scholarly journals The Association of Autoimmune Diseases with Type 1 Diabetes Mellitus in Children Depends Also by the Length of Partial Clinical Remission Phase (Honeymoon)

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Gulsum Ozen ◽  
Angela Zanfardino ◽  
Santino Confetto ◽  
Alessia Piscopo ◽  
Francesca Casaburo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Immune System ◽  
Autoimmune Disease ◽  
Type 1 Diabetes Mellitus ◽  
Clinical Remission ◽  
Insulin Production ◽  
Remission Phase ◽  
Type 1 Dm

Type 1 diabetes mellitus (DM) is characterized by irreversible, autoimmune, pancreatic β-cell destruction. During the disease, some patients experience a phase of Partial Clinical Remission (PCR) known as “honeymoon.” This is a transitory period that is characterized by insulin production by residual β cells following DM diagnosis and initiating the insulin therapy. In this study, we aimed to evaluate the influence of insulin production on immune system after the onset of diabetes, and we showed that the duration of honeymoon period could be related to the onset of other autoimmune conditions. For this retrospective study, 159 children aged between 11 and 18 years with type 1 DM were eligible. They have been diagnosed diabetes at least 10 years ago and use exogenous insulin. Our results showed that younger age at the onset of Type 1 DM in children, predicts Celiac Disease. Female sex and low HCO3 levels at the onset of DM had a high predictive value on patients who did not experience longer Partial Clinical Remission phase. Patients with higher BMI at the diagnosis of DM experienced shorter honeymoon period than the average. Smaller of our patients who diagnosed just DM have more than 297 days honeymoon period with respect to patients with one associated autoimmune disease. This may be due to a continuous and prolonged stimulation of immune system during the period of honeymoon that predispose the patient to develop other TH1 diseases. The patients who experienced more than 297 days Partial Clinical Remission seem under risk of developing one other autoimmune disease more than the patients who experienced less than 297 days Partial Clinical Remission. We have to consider that this observation is very intriguing because many protocols spring-up to try prolonging the honeymoon period in patients with autoimmune DM. If this aim is important from a metabolic point of view, long follow-ups are needed to be sure that the risk of other autoimmune diseases does not increase.

scholarly journals Four-year clinical remission of type 1 diabetes mellitus in two patients treated with sitagliptin and vitamin D3

2016 ◽  
Vol 2016 ◽  
Author(s):  
Marcelo Maia Pinheiro ◽  
Felipe Moura Maia Pinheiro ◽  
Margareth Afonso Torres
Keyword(s):  
Diabetes Mellitus ◽  
Immune Response ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Vitamin D3 ◽  
Clinical Remission ◽  
Insulin Production ◽  
C Peptide ◽  
New Onset

Summary Type 1 diabetes mellitus (T1DM) is a chronic disease characterized by autoimmune destruction of pancreatic beta cells and inadequate insulin production. Remission criteria in T1DM take into account serum levels of C-peptide and glycosylated hemoglobin, as well as the dose of insulin administered to the patient. However, remission of T1DM lasting longer than 1 year is rare. We describe here the cases of two young women who presented with positive glutamic acid decarboxylase (GAD) antibody and classic clinical manifestations of T1DM. Both patients had a prior history of Hashimoto’s thyroiditis. They were initially treated with a basal-bolus regimen of insulin (glargine and lispro/glulisine). Once their blood glucose levels were controlled, they were started on oral sitagliptin 100 mg and vitamin D3 5000 IU daily. After this therapy, both patients achieved clinical diabetes remission for 4 years, along with a decrease in anti-GAD antibody levels. These benefits were probably associated with immunological effects of these medications. Inhibition of dipeptidyl peptidase 4 (DPP-4) in animal models deregulates Th1 immune response, increases secretion of Th2 cytokines, activates CD4+CD25+FoxP3+ regulatory T-cells and prevents IL-17 production. Vitamin D3 also activates CD4+CD25+FoxP3+ regulatory T-cells, and these medications combined can improve the immune response in patients with new-onset T1DM and probably promote sustained clinical remission. Learning points: The use of sitagliptin and vitamin D3 in patients with new-onset type 1 diabetes mellitus (T1DM) may help decrease the daily insulin requirement by delaying beta cell loss and improving endogenous insulin production. The use of sitagliptin and vitamin D3 in new-onset T1DM could help regulate the imbalance between Th17 and Treg cells. Age 14 years or above, absence of ketoacidosis and positive C-peptide levels in patients with T1DM are good criteria to predict prolonged T1DM remission. The determination of anti-GAD antibodies and C-peptide levels could be helpful in the follow-up of patients in use of sitagliptin and vitamin D3, which could be associated with prolonged T1DM clinical remission.

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Statistical Significance ◽  
Control Group ◽  
Acid Decarboxylase ◽  
Thyroid Peroxidase ◽  
The Difference ◽  
Type 1 Dm

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

scholarly journals Dynamics of incidence and prevalence of type 1 diabetes mellitus in children in the Russian Federation (2001-2007)

2009 ◽  
Vol 12 (3) ◽  
pp. 23-27
Author(s):  
Tatiana Yur'evna Shiryaeva ◽  
Ekaterina Andreevna Andrianova ◽  
Yury Ivanovich Suntsov
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Far East ◽  
Secondary Source ◽  
Sources Of Information ◽  
Pediatric Endocrinology ◽  
Type 1 Dm ◽  
Epidemiological Characteristics

Aim. To study dynamics of main epidemiological characteristics (incidence and prevalence) of type 1 diabetes mellitus (DM) in children in theRussian Federation (RF) and its Federal districts (FD) in 2001-2007. Materials and methods. Analysis of main epidemiological characteristics (incidence, prevalence, mortality) of type 1 DM in children of RF has beenunderway in the Institute of Pediatric Endocrinology, ERC, since 2001 based on results of questionnaire studies. The questionnaires regularly distributedamong Health Committees of RF subjects (primary sources of information) are designed to collect data on the size, age and sex compositionof childrens populations affected by DM1 and the number of newly diagnosed cases as per the end of each reporting year. The data obtainedare compared with those stored in the State Diabetes Registry (secondary source of information). Results. Major trends in the dynamics of epidemiological characteristics of type 1 DM in children of RF are similar to those worldwide. Mean annualgrowth rate is 2,8%. The incidence of DM1 remains highest in the North-West FD (15,66 per 100 000 children) followed by Central andVolga FDs (12,82 and 10,6 respectively) where its is close to the average value FDr RF (11,01). The incidence of DM1 continues to decrease in theSouthern FD (6,61% per year) and undergoes up-and-down fluctuations in Ural and Siberian FDs. It steadily grows in the Far East FD. TheNorth-South gradient of DM1 morbidity across the territory of RF has persisted during the study period. Conclusion. Monitoring main epidemiological characteristics of type 1 diabetes mellitus in children of RF is an integral component of the organizationof medical and preventive aid to these patients that creates a basis for predicting morbidity, planning measures for its control, and improvinggeneral quality of healthcare provided to diabetic children

ALLERGIC DISEASES IN TYPE 1 DIABETIC PATIENTS: A BRIEF REVIEW

2015 ◽  
Vol 18 (2-3) ◽  
pp. 65-71
Author(s):  
Alina Gabriela Dutu ◽  
◽  
Silviu Albu ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Autoimmune Disease ◽  
Type 1 Diabetes Mellitus ◽  
Allergic Diseases ◽  
Developed Countries ◽  
Diabetic Patients ◽  
Inverse Association ◽  
Stepping Stones

Type 1 diabetes mellitus is considered an autoimmune disease mediated by Th1 lymphocytes, while allergic diseases are characterized by Th2-mediated immune response. Their incidence is rising in developed countries and the interaction between autoimmune and atopic diseases has been a subject of interest for decades. There are many controversies about the association or mutual exclusion of these diseases, but classical paradigm based on the assumption that diseases mediated by Th1 and Th2 should be mutually exclusive, has been revised considering both the role of regulatory T cells Threg, and the environmental factors involved. The aim of this review is to investigate the association of allergic diseases (rhinitis, asthma, dermatitis) in patient diagnosed with type 1 diabetes mellitus. The studies that attempted to shed light on this topic had surprisingly varied results. These ranged from statistically significant proof of an inverse association between an autoimmune disease and one or several atopic ones to other implying positive associations. Although up to now studies on this subject present seemingly discordant results, each attempt raises new questions and sheds light on new factors involved in the interaction of these diseases. They present much needed stepping stones for future studies to learn from and adapt.

Abstract 352: Myocardial Neuregulin-1/ErbB Signaling Is Impaired in the Setting of Post--Myocardial Infarction Heart Failure Complicated by Type 1 Diabetes Mellitus

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Oghenerukevwe Odiete ◽  
Kathleen E Dennis ◽  
Douglas B Sawyer ◽  
Michael F Hill
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Type 1 Diabetes ◽  
Protein Expression ◽  
Type 1 Diabetes Mellitus ◽  
Neuregulin 1 ◽  
Erbb Signaling ◽  
Type 1 Dm

Background: Type 1 diabetes mellitus (DM) patients surviving myocardial infarction (MI) are at heightened risk for the subsequent development of heart failure (HF). Despite the worse outcomes, investigations into the pathophysiological mechanisms that contribute to the increased frequency of HF after MI in the type 1 DM heart remain scarce. Neuregulin-1 (NRG-1), along with the ErbB family of receptor tyrosine kinases through which NRG-1 ligands signal, have been shown to be intimately involved in mediating cardiac recovery after MI. However, the impact of type 1 DM on this signaling system post-MI remains to be elucidated. Therefore, in the present study, we examined myocardial NRG-1/ErbB signaling during post-MI HF in the presence of type 1 DM. Methods: Type 1 DM was induced in male Sprague-Dawley rats via a single intraperitoneal injection of streptozotocin (STZ) (65 mg/kg). Two weeks after induction of type 1 DM, MI was produced in DM and non-DM rats by ligation of the left anterior descending (LAD) coronary artery. Residual left ventricular (LV) function was assessed by echocardiography at 4 weeks post-MI. Following echocardiographic assessment, NRG-1, ErbB2, and ErbB4 protein expression was assessed in the remote, surviving LV myocardium of DM and non-DM rats using Western blot techniques. Results: LV Fractional Shortening (FS) and LV Ejection Fraction (EF) were significantly lower in the DM + MI group compared to the MI group ([LVFS: DM + MI, 17.9 ± 0.7 (n=6) vs. MI, 25.2 ± 2.2 (n=6), p <0.05; LVEF: DM + MI, 35.5 ± 1.4 (n=6) vs. MI, 47.5 ± 3.5 (n=6), p <0.05]), indicating an increased functional severity of HF in the diabetic post-MI group. The weight of myocardial scar caused by the infarction was not significantly different between the MI groups ([DM + MI, 0.19 ± 0.02 g (n=4) vs. MI, 0.20 ± 0.03 g (n=4), p =0.70]). ErbB2, ErbB4, and NRG-1 protein expression levels were all significantly lower in the DM + MI group compared to the MI group. Conclusions: These findings demonstrate that type 1 DM impairs myocardial NRG-1/ErbB signaling in response to MI, which may contribute to the accelerated progression of subsequent HF. Augmentation of NRG-1 or its downstream signaling pathways may represent a novel therapeutic strategy for ameliorating post-MI HF in the setting of type 1 DM.

scholarly journals Risk of Urticaria in Children with Type 1 Diabetes Mellitus: A Nationwide Cohort Study

2019 ◽  
Vol 17 (1) ◽  
pp. 176
Author(s):  
Shih-Yi Lin ◽  
Cheng-Li Lin ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
Chung-Y. Hsu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Hazard Ratio ◽  
Control Group ◽  
Case Group ◽  
Research Database ◽  
Increased Risk ◽  
Type 1 Dm

Type 1 diabetes mellitus (T1DM) has been linked to many autoimmune problems. The association between T1DM and urticaria warrants investigation. Data were extracted from the National Health Insurance Research Database (NHIRD) of Taiwan. Participants with T1DM were recruited as the case group, and that group was matched by sex and age at a ratio of 1:4 to the control group comprising those without T1DM. The study period was 1998–2011. All participants were followed up to the diagnosis of urticaria, withdrawal from the insurance program, death, or the end of the study. A multivariable Cox proportional hazard model was used to calculate the adjusted and crude hazard ratios for urticaria. A total of 5895 participants (1179 in the case group and 4716 in the control group) were followed up in the study. The total incidence rate of urticaria in patients with type 1 DM was 26.6 per 1000 person-years, and that in controls was 6.85 per 1000 person-years. Compared with the control group, the hazard ratio of urticaria in the case group was 2.84 (95% CI = 2.27–3.56). Compared with age-matched participants without T1DM, patients with type 1 DM aged <18 years had a 3.62-fold higher risk of urticaria (95% CI = 2.85–4.59). The hazard ratio in patients with an adjusted Diabetes Complications Severity Index (aDCSI) score of 1.01–2.00 per year was 2.57 (95% CI = 1.18–5.57), and that in patients with an aDCSI score of >2.00 per year was 4.47 (95% CI = 2.68–7.47). T1DM patients aged <18 years had an increased risk of urticaria, but a similar phenomenon was not observed among T1DM patients older than 18 years.

scholarly journals Clinical determinants of the remission phase in children with new-onset type 1 diabetes mellitus in two years of observation

2019 ◽  
Vol 25 (1) ◽  
pp. 6-16
Author(s):  
Marta Rydzewska ◽  
Monika Kulesza ◽  
Marta Olszewska ◽  
Milena Jamiołkowska ◽  
Włodzimierz Łuczyński ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Onset Type ◽  
Remission Phase ◽  
New Onset

scholarly journals Pathogenesis of Type 1 Diabetes Mellitus: A Brief Overview

2012 ◽  
Vol 19 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Adrian Vlad ◽  
Romulus Timar
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Chronic Complications ◽  
Type 1 Dm ◽  
Preventive Methods

Pathogenesis of Type 1 Diabetes Mellitus: A Brief OverviewBefore the discovery of insulin, type 1 diabetes mellitus (DM) was a disease with acute evolution, leading to death shortly after diagnosis. During the first years of insulin therapy, the medical world was optimistic, even enthusiastic, considering that the therapeutic solution for the malady was found. Unfortunately this was only an illusion, because the patients started to develop chronic complications that shortened their lifespan and impaired their quality of life. In other words, insulin therapy transformed type 1 DM into a chronic disease. The prevention or the delay of the onset of hyperglycemia emerged as a new solution for the patients and, consequently, the understanding of the pathogenesis of the disease (a prerequisite for developing efficient preventive methods) became a priority for all the diabetologists involved in research. Almost 40 years have passed since the autoimmune theory regarding the pathogenesis of type 1 DM was imagined but, despite the tremendous research performed in this field since then, the prevention could not be obtained. The aim of this paper is to present the most important theoretic notions regarding the mechanisms that underlie the development of type 1 DM, in the way they are understood today.

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