scholarly journals The Stricter the Better? The Relationship between Targeted HbA1cValues and Metabolic Control of Pediatric Type 1 Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Marcin Braun ◽  
Bartlomiej Tomasik ◽  
Ewa Wrona ◽  
Wojciech Fendler ◽  
Przemyslawa Jarosz-Chobot ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control ◽  
Meta Analysis ◽  
Group A ◽  
Study Population ◽  
A Prospective Study ◽  
Pediatric Type 1 Diabetes

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.

scholarly journals Impact of ELKa, the Electronic Device for Prandial Insulin Dose Calculation, on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Agnieszka Kowalska ◽  
Katarzyna Piechowiak ◽  
Anna Ramotowska ◽  
Agnieszka Szypowska
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control ◽  
Electronic Device ◽  
Intervention Group ◽  
Insulin Dosage ◽  
Control Group ◽  
Prandial Insulin

Background. The ELKa system is composed of computer software, with a database of nutrients, and a dedicated USB kitchen scale. It was designed to automatize the everyday calculations of food exchanges and prandial insulin doses. Aim. To investigate the influence of the ELKa on metabolic control in children with type 1 diabetes mellitus (T1DM). Methods. A randomized, parallel, open-label clinical trial involved 106 patients aged <18 years with T1DM, HbA1C≤10%, undergoing intensive insulin therapy, allocated to the intervention group, who used the ELKa (n=53), or the control group (n=53), who used conventional calculation methods. Results. After the 26-week follow-up, the intention-to-treat analysis showed no differences to all endpoints. In per protocol analysis, 22/53 (41.5%) patients reporting ELKa usage for >50% of meals achieved lower HbA1C levels (P=0.002), lower basal insulin amounts (P=0.049), and lower intrasubject standard deviation of blood glucose levels (P=0.023) in comparison with the control. Moreover, in the intervention group, significant reduction of HbA1C level, by 0.55% point (P=0.002), was noted. No intergroup differences were found in the hypoglycemic episodes, BMI-SDS, bolus insulin dosage, and total daily insulin dosage. Conclusions. The ELKa system improves metabolic control in children with T1DM under regular usage. The trial is registered at ClinicalTrials.gov, number NCT02194517.

scholarly journals Improvement in metabolic control of type 1 diabetes mellitus in a tertiary unit: 2005 vs 2012

2013 ◽  
Author(s):  
Joana Caetano ◽  
Sara Ferreira ◽  
Ester Pereira ◽  
Marta Ferreira ◽  
Helena Lourenco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control

771-P: The Effect of Adding Acarbose to Insulin Therapy in Type 1 Diabetes Mellitus: A Systematic Review and Meta-analysis

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 771-P
Author(s):  
ZHIGU LIU ◽  
DAIZHI YANG ◽  
WEN XU ◽  
JING LV ◽  
HUIMIN LIN ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Meta Analysis

scholarly journals Exhaled volatile substances in children suffering from type 1 diabetes mellitus: results from a cross-sectional study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Phillip Trefz ◽  
Juliane Obermeier ◽  
Ruth Lehbrink ◽  
Jochen K. Schubert ◽  
Wolfram Miekisch ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Invasive

Abstract Monitoring metabolic adaptation to type 1 diabetes mellitus in children is challenging. Analysis of volatile organic compounds (VOCs) in exhaled breath is non-invasive and appears as a promising tool. However, data on breath VOC profiles in pediatric patients are limited. We conducted a cross-sectional study and applied quantitative analysis of exhaled VOCs in children suffering from type 1 diabetes mellitus (T1DM) (n = 53) and healthy controls (n = 60). Both groups were matched for sex and age. For breath gas analysis, a very sensitive direct mass spectrometric technique (PTR-TOF) was applied. The duration of disease, the mode of insulin application (continuous subcutaneous insulin infusion vs. multiple daily insulin injection) and long-term metabolic control were considered as classifiers in patients. The concentration of exhaled VOCs differed between T1DM patients and healthy children. In particular, T1DM patients exhaled significantly higher amounts of ethanol, isopropanol, dimethylsulfid, isoprene and pentanal compared to healthy controls (171, 1223, 19.6, 112 and 13.5 ppbV vs. 82.4, 784, 11.3, 49.6, and 5.30 ppbV). The most remarkable differences in concentrations were found in patients with poor metabolic control, i.e. those with a mean HbA1c above 8%. In conclusion, non-invasive breath testing may support the discovery of basic metabolic mechanisms and adaptation early in the progress of T1DM.

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.

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