scholarly journals Comparison of Demographic and Diagnostic Markers in New Onset Pediatric Type 1 and Type 2 Diabetes

2021 ◽  
Author(s):  
Teresa Nieto ◽  
Beatriz Castillo ◽  
Jacobo Nieto ◽  
Maria Jose Redondo
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Minority ◽  
Hemoglobin A1c ◽  
Multiple Logistic Regression Analysis ◽  
Islet Autoantibody ◽  
Diabetes Diagnosis ◽  
C Peptide ◽  
Racial Ethnic

Purpose Type 1 diabetes (T1D) is the most common type of diabetes in children, but the frequency of type 2 diabetes (T2D) is increasing rapidly. Classification of diabetes is based on a constellation of features that are typical of each type. We aimed to compare demographic, clinical and laboratory characteristics at diabetes diagnosis in pediatric T1D and T2D. Methods We studied children who attended a large academic hospital in Houston, Texas (USA) with a new diagnosis of T2D (n=753) or T1D (n=758). We compared age, sex, race/ethnicity, presence of obesity, glucose, hemoglobin A1c, islet autoantibody positivity, C-peptide, and presence of diabetic ketoacidosis (DKA) at diabetes diagnosis. Results At diagnosis of diabetes, children with T2D, compared with those with T1D, were older (13.6 vs 9.7% years old), more likely females (63.2% vs 47.8%), of racial/ethnic minority (91.1%% versus 42.3%) and obese (90.9% vs 19.4%), and were less likely to have DKA (7.8% vs 35.0%) and diabetes autoantibodies (5.5% vs 95.4%). Children with T2D also had significantly less marked elevation of glucose and hemoglobin A1c, and lower C-peptide levels (all comparisons, p<0.0001). In multiple logistic regression analysis, older age, racial/ethnic minority, obesity, higher C-peptide and negative islet autoantibodies were independently associated with T2D (all, p<0.05) while sex, glucose, hemoglobin A1c and DKA were not (model p<0.0001). Conclusions There are important demographic, clinical and laboratory differences between T1D and T2D in children with T1D. However, none of the characteristics was unique to either diabetes type, which poses challenges to diabetes classification at diagnosis.

scholarly journals Involvement of dietitians in diabetes care, results from a secondary care hospital in Greece

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Zoe Pafili ◽  
Sophia Samara ◽  
Charilaos Dimosthenopoulos ◽  
Olga Gkortzi
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Secondary Care ◽  
Diabetes Management ◽  
Nutrition Therapy ◽  
Dietary Advice ◽  
Diabetes Diagnosis ◽  
Diabetes Patients

AbstractIntroductionAccording to diabetes care standards nutrition therapy should be an integral part of diabetes management, and all individuals with diabetes should be referred to a registered dietitian for nutrition therapy at—or soon after—diagnosis and for ongoing follow-up. There is limited international data that indicate that a large percentage of people with diabetes have not received structured diabetes education and have not visited a dietitian. The aim of this study was to assess the involvement of dietitians in diabetes care in Greece.Materials and MethodsAll adult diabetic patients admitted to a secondary care general hospital in Greece during 30 consecutive days were included in the study. Patients admitted in the ICU, CICU, day clinics and hemodialysis patients were excluded. Data were obtained by personal interviews using a 40 item questionnaire which included 10 questions regarding number of visits to dietitians for diabetes management, whether patients were referred by their doctors or sought dietary advice by their own, reasons for visiting a dietitian, goal achievement and patient satisfaction.ResultsIn total 124 patients (68 males and 56 females) with diabetes were admitted to the hospital during the study period (4 type 1, 114 type 2 and 6 pregnancy diabetes). Data were obtained from 3 (22.8 ± 6 yrs, 26.1 ± 5.7kg/m2,8.3 ± 5.9 yrs with diabetes),105 (76.6 ± 11.3 yrs, 28.0 ± 5.3 kg/m2, 12.8 ± 9.3 yrs with diabetes), and 5 (32.6 ± 4.4 yrs, 28.5 ± 4.0 kg/m2) patients with type 1, type 2 and pregnancy diabetes respectively. Two out of 3 type 1 diabetes and 1 out of 5 patients with pregnancy diabetes interviewed reported to have been referred to a dietitian by their doctor. Only 5.7% (6 patients) of type 2 diabetes patients reported to have been referred to a dietitian by their doctor and another 5.7% have visited a dietitian on their own initiative. Five out of 6 referrals were at diabetes diagnosis. The number of encounters with a dietitian ranged from 1 to 24 with patients seeking to loose weight having the greater number of encounters. Of type 2 diabetes patients 94.3% did not receive lifestyle advice before commencing diabetes medication whereas 25% did not receive any dietary advice by any health professional even after starting medication.ConclusionsIn our cohort the majority of diabetes patients had not received dietary counseling by a dietitian, whereas about one fourth of type 2 diabetes patients had not received any dietary advice.

Urinary C-peptide creatinine ratio to differentiate type 2 diabetes mellitus from type 1 in pediatric patients

2020 ◽  
Vol 179 (7) ◽  
pp. 1115-1120
Author(s):  
Wafaa Elzahar ◽  
Ahmed Arafa ◽  
Amira Youssef ◽  
Adel Erfan ◽  
Doaa El Amrousy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pediatric Patients ◽  
Creatinine Ratio ◽  
C Peptide

scholarly journals Adiponectin has different mechanisms in type 1 and type 2 diabetes with C-peptide link

2009 ◽  
Vol 32 (4) ◽  
pp. 271 ◽  
Author(s):  
Spomenka Ljubic ◽  
Jozo Boras ◽  
Anamarija Jazbec ◽  
Marijana Vucic Lovrencic ◽  
Vinko Vidjak ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
C Peptide

Purpose: Adiponectin (ApN) is considered to be responsible for reduction of inflammation and is known to be included in lipid metabolism. This study was designed to assess the role of adiponectin in patients with type 1 and type 2 diabetes and to determine parameters important in the prediction of adiponectin. Methods: Adiponectin, high sensitive C-reactive protein, fibrinogen, homocysteine, C-peptide, and lipid panel in addition to clinical and laboratory parameters important for the definition of diabetes, obesity and the metabolic syndrome were measured in 118 patients. Results: The best model (R2=0.989) for predicting adiponectin in type 1 diabetes included fibrinogen, white blood cell count, uric acid and triglycerides. In type 2 diabetes the best model (R2=0.751) included C-peptide, white blood cell count, systolic blood pressure, fasting blood glucose, glycated hemoglobin and high-density lipoprotein cholesterol. ANOVA showed among-group differences in adiponectin (P=0.028), body mass index (P < 0.001), fasting blood glucose (P < 0.001) and high-density lipoprotein cholesterol (P =0.012) according to the type of diabetes. Between-group differences were also observed in adiponectin (P =0.033) and high-density lipoprotein cholesterol (P =0.009) according to sex. Adiponectin correlated (P < 0.05) with body mass index, C-peptide, pulse pressure and high-density lipoprotein cholesterol. Conclusion: Adiponectin levels were higher in type 1 diabetes. The association between C-peptide and adiponectin is probably one of the reasons for their different respective levels in different types of diabetes. Interrelations between adiponectin and inflammation, dyslipidemia, C-peptide levels and sex appear to be important for complex adiponectin modulation and action.

scholarly journals Incident Type 2 Diabetes Duration and Cancer Risk: A Prospective Study in Two US Cohorts

2020 ◽  
Author(s):  
Yang Hu ◽  
Xuehong Zhang ◽  
Yanan Ma ◽  
Chen Yuan ◽  
Molin Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cancer Risk ◽  
Cancer Incidence ◽  
Health Study ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
C Peptide ◽  
Incident Type ◽  
A Prospective Study

Abstract Background The influence of type 2 diabetes mellitus (T2D) duration on cancer incidence remains poorly understood. Methods We prospectively followed for cancer incidence 113 429 women in the Nurses’ Health Study (1978-2014) and 45 604 men in the Health Professionals Follow-up Study (1988-2014) who were free of diabetes and cancer at baseline. Cancer incidences were ascertained by review of medical records. Results In the multivariable-adjusted model incident, T2D was associated with higher risk of cancers in the colorectum, lung, pancreas, esophagus, liver, thyroid, breast, and endometrium. The pooled hazard ratios (HRs) ranged from 1.21 (95% confidence interval [CI] = 1.06 to 1.38) for colorectal cancer to 3.39 (95% CI = 2.24 to 5.12) for liver cancer. For both composite cancer outcomes and individual cancers, the elevated risks did not further increase after 8 years of T2D duration. The hazard ratio for total cancer was 1.28 (95% CI = 1.17 to 1.40) for T2D duration of 4.1-6.0 years, 1.37 (95% CI = 1.25 to 1.50) for 6.1-8.0 years, 1.21 (95% CI = 1.09 to 1.35) for 8.1-10.0 years, and 1.04 (95% CI = 0.95 to 1.14) after 15.0 years. In a cross-sectional analysis, a higher level of plasma C-peptide was found among participants with prevalent T2D of up to 8 years than those without T2D, whereas a higher level of HbA1c was found for those with prevalent T2D of up to 15 years. Conclusions Incident T2D was associated with higher cancer risk, which peaked at approximately 8 years after diabetes diagnosis. Similar duration-dependent pattern was observed for plasma C-peptide. Our findings support a role of hyperinsulinemia in cancer development.

KETOACIDOSIS IN TYPE 2 DIABETES: C-PEPTIDE AT PRESENTATION DIFFERENTIATES DIABETES MELLITUS 2 FROM TYPE 1 DIABETES.

2004 ◽  
Vol 52 ◽  
pp. S137-S138
Author(s):  
M. Iv ◽  
A. Stammreich ◽  
J. Canales ◽  
H. Pham ◽  
G. P. Scheel ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
C Peptide ◽  
Diabetes Mellitus 2

scholarly journals Test–retest reliability of self-reported diabetes diagnosis in the Norwegian Women and Cancer Study: A population-based longitudinal study (n =33,919)

2016 ◽  
Vol 4 ◽  
pp. 205031211562285 ◽  
Author(s):  
Mashhood Ahmed Sheikh ◽  
Eiliv Lund ◽  
Tonje Braaten
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Diabetes Diagnosis ◽  
Clear Pattern ◽  
Retest Reliability ◽  
Cancer Study ◽  
Test Retest Reliability ◽  
Kappa Agreement

Objective: Self-reported information from questionnaires is frequently used in epidemiological studies, but few of these studies provide information on the reproducibility of individual items contained in the questionnaire. We studied the test–retest reliability of self-reported diabetes among 33,919 participants in Norwegian Women and Cancer Study. Methods: The test–retest reliability of self-reported type 1 and type 2 diabetes diagnoses was evaluated between three self-administered questionnaires (completed in 1991, 1998, and 2005 by Norwegian Women and Cancer participants) by kappa agreement. The time interval between the test–retest studies was ~7 and ~14 years. Sensitivity of the kappa agreement for type 1 and type 2 diabetes diagnoses was assessed. Subgroup analysis was performed to assess whether test–retest reliability varies with age, body mass index, physical activity, education, and smoking status. Results: The kappa agreement for both types of self-reported diabetes diagnoses combined was good (⩾0.65) for all three test–retest studies (1991–1998, 1991–2005, and 1998–2005). The kappa agreement for type 1 diabetes was good (⩾0.73) in the 1991–2005 and the 1998–2005 test–retest studies, and very good (0.83) in the 1991–1998 test–retest study. The kappa agreement for type 2 diabetes was moderate (0.57) in the 1991–2005 test–retest study and good (⩾0.66) in the 1991–1998 and 1998–2005 test–retest studies. The overall kappa agreement in the 1991–1998 test–retest study was stronger than in the 1991–2005 test–retest study and the 1998–2005 test–retest study. There was no clear pattern of inconsistency in the kappa agreements within different strata of age, BMI, physical activity, and smoking. The kappa agreement was strongest among the respondents with 17 or more years of education, while generally it was weaker among the least educated group. Conclusion: The test–retest reliability of the diabetes was acceptable and there was no clear pattern of inconsistency in the kappa agreement stratified by age, body mass index, physical activity, and smoking. The study suggests that self-reported diabetes diagnosis from middle-aged women enrolled in the Norwegian Women and Cancer Study is reliable.

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