Study of Circulating Apelin in Type 1 Diabetic Patients and its Association with Glycemic Control in a Group of Egyptian Population

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan Mohammed Ali Amer ◽  
Maram Mohammed Maher Mahdy ◽  
Dina Ahmed Marwan Marwan ◽  
Doaa Abd Ellatif Ahmed Taha
Keyword(s):  
Type 1 Diabetes ◽  
Energy Metabolism ◽  
Glycemic Control ◽  
Metabolic Diseases ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Obesity And Diabetes ◽  
Wide Range ◽  
Type 1 Diabetic Patients

Abstract Background Type 1 diabetes mellitus (T1DM) is one of the most common chronic and metabolic diseases worldwide. The incidence of T1DM is reported to be increasing by 3-5% per year, and the number of people with diabetes is estimated to reach 380 million by 2025. Several studies have shown that TIDM is associated with metabolic abnormalities and alteration of adipose tissue hormones (adipokines). Apelin, one of the most abundantly expressed adipocytokine, is a bioactive peptide and produces its effects through a cell surface G protein-coupled receptor called APJ.The apelinergic system, is involved in a wide range of functions including regulation of body fluid homeostasis, cardiovascular system, angiogenesis and energy metabolism . Additionally, apelin participates in pathological processes, including obesity and diabetes. Apelin plays a beneficial role in energy metabolism. Objectives The aim of this study is to evaluate serum Apelin levels in patients with type 1 diabetes and to correlate the serum Apelin level and glycemic control. Patients and Methods This study was a cross sectional study. Participants were classified into two groups. The first group included 60 patient with T1DM recruited from Ain Shams University Endocrinology and Diabetes outpatient clinics in Cairo during the period from June 2019 to January2002 and the second group included 40 healthy controls. Serum apelin (APLN), FBS, 2hrPP, HbA1c, lipid profile and eGDR were measured for each case. Results Comparison between T1DM patients and controls revealed that serum apelin levels, were significantly increased in cases compared to controls. Negative correlations were found between Apelin and HbA1c% in the diabetic group as a marker for glycemic control so apelin may have a promising role as biomarkers in T1DM. Conclusion Our study showed that apelin concentrations were increased in type 1 diabetic patients compared to healthy controls. The potential association of apelin with insulin secretion and action may reveal new pathways in the pathogenesis of type 1 diabetes. Apelin in T1DM patients may be considered as promising adipokines for predicting glycemic control.

Early Neurodegeneration of the Inner Retinal Layers in Type 1 Diabetes Mellitus

2015 ◽  
Vol 235 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Fatih C. Gundogan ◽  
Fahrettin Akay ◽  
Salih Uzun ◽  
Umit Yolcu ◽  
Eylem Çağıltay ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Structural Changes ◽  
Linear Regression Analysis ◽  
Diabetic Patients ◽  
Ganglion Cell Complex ◽  
Healthy Controls ◽  
Retinal Layers ◽  
Rnfl Thickness ◽  
Type 1 Diabetic Patients

Purpose: This study explores retinal structural changes in type 1 diabetes without clinically diagnosed diabetic retinopathy (DR). Methods: Peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, and macular thickness (MT) were measured in 90 type 1 diabetic patients by using spectral domain optical coherence tomography. The values were compared with 100 sex- and age-matched healthy controls. The independent t test was used to assess differences in the mean age, mean diabetic and ocular parameters, and the thickness values between the diabetic and control groups. Multiple linear regression analysis was performed to investigate the correlation between the thickness values and diabetic and ocular parameters. Results: Whole-RNFL, the superior and inferior quadrants, and the superior half of the peripapillary RNFL thicknesses were significantly thinner in diabetic patients compared with controls (p < 0.05). GCC thicknesses in the average macular, outer temporal superior and outer temporal inferior sectors were significantly thinner in diabetic patients (p < 0.05). Central and average MTs were similar in both groups (p > 0.05). There were significant negative correlations of the duration of type 1 diabetes with the inner nasal MT, inner temporal superior GCC thickness, inner nasal inferior GCC thickness, and outer nasal superior GCC thickness (p < 0.05). Similarly, there were significant negative correlations of the level of HbA1c with the whole-RNFL thickness, superior-half-RNFL thickness, and superior-quadrant-RNFL thickness (p < 0.05). Conclusions: Type 1 diabetic patients without clinically diagnosed DR had neurodegeneration in the inner retinal layers compared with healthy controls.

scholarly journals Factors Predicting Glycemic Control in Type 1 Diabetic Patient

2016 ◽  
Vol 3 (1) ◽  
pp. 153-158 ◽  
Author(s):  
Meriem Yazidi ◽  
Mélika Chihaoui ◽  
Fatma Chaker ◽  
Ons Rjeb ◽  
Hédia Slimane
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Diabetes Onset ◽  
One Year ◽  
Type 1 Diabetic Patients

Background: Recent years have been marked by numerous advances in the quality of type 1 diabetes care. However, glycemic control remains suboptimal for many patients with type 1 diabetes. The aim of our study was to identify factors associated with poor glycemic control in type 1 diabetic patients. Methods: We studied in a retrospective manner, 188 type 1 diabetic patients, admitted to our department then followed up for at least one year. Results: There was a negative correlation between age at diabetes onset and HbA1c value (p=0.02). Adolescents had higher HbA1c value than adults (10.8±2.9% vs. 9.2±2.8%, p=0.02). No relationship was found between number of daily insulin injections and mean HbA1c value. Mean HbA1c was higher in patients with poor compliance to insulin therapy (11.1±3.3% vs. 8.9±2.4%, p<0.0001), in those with less than 3 clinic visits per year (10.7±3.5% vs. 9.0±2.1%, p=0.001), in subjects with lipohypertrophy (10.9±2.5% vs. 9.2±3.4%, p=0.008) and those with known celiac disease (14.5±5.2% vs. 9.6±2.9%, p=0.005). Conclusion: Several factors were associated with poor glycemic control in our type 1 diabetic patients. Most of them can be changed in particular by strengthening education strategies.

scholarly journals EVALUATION OF URINARY MICROALBUMIN LEVELS IN TYPE 1 DIABETES MELLITUS PATIENTS IN ASSOCIATION WITH THE GLYCEMIC CONTROL

2020 ◽  
pp. 1-2
Author(s):  
Sara Mohammed ◽  
Faizan I Asrar Nazki ◽  
Mohsin Wazir ◽  
Syyeda Anees
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
P Value ◽  
Diabetic Patients ◽  
Group 3 ◽  
Type 1 Diabetic Patients

Aims: To evaluate the urinary microalbumin levels in Type 1 Diabetes Mellitus in association with the glycemic control. Methodology: 100 subjects were enrolled (50 controls and 50 type 1 diabetic patients) with age and sex matched. 50 Type 1 diabetic patients were grouped into 3 based on their glycemic status. Venous blood and urine is collected for the estimation of the urinary microalbumin, serum creatinine, fasting blood glucose and HbA1c. Results: The present study received significant correlations between MA and HbA1c with their respective controls with p –value < 0.005. The difference of means between Group 2 and Group 3 is statistically significant, and between Group 1 and Group 3 is also statistically significant (p value <0.05). Conclusion: The present study stated that urinary microalbumin was found to be higher in type 1 DM. The raised MA levels are found to be associated with poor glycemic control in Type 1 diabetes mellitus.

The Role of Physical Exercise in Obesity and Diabetes

2018 ◽  
Vol 66 (3) ◽  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Physical Exercise ◽  
Treatment Guidelines ◽  
Treatment Guideline ◽  
Obesity And Diabetes ◽  
Regular Physical Exercise

The prevalence of obesity is increasing world-wide. Obesity is associated with a plethora of metabolic and clinical constraints, which result in a higher risk for the development of cardiovascular complications and metabolic disease, particularly insulin resistance and type 2 diabetes. Obesity is an acknowledged determinant of glycemic control in patients with type 1 diabetes and accounts for the majority of premature death due to cardiovascular events. Physical exercise is generally recommended in patients with diabetes in order to prevent the development of or reduce existing obesity, as adopted by every international treatment guideline so far. Regular physical exercise has a beneficial impact on body composition, cardiovascular integrity, insulin sensitivity and quality of life. However, only a minority of patients participates in regular physical exercise, due to individual or ­disease-related barriers. In type 2 diabetes, there is robust evidence for beneficial effects of physical exercise on glycemic control, cardiovascular health and the development of diabetes-related long-term complications. In type 1 diabetes and patients treated with insulin, a higher risk for exercise-­related hypoglycemia has to be considered, which requires certain prerequisites and adequate adaptions of insulin ­dosing. Current treatment guidelines do only incompletely address the development of exercise-related hypoglycemia. However, every patient with diabetes should participate in regular physical exercise in order to support and enable ­sufficient treatment and optimal glycemic control.

Cardiac responses to insulin-induced hypoglycemia in nondiabetic and intensively treated type 1 diabetic patients

2001 ◽  
Vol 281 (5) ◽  
pp. E1029-E1036 ◽  
Author(s):  
Raymond R. Russell ◽  
Deborah Chyun ◽  
Steven Song ◽  
Robert S. Sherwin ◽  
William V. Tamborlane ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Radionuclide Angiography ◽  
Left Ventricular ◽  
Cardiac Response ◽  
Left Ventricular Ejection ◽  
Diabetic Patients ◽  
Plasma Catecholamine ◽  
Ventricular Ejection Fraction ◽  
Type 1 Diabetic Patients

Insulin-induced hypoglycemia occurs commonly in intensively treated patients with type 1 diabetes, but the cardiovascular consequences of hypoglycemia in these patients are not known. We studied left ventricular systolic [left ventricular ejection fraction (LVEF)] and diastolic [peak filling rate (PFR)] function by equilibrium radionuclide angiography during insulin infusion (12 pmol · kg−1 · min−1) under either hypoglycemic (∼2.8 mmol/l) or euglycemic (∼5 mmol/l) conditions in intensively treated patients with type 1 diabetes and healthy nondiabetic subjects ( n = 9 for each). During hypoglycemic hyperinsulinemia, there were significant increases in LVEF (ΔLVEF = 11 ± 2%) and PFR [ΔPFR = 0.88 ± 0.18 end diastolic volume (EDV)/s] in diabetic subjects as well as in the nondiabetic group (ΔLVEF = 13 ± 2%; ΔPFR = 0.79 ± 0.17 EDV/s). The increases in LVEF and PFR were comparable overall but occurred earlier in the nondiabetic group. A blunted increase in plasma catecholamine, cortisol, and glucagon concentrations occurred in response to hypoglycemia in the diabetic subjects. During euglycemic hyperinsulinemia, LVEF also increased in both the diabetic (ΔLVEF = 7 ± 1%) and nondiabetic (ΔLVEF = 4 ± 2%) groups, but PFR increased only in the diabetic group. In the comparison of the responses to hypoglycemic and euglycemic hyperinsulinemia, only the nondiabetic group had greater augmentation of LVEF, PFR, and cardiac output in the hypoglycemic study ( P < 0.05 for each). Thus intensively treated type 1 diabetic patients demonstrate delayed augmentation of ventricular function during moderate insulin-induced hypoglycemia. Although diabetic subjects have a more pronounced cardiac response to hyperinsulinemia per se than nondiabetic subjects, their response to hypoglycemia is blunted.

scholarly journals Mitochondrial Alterations and Enhanced Human Leukocyte/Endothelial Cell Interactions in Type 1 Diabetes

2020 ◽  
Vol 9 (7) ◽  
pp. 2155
Author(s):  
Francesca Iannantuoni ◽  
Aranzazu M. de Marañon ◽  
Zaida Abad-Jiménez ◽  
Francisco Canet ◽  
Pedro Díaz-Pozo ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Type 1 Diabetes ◽  
Adhesion Molecules ◽  
Mitochondrial Function ◽  
Mitochondrial Membrane ◽  
Diabetic Patients ◽  
Ros Production ◽  
Mitochondrial Ros ◽  
Type 1 Diabetic Patients

Type 1 diabetes has been associated with oxidative stress. This study evaluates the rates of oxidative stress, mitochondrial function, leukocyte–endothelium interactions and adhesion molecules in type 1 diabetic patients. The study population consisted of 52 diabetic patients and 46 body-composition and age-matched controls. We assessed anthropometric and metabolic parameters, oxidative stress and mitochondrial function by evaluating reactive oxygen species (ROS) production, mitochondrial ROS production, mitochondrial membrane potential and superoxide dismutase (SOD) and catalase (CAT) expression in polymorphonuclear leukocytes from type 1 diabetic patients. In addition, we evaluated interactions between leukocytes and human umbilical vein endothelial cells (HUVEC), and serum expression of adhesion molecules (P-selectin, VCAM-1 and ICAM-1), proinflammatory cytokines (IL-6 and TNFα) and myeloperoxidase (MPO). HbA1C and glucose levels were higher in diabetic patients than in control subjects, as expected. Mitochondrial function was altered and leukocyte–endothelium interactions were enhanced in diabetic patients, which was evident in the increase in total and mitochondrial ROS production, higher mitochondrial membrane potential, enhanced leukocyte rolling and adhesion, and decreased rolling velocity. Furthermore, we observed an increase in levels of adhesion molecules P-selectin, VCAM-1, and ICAM-1 in these subjects. In addition, type 1 diabetic patients exhibited an increase in proinflammatory mediators TNFα and MPO, and a decreased expression of SOD. The enhancement of leukocyte–endothelium interactions and proinflammatory markers correlated with glucose and HbA1Clevels. Mitochondrial alteration, oxidative stress, and enhanced leukocyte–endothelium interactions are features of type 1 diabetes and may be related to cardiovascular implications.

Association between urinary N-acetyl-beta-glucosaminidase and its isoenzyme patterns and microangiopathy in type 1 diabetes mellitus

1991 ◽  
Vol 37 (10) ◽  
pp. 1696-1699 ◽  
Author(s):  
C D Agardh ◽  
E Agardh ◽  
A Isaksson ◽  
B Hultberg
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control ◽  
Isoenzyme Pattern ◽  
Diabetic Patients ◽  
Type 1 Diabetic Patients ◽  
Isoenzyme Patterns ◽  
Apparently Healthy

Abstract Urinary N-acetyl-beta-glucosaminidase (NAG) and its isoenzymes (NAG A and NAG B) in samples from 87 type 1 diabetic patients and 40 apparently healthy reference subjects were studied with enzyme immunoassays. The diabetic patients had higher concentrations of urinary NAG than did the control subjects (P less than 0.01), but the isoenzyme pattern did not differ. There was a positive correlation between metabolic control (Hb A1c concentrations) and total NAG (P less than 0.01), NAG A (P less than 0.01), and NAG B (P less than 0.001). The diabetic patients were divided into three groups, depending on the degree of retinopathy. Subjects with severe forms of retinopathy did not have increased concentrations of urinary NAG unless they had concomitant nephropathy. The isoenzyme pattern was similar irrespective of degree of retinopathy or nephropathy. The results indicate that concentrations of urinary NAG are positively correlated to the degree of nephropathy, whereas there is no such correlation to the degree of retinopathy.

Treatment satisfaction and glycemic control in young Type 1 diabetic patients in transition from pediatric health care: CSII versus MDI

Endocrine ◽  
2013 ◽  
Vol 46 (2) ◽  
pp. 256-262 ◽  
Author(s):  
Maria Ida Maiorino ◽  
Giuseppe Bellastella ◽  
Michela Petrizzo ◽  
Maria Rosaria Improta ◽  
Clementina Brancario ◽  
...  
Keyword(s):  
Health Care ◽  
Glycemic Control ◽  
Treatment Satisfaction ◽  
Diabetic Patients ◽  
Pediatric Health ◽  
Pediatric Health Care ◽  
Type 1 Diabetic Patients

Glycosuria amount in response to hyperglycaemia and risk for diabetic kidney disease and related events in Type 1 diabetic patients

2018 ◽  
Vol 34 (10) ◽  
pp. 1731-1738 ◽  
Author(s):  
Charlyne Carpentier ◽  
Séverine Dubois ◽  
Kamel Mohammedi ◽  
Narimène Belhatem ◽  
Béatrice Bouhanick ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Renal Plasma Flow ◽  
Individual Variability ◽  
Low Risk ◽  
Diabetic Patients ◽  
Risk Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Type 1 Diabetic Patients

Abstract Background Hyperglycaemia impairs tubulo-glomerular feedback. We tested whether variable tubulo-glomerular feedback during hyperglycaemia contributes to renal risk heterogeneity seen in Type 1 diabetes. Methods During the period 1990–92, we studied the tubulo-glomerular feedback in Type 1 diabetic patients at high or low renal risk [21 of 54 with glomerular hyperfiltration and/or microalbuminuria against 11 of 55 with normal glomerular filtration rate (GFR) and urinary albumin despite uncontrolled diabetes]. The GFR, effective renal plasma flow, mean arterial pressure and fractional reabsorptions of glucose, osmols, sodium and lithium were measured sequentially during normo- and hyperglycaemia. All patients were followed up until 2016 for incident proteinuria, estimated GFR &lt;60 mL/min/1.73 m2, doubling of serum creatinine, end-stage renal disease or all-cause death. Results Glycaemia increased from 6.1 ± 1.3 to 15.1 ± 1.9 mmol/L in both high-risk and low-risk patients. Glycosuria was lower in the high- versus low-risk patients: 0.34 ± 0.25 versus 0.64 ± 0.44 mmol/min (P = 0.03). Both groups displayed similar kidney function during normoglycaemia. Hyperglycaemia increased more importantly GFR and fractional reabsorptions, and pre-glomerular vasodilatation in the high- than in the low-risk patients (all P &lt; 0.05). Over 21 years, 31.5% high- versus 12.7% low-risk patients developed endpoints (adjusted P = 0.006). In a multi-adjusted survival analysis of patients having undergone renal tests, each 0.10 mmol/min glycosuria during hyperglycaemia reduced the outcome risk by 0.72 (95% confidence interval 0.49–0.97, P = 0.03). Conclusions Reduced tubulo-glomerular feedback and glycosuria during hyperglycaemia indicate high renal risk for Type 1 diabetic patients. Inter-individual variability in tubulo-glomerular feedback activity determines renal risk in Type 1 diabetes.

scholarly journals Humoral Immune Responses of Type 1 Diabetes Patients to Mycobacterium avium subsp. paratuberculosis Lend Support to the Infectious Trigger Hypothesis

2007 ◽  
Vol 15 (2) ◽  
pp. 320-326 ◽  
Author(s):  
Leonardo A. Sechi ◽  
Valentina Rosu ◽  
Adolfo Pacifico ◽  
Giovanni Fadda ◽  
Niyaz Ahmed ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Immune Responses ◽  
Mycobacterium Avium ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Heparin Binding ◽  
Whole Cell ◽  
Humoral Immune ◽  
Humoral Immune Responses

ABSTRACT Mycobacterium avium subsp. paratuberculosis is a zoonotic pathogen whose association with Crohn's disease in humans is under scrutiny. The objective of this work was to investigate its association with other chronic diseases such as type 1 diabetes mellitus (T1DM), where the involvement of a persistent pathogen such as M. avium subsp. paratuberculosis could be the trigger. For this purpose, 59 diabetic patients and 59 healthy controls were investigated for the presence of antibodies against two recombinant proteins of M. avium subsp. paratuberculosis and the whole-cell lysate. Extremely significant humoral immune responses to recombinant heparin binding hemagglutinin and glycosyl transferase proteins and the whole-cell lysates of M. avium subsp. paratuberculosis bacilli were observed in T1DM patients and compared to those of healthy controls. Finding evidence of M. avium subsp. paratuberculosis involvement in T1DM is perhaps a novel finding that might serve as a foundation stone in establishing an infectious etiology for T1DM.

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