collagen increased with severety of diabetic nephropathy, correlating with the urinary albumin/creatinineratio, serum creatinine and parameters of daytime and nighttime systolic and diastolic blood pressure. Patients with excessive accumulation of typeIV collagen in the glomeruli had significantly higher level of type IV collagen in the urine. Conclusion. The determination of urinary type IV collagen can be used for early detection of renal fibrosis in patients with type 1 diabetes.

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Cardiac Affection in Type 1 Diabetic Patients in Relation to Omentin

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2015.132 ◽

2015 ◽

Vol 3 (4) ◽

pp. 699-704 ◽

Cited By ~ 3

Author(s):

Soha M. Abd El Dayem ◽

Ahmed A. Battah ◽

Amal El Shehaby

Keyword(s):

Type 1 Diabetes ◽

Regression Analysis ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

Stepwise Multiple Regression ◽

Cardiac Autonomic Neuropathy ◽

Control Group ◽

Diabetic Patients ◽

Stepwise Multiple Regression Analysis

AIM: To evaluate cardiac affection in type 1 diabetes in relation to Omentin.PATIENTS AND METHODS: Sixty two diabetics and 30 volunteer of the same age and sex were included as a control group. Blood sample was taken for assessment of omentin and oxidized low density lipoprotein (OxLDL), glycosylated hemoglobin (HbA1) and lipid profile. Urine sample was taken for assessment of albumin/ creatinine ratio. 24 hour holter was also done. T-test, simple correlation followed by stepwise multiple regression analysis was used for analysis of data.RESULTS: Parameters of 24 hour holter were significantly lower in diabetics. Omentin was significantly lower, while OxLDL were significantly higher than controls. RMSSD, ST deviation and OxLDL were the parameters related to omentin by stepwise multiple regression analysis in diabetics.CONCLUSION: Diabetic patients had a cardiac autonomic neuropathy. A significant reduction of omentin and elevation OxLDL imply that they influence glucose metabolism in type 1 diabetes. Omentin had a significant relation to 24 hr holter which may reflect its role in cardiac affection. Omentin and OxLDL had a role in renal affection.

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Assessment of Serum Concentrations of Adropin, Afamin, and Neudesin in Children with Type 1 Diabetes

BioMed Research International ◽

10.1155/2019/6128410 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Agnieszka Polkowska ◽

Izabela Elżbieta Pasierowska ◽

Marta Pasławska ◽

Elżbieta Pawluczuk ◽

Artur Bossowski

Keyword(s):

Type 1 Diabetes ◽

Glucose Metabolism ◽

Statistical Significance ◽

Serum Levels ◽

Control Group ◽

Diabetic Patients ◽

Serum Concentrations ◽

Novel Biomarkers ◽

Varied Duration

Introduction. The increasing knowledge of adropin, afamin, and neudesin and the regulation of glucose metabolism and insulin resistance allows for the assessment of the differences in their concentrations between the groups with varied duration of diabetes mellitus (DM). Aim of the Study. Assessment of serum levels of adropin, afamin, and neudesin in children with type 1 diabetes, with respect to the disease duration. Materials and Methods. The study consisted of 138 patients aged 5–18 years (M 40.58%). Children with type 1 diabetes (n = 68) were compared to the control group (n = 70). The diabetic group was divided into 4 subgroups: (I) newly diagnosed patients, after an episode of ketoacidosis (n = 14), (II) duration no longer than 5 years (n = 18), (III) 5 to 10 years (n = 27), and (IV) longer than 10 years (n = 9). Serum concentrations of adropin, afamin, and neudesin were assessed and compared between the groups of patients. The criterion for statistical significance was p<0.05. Results. The concentrations of adropin and afamin across all subgroups were lower than that in the control group, while neudesin levels were higher in diabetic patients compared to the control group. The differences were statistically significant. Conclusions. Adropin, afamin, and neudesin may play a major role in the regulation of glucose metabolism and have a significant potential as novel biomarkers to predict future metabolic disorders. However, further multicentre studies on a larger cohort of patients are necessary to specify the role of these substances in the course and treatment of type 1 diabetes.

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Plasma osteoprotegerin levels are associated with glycaemic status, systolic blood pressure, kidney function and cardiovascular morbidity in type 1 diabetic patients

Acta Endocrinologica ◽

10.1530/eje.1.02049 ◽

2006 ◽

Vol 154 (1) ◽

pp. 75-81 ◽

Cited By ~ 103

Author(s):

Lars Melholt Rasmussen ◽

Lise Tarnow ◽

Troels Krarup Hansen ◽

Hans-Henrik Parving ◽

Allan Flyvbjerg

Keyword(s):

Blood Pressure ◽

Type 1 Diabetes ◽

Systolic Blood Pressure ◽

Kidney Function ◽

Vascular Complications ◽

Diabetic Patients ◽

Diabetic Vascular Complications ◽

Patients With Diabetes ◽

Type 1 Diabetic Patients

Objective: The bone-related peptide osteoprotegerin (OPG) has recently been found in increased amounts in the vasculature in diabetes. It is produced by vascular smooth muscle and endothelial cells, and may be implicated in the development of vascular calcifications. OPG is present in the circulation, where increased amounts have been observed in patients with diabetes. In this study, we examined whether plasma OPG is associated with the glycaemic and vascular status of patients with type 1 diabetes. Methods: Two gender-, age- and duration-comparable groups of type 1 diabetic patients either with (n = 199) or without (n = 192) signs of diabetic nephropathy were studied. Plasma OPG was determined by an ELISA. Results: The plasma OPG concentration was significantly higher in patients with nephropathy than those without (3.11 (2.49–3.99) vs 2.57 (2.19–3.21) (median (interquartiles), ng/ml), P < 0.001). Plasma OPG correlated with haemoglobin A1c (HbA1c), systolic blood pressure and age in both groups and, in addition, with kidney function in the nephropathic group. These correlations remained significant in multivariate models. In addition, we found that plasma OPG concentrations were increased among patients with cardiovascular diseases (CVD), both in the normoalbuminuric and the nephropathic groups. The differences between nephropathic and normoalbuminuric, as well as subgroups with and without CVD, could largely be ascribed to changes in HbA1c, age, systolic blood pressure and creatinine. Conclusion: OPG is associated with glycaemic control and CVD in patients with type 1 diabetes, compatible with the hypothesis that OPG is associated with the development of diabetic vascular complications.

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Peculiarities of Physical Activity and Self‑Esteem of Young People with Diabetes Mellitus Type 1 and Healthy Persons Aged 18–25 Years

Baltic Journal of Sport and Health Sciences ◽

10.33607/bjshs.v4i83.305 ◽

2018 ◽

Vol 4 (83) ◽

Author(s):

Sandrija Čapkauskienė ◽

Daiva Vizbaraitė ◽

Deimantė Šeštokaitė

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Healthy Subjects ◽

Self Esteem ◽

Diabetes Mellitus Type 1 ◽

Diabetes Mellitus Type ◽

Diabetic Patients ◽

Patients With Diabetes ◽

Healthy Persons

Research background and hypothesis. Careful diabetes control slows the onset and progression of life-threatening complications, the development of disability and early disability-related unemployment, and prolongs life expectancy (Danytė et al., 2000). The benefits of physical activity on regular basis comprise improved cardiovascular health, increased lean body mass, improved blood lipid profile, enhanced psycho-social wellbeing and decreased obesity (Riddell, Iscoe, 2006). Physical activity is one of the main factors influencing glucose level in diabetic patients’ blood (Wiśniewski, 2010). Analysis of self-esteem of the studied revealed a wide range of findings, from trying to outline the modest achievements, pride, and even unwillingness to discuss it to low self-esteem, feeling of guilt and self-reproach for mistakes and failures (Žemaitis, 1995). The aim of the study was to determine physical activity and self-esteem of healthy subjects and patients with diabetes mellitus type 1 aged 18–25 years.Methods. The study included 140 individuals (aged from 18 to 25 years). Among 41 patients with type 1 diabetes mellitus there were 33 young women and 8 young men, and among 99 healthy persons – 79 young women and 29 young men. All the subjects were asked to fill in the questionnaire orientated to physical activity and self-esteem. The short IPAQ questionnaire was used to research physical activity and Rosenberg’s Self-Esteem Scale was used to assess self esteem.Research results. Approximately 60% of subjects with diabetes mellitus type 1 and about 50% of healthy persons rated their physical activity as moderate. Intensive 60-minute-physical activity was reported by 48.5% of healthy subjects and 34.1% of diabetic patients, moderate 60-minute-physical activity was pointed out by 38.2% of diabetic patients and 35.8% of healthy research participants. The largest walking interval was 1–1.5 hours: in the diabetic group– 28.8%, in the healthy group – 31.65%. Healthy young men and women were physically more active than diabetic patients. Self-esteem in both genders of healthy subjects and diabetic patients was determined as moderate.Discussion and conclusions. Physical activity of women and men with diabetes mellitus type 1 aged 18–25 years was valued as moderate, meanwhile physical activity in healthy persons – moderate or high. Self-esteem is moderate in both groups of patients with diabetes and healthy persons. Healthy men are more active than diabetic patients, similarly, women having diabetes mellitus type 1 are more physically passive than healthy ones. Both patients with diabetes mellitus type 1 and healthy individuals aged 18–25 reported moderate self-esteem.Keywords: diabetes mellitus type 1, physical activity, self-esteem.

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Association of the CCR5 gene with type 1 diabetes mellitus

Problems of Endocrinology ◽

10.14341/probl20135923-6 ◽

2013 ◽

Vol 59 (2) ◽

pp. 3-6

Author(s):

O I Kopylova ◽

T L Kuraeva ◽

E Iu Lavrikova ◽

E V Titovich ◽

A G Nikitin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Healthy Subjects ◽

Significant Rise ◽

Diabetic Patients ◽

Ccr5 Gene ◽

Base Pair Deletion ◽

Time Amplification

Aim of the study. To elucidate the association between the polymorphous marker A/del132 of the CCR5 gene with type 1 diabetes mellitus. Materials and methods. The study included 177 patients with type 1 diabetes mellitus (DM1) and 408 healthy subjects (ethnic Russians). CR5 alleles and genotypes were identified with the use of the real-time amplification technique. Results. It was shown that the CCR5 allele without 32 base pair deletion (allele A) predominated in both diabetic patients and diabetes-free subjects. The difference between their occurrence in the two groups was insignificant. At the same time, we documented a significant rise in the frequency of del132/del132 genotype in the diabetic patients compared with the healthy subjects (p=0.008). It is concluded that carriers of the CCR5-del32/del32 genotype in the Russian population of Moscow are at high risk of developing type 1 diabetes mellitus.

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Influence of diabetes mellitus on corneal thickness

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1410529s ◽

2014 ◽

Vol 142 (9-10) ◽

pp. 529-534 ◽

Cited By ~ 2

Author(s):

Ivan Sencanic ◽

Miroslav Stamenkovic ◽

Vesna Jovanovic ◽

Sinisa Babovic ◽

Vesna Jaksic ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Healthy Subjects ◽

Corneal Thickness ◽

Ultrastructural Changes ◽

Control Group ◽

Diabetic Patients ◽

Ophthalmological Examination ◽

Study Results ◽

Significant Difference

Introduction. Ultrastructural changes in corneas of patients with diabetes mellitus have been previously described. Objective. The aim of this study was to compare central corneal thickness (CDR) values in diabetic patients without retinopathy at the stage of diabetic nonproliferative and proliferative retinopathy and CDR in a control group of healthy subjects. Methods. The study included 121 diabetic patients and 125 healthy subjects matched according to gender and age. Each patient underwent ophthalmological examination involving a dilated fundus examination and CDR measurement using the ultrasound pachymeter. The eyes of diabetic patients were classified according to Early Treatment Diabetic Retinopathy Study into three groups: without diabetic retinopathy (NDR), with nonproliferative diabetic retinopathy (NPDR) and a group with proliferative diabetic retinopathy (PDR). Only one eye of each subject was chosen for the study. Results. The mean CDR value was significantly higher in the diabetic group (570.52?31.81 ?m) compared with the control group (541.42?27.82 ?m). The difference between the two groups was statistically significant (p<0.0001). The highest mean CDR value was recorded in the PDR group (585.97?28.58 ?m), followed by the NPDR group (570.84?30.27 ?m), whereas the lowest mean CDR value was recorded in the NDR group (559.80?31.55 ?m). There was a statistically significant difference in CDR between the NDR and PDR groups, as well as between the NPDR and PDR groups (p<0.001, p<0.05 respectively). No significant difference was recorded between the NDR and NPDR groups (p>0.05). Conclusion. CDR of diabetic patients was higher compared to healthy subjects. The highest mean value of CDR was registered in the PDR group, followed by the NPDR and the NDR groups.

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