Racial differences in neighborhood disadvantage, inflammation and metabolic control in black and white pediatric type 1 diabetes patients

Introduction. It remains unclear howHbA1crecommendations influence metabolic control of paediatric patients with type 1 diabetes mellitus. To evaluate this we compared reportedHbA1cwith guideline thresholds.Materials and Methods. We searched systematically MEDLINE and EMBASE for studies reporting onHbA1cin children with T1DM and grouped them according to targetedHbA1cobtained from regional guidelines. We assessed the discrepancies in the metabolic control between these groups by comparing meanHbA1cextracted from each study and the differences between actual and targetedHbA1c.Results. We included 105 from 1365 searched studies. The median (IQR)HbA1cfor the study population was 8.30% (8.00%–8.70%) and was lower in “6.5%” than in “7.5%” as targetedHbA1clevel (8.20% (7.85%–8.57%) versus 8.40% (8.20%–8.80%);p=0.028). Median difference between actual and targetedHbA1cwas 1.20% (0.80%–1.70%) and was higher in “6.5%” than in “7.5%” (1.70% (1.30%–2.07%) versus 0.90% (0.70%–1.30%), resp.;p<0.001).Conclusions. Our study indicates that the 7.5% threshold results inHbA1clevels being closer to the therapeutic goal, but the actual values are still higher than those observed in the “6.5%” group. A meta-analysis of raw data from national registries or a prospective study comparing both approaches is warranted as the next step to examine this subject further.

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“Let the Algorithm Do the Work”: Reduction of Hypoglycemia Using Sensor-Augmented Pump Therapy with Predictive Insulin Suspension (SmartGuard) in Pediatric Type 1 Diabetes Patients

Diabetes Technology & Therapeutics ◽

10.1089/dia.2016.0349 ◽

2017 ◽

Vol 19 (3) ◽

pp. 173-182 ◽

Cited By ~ 58

Author(s):

Torben Biester ◽

Olga Kordonouri ◽

Martin Holder ◽

Kerstin Remus ◽

Dorothee Kieninger-Baum ◽

...

Keyword(s):

Type 1 Diabetes ◽

Pump Therapy ◽

Insulin Suspension ◽

Pediatric Type 1 Diabetes ◽

Diabetes Patients

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Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients

Pediatric Diabetes ◽

10.1111/j.1399-5448.2009.00630.x ◽

2010 ◽

Vol 11 (7) ◽

pp. 455-461 ◽

Cited By ~ 29

Author(s):

Arlette A Soros ◽

Stuart A Chalew ◽

Robert J McCarter ◽

Rachel Shepard ◽

James M Hempe

Keyword(s):

Type 1 Diabetes ◽

Hemoglobin A1c ◽

Pediatric Type 1 Diabetes ◽

Hemoglobin Glycation ◽

Diabetes Patients

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Retrospective comparative analysis of metabolic control and early complications in familial and sporadic type 1 diabetes patients

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2012.03.016 ◽

2012 ◽

Vol 26 (3) ◽

pp. 219-224 ◽

Cited By ~ 5

Author(s):

Yael Lebenthal ◽

Shlomit Shalitin ◽

Michal Yackobovitch-Gavan ◽

Moshe Phillip ◽

Liora Lazar

Keyword(s):

Type 1 Diabetes ◽

Comparative Analysis ◽

Metabolic Control ◽

Early Complications ◽

Diabetes Patients

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Long-term Improvement of Metabolic Control Without Increased Risk of Hypoglycaemia by Intensive Insulin Regimens in Type 1 Diabetes Patients Treated in a Regular Clinical Setting

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2007-956165 ◽

2007 ◽

Vol 115 (03) ◽

pp. 182-186 ◽

Cited By ~ 4

Author(s):

L. Pérez Méndez ◽

E. Álvarez-García ◽

P. Álvarez-Vázquez ◽

E. Hervás ◽

A. Casterás ◽

...

Keyword(s):

Type 1 Diabetes ◽

Metabolic Control ◽

Clinical Setting ◽

Increased Risk ◽

Diabetes Patients

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Novel, Culturally Sensitive Shared Group Appointment Program for Hispanic Pediatric Type 1 Diabetes Patients Is Feasible, Improves Technology Uptake, and Has Promising Results on Better Diabetes Outcomes

Diabetes ◽

10.2337/db18-1369-p ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 1369-P

Author(s):

ANDREA GERARD GONZALEZ ◽

ANDREA CAROLINA BRADY ◽

GEORGEANNA J. KLINGENSMITH ◽

LAURA PYLE ◽

JESSICA THURSTON

Keyword(s):

Type 1 Diabetes ◽

Culturally Sensitive ◽

Diabetes Outcomes ◽

Pediatric Type 1 Diabetes ◽

Diabetes Patients

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MALDI-TOF Protein Profiling Reflects Changes in Type 1 Diabetes Patients Depending on the Increased Amount of Adipose Tissue, Poor Control of Diabetes and the Presence of Chronic Complications

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052263 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2263

Author(s):

Agnieszka Zawada ◽

Dariusz Naskręt ◽

Eliza Matuszewska ◽

Zenon Kokot ◽

Marian Grzymisławski ◽

...

Keyword(s):

Type 1 Diabetes ◽

Metabolic Control ◽

Pancreatic Beta Cell ◽

Protein Profiling ◽

Chronic Complications ◽

Complement C4 ◽

Poor Metabolic Control ◽

Maldi Tof ◽

Diabetes Patients

Introduction: Protein profiling allows the determination of the presence of proteins marking various stages of the disease, and differentiates between people at risk of various diseases. In type 1 diabetes, protein profiling had been previously used to find blood markers other than islet autoantibodies to indicate the pancreatic beta cell destruction process and to reflect the progression of type 1 diabetes mellitus (T1DM). However, T1DM is an auto-immune disease and its clinical presentation changes in time of its duration. The aim of the study: To find differences in protein profiles in patients with type 1 diabetes according to diabetes control (HbA1c > 7%) and with presence of diabetic complications or obesity. It may help to identify subgroups of patients who may need a better clinical supervision and individualized treatment. Material and methods: A group of 103 patients with auto-immunologically confirmed T1DM, and meeting the following inclusion criteria: Caucasian race, duration of diabetes >5 years, were used in the study. Criteria of exclusion: past or present cancer (treated with chemo-/radiotherapy), diseases of the liver (ALT > 3 × ULN) except for people with simple hepatic steatosis, chronic renal disease (eGFR < 30 mL/1.73 m2/min), and acute inflammation (CRP > 5 mg/dL). The study group was divided in terms of the presence of chronic complications, obesity, or poor metabolic control (HbA1c > 7%). Protein profiling was completed by using the MALDI-TOF MS (matrix-assisted laser desorption/ionization-time of flight mass spectrometry) analyzer. Results: Differentiating proteins were identified in all of the groups. The groups burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Conclusion: The groups of type 1 diabetes patients burdened with complications, obesity, and poor metabolic control were characterized by increased levels of fibrinogen, complement C4 and C3. Further detailed studies are necessary to determine more subtle changes in the proteomic profile of patients with type 1 diabetes.

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