Bone Structure and Predictors of Fracture in Type 1 and Type 2 Diabetes

Abstract Context: Type 1 and type 2 diabetes mellitus are associated with an increased risk of fracture. Objective: The objective of the study was to compare the bone structure and density between type 1 and type 2 diabetes patients and to investigate fracture associations. Design: This was a cross-sectional study. Setting and Patients: Physician-diagnosed type 1 and type 2 diabetes patients were included from the outpatient clinics at two university hospitals participated in the study. Main Outcome Measures: Bone density and structure were assessed by dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography. Blood samples were collected for bone turnover markers. Prevalent vertebral fractures were assessed by vertebral fracture assessment and x-ray, and incident fractures were collected from The Danish National Hospital Discharge Register. Results: Bone mineral density (BMD) was higher in type 2 than type 1 diabetes patients at the hip, femur, and spine; however, only the hip differed in multivariate-adjusted models. Bone tissue stiffness at the tibia was increased in type 2 diabetes patients also in adjusted models. Sclerostin levels were inversely associated with fracture in type 1 diabetes patients. The patients with the highest tertile of sclerostin had an 81% decreased risk of a fracture compared with the lowest tertile. Conclusions: Type 1 and type 2 diabetes patients differ in BMD of the hip and tissue stiffness at the tibia. Sclerostin may be a marker independent of BMD to predict fractures in type 1 diabetes patients and thus potentially of clinical importance. Studies with longer follow-up are needed.

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Insulin Administration May Trigger Type 1 Diabetes in Japanese Type 2 Diabetes Patients With Type 1 Diabetes High-Risk HLA Class II and the Insulin Gene VNTR Genotype

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-1759 ◽

2014 ◽

Vol 99 (9) ◽

pp. E1793-E1797 ◽

Cited By ~ 3

Author(s):

Wataru Nishida ◽

Masao Nagata ◽

Akihisa Imagawa ◽

Toshiaki Hanafusa ◽

Jun Ohashi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

High Risk ◽

Class Ii ◽

Hla Class Ii ◽

Insulin Gene ◽

Insulin Administration ◽

Diabetes Patients

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Bone mineral density spectrum in individuals with type 1 diabetes, latent autoimmune diabetes in adults, and type 2 diabetes

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.3390 ◽

2020 ◽

Cited By ~ 1

Author(s):

Yuhang Hu ◽

Xia Li ◽

Xiang Yan ◽

Gan Huang ◽

Ruchun Dai ◽

...

Keyword(s):

Bone Mineral Density ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Bone Mineral ◽

Autoimmune Diabetes ◽

Mineral Density ◽

Density Spectrum ◽

Latent Autoimmune Diabetes

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Differences and Similarities in Neuropathy in Type 1 and 2 Diabetes: A Systematic Review

Journal of Personalized Medicine ◽

10.3390/jpm11030230 ◽

2021 ◽

Vol 11 (3) ◽

pp. 230

Author(s):

Mar Sempere-Bigorra ◽

Iván Julián-Rochina ◽

Omar Cauli

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Nervous System ◽

Screening Tests ◽

Cardiac Autonomic Neuropathy ◽

Blood Levels ◽

Diabetic Patients ◽

Diabetes Patients

Background: Diabetic neuropathy is defined as the dysfunction of the peripheral nervous system in diabetic patients. It is considered a microvascular complication of diabetes mellitus. Its presence is associated with increased morbidity and mortality. Although several studies have found alterations at somatic motor, sensory levels and at the level of autonomic nervous system in diabetic patients, there is not a systematic approach regarding the differences in neuropathy between the major variants of diabetes, e.g., type 1 and 2 diabetes at both neurological and molecular level. Data sources: we systematically (Medline, Scopus, and Cochrane databases) evaluated the literature related to the difference of neuropathy in type 1 and 2 diabetes, differences in molecular biomarkers. Study characteristics: seventeen articles were selected based on pre-defined eligibility criteria. Conclusions: both superficial sensitivity (primarily thermal sensitivity to cold) and deep sensitivity (such as vibratory sensitivity), have been reported mainly in type 2 diabetes. Cardiac autonomic neuropathy is one of the diabetic complications with the greatest impact at a clinical level but is nevertheless one of the most underdiagnosed. While for type 1 diabetes patients most neuropathy alterations have been reported for the Valsalva maneuver and for the lying-to-standing test, for type 2 diabetes patients, alterations have been reported for deep-breathing test and the Valsalva test. In addition, there is a greater sympathetic than parasympathetic impairment, as indicated by the screening tests for autonomic cardiac neuropathy. Regarding subclinical inflammation markers, patients with type 2 diabetes showed higher blood levels of inflammatory markers such as high-sensitivity C-reactive protein, proinflammatory cytokines IL-6, IL-18, soluble cell adhesion molecules and E-selectin and ICAM-1, than in type 1 diabetes patients. By contrast, the blood levels of adiponectin, an adipocyte-derived protein with multiple paracrine and endocrine activities (anti-inflammatory, insulin-sensitizing and proangiogenic effects) are higher in type 1 than in type 2 diabetic patients. This review provides new insights into the clinical differences in type 1 and 2 diabetes and provide future directions in this research field.

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TYK2 Promoter Variant Is Associated with Impaired Insulin Secretion and Lower Insulin Resistance in Japanese Type 2 Diabetes Patients

Genes ◽

10.3390/genes12030400 ◽

2021 ◽

Vol 12 (3) ◽

pp. 400

Author(s):

Hitoe Mori ◽

Hirokazu Takahashi ◽

Keiichiro Mine ◽

Ken Higashimoto ◽

Kanako Inoue ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Insulin Secretion ◽

Fasting Insulin ◽

C Peptide ◽

Impaired Insulin ◽

Diabetes Patients

Accumulating evidence has suggested that viral infection causes type 1 diabetes due to direct β-cell damage and the triggering of autoimmune reactivity to β cells. Here, we elucidated that the tyrosine kinase 2 (Tyk2) gene, encoding an interferon receptor signaling molecule, is responsible for virus-induced diabetes in mice, and its promoter variant confers a risk of type 1 diabetes in humans. This study investigated the relationship between a TYK2 promoter variant (TYK2PV) and insulin secretion in type 2 diabetes patients. TYK2PV status was determined using direct DNA sequencing and its associations with fasting insulin, C-peptide, and homeostatic model assessment of insulin resistance (HOMA-IR) were evaluated in type 2 diabetes patients without sulfonylurea or insulin medication. Of the 172 patients assessed, 18 (10.5%) showed TYK2PV-positivity. Their body mass index (BMI) was significantly lower than in those without the variant (23.4 vs. 25.4 kg/m2, p = 0.025). Fasting insulin (3.9 vs. 6.2 μIU/mL, p = 0.007), C-peptide (1.37 vs. 1.76 ng/mL, p = 0.008), and HOMA-IR (1.39 vs. 2.05, p = 0.006) were lower in those with than in those without the variant. Multivariable analysis identified that TYK2PV was associated with fasting insulin ≤ 5 μIU/mL (odds ratio (OR) 3.63, p = 0.025) and C-peptide ≤ 1.0 ng/mL (OR 3.61, p = 0.028), and also lower insulin resistance (HOMA-IR ≤ 2.5; OR 8.60, p = 0.042). TYK2PV is associated with impaired insulin secretion and low insulin resistance in type 2 diabetes. Type 2 diabetes patients with TYK2PV should be carefully followed in order to receive the appropriate treatment including insulin injections.

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Ankle-brachial index and diabetic neuropathy: study of 225 patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20170084 ◽

2017 ◽

Vol 75 (8) ◽

pp. 533-538 ◽

Cited By ~ 1

Author(s):

Liliana Chevtchouk ◽

Marcio Heitor Stelmo da Silva ◽

Osvaldo José Moreira do Nascimento

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Neuropathic Pain ◽

Disease Onset ◽

Ankle Brachial Index ◽

Cross Sectional Study ◽

Cross Sectional ◽

Diabetes Patients

ABSTRACT Objective To evaluate neuropathic pain and peripheral vascular disease in diabetics and compare this with the length of time since diagnosis in type 1, and type 2 diabetes. Methods A cross-sectional study with 225 diabetics chosen from their responses on the DN4 questionnaire, who were then evaluated with the ankle-brachial index (ABI), separating type 1 diabetes from type 2 diabetes. Results A higher incidence of neuropathic pain in those over 60 years of age showed an ABI > 1.3. Neuropathic pain was related to an abnormal ABI in 144 patients (64.2%). A statistically significant value was obtained in type 2 diabetes patients with more than 10 years from disease onset, 69 with altered ABI and 25 with normal ABI. There was an altered ABI (< 0.9) observed in 33% of type 1 diabetes patients and in 67% of type 2 diabetes patients. Conclusion The ABI test in type 1 diabetes and type 2 diabetes patients is important even in those who are asymptomatic. A diagnosis of more than 10 years prior, regardless of the presence of neuropathic pain or ischemic signs, altered the ABI.

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Drug Utilization Evaluation of Anti-Diabetic Medication through Prescription Monitoring

Asian Journal of Pharmaceutical Research and Development ◽

10.22270/ajprd.v7i3.537 ◽

2019 ◽

Vol 7 (3) ◽

pp. 75-77

Author(s):

Sunaina Verma ◽

Yogesh Joshi ◽

Ankita Singh

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Drug Utilization ◽

Diabetic Patients ◽

Care Hospital ◽

Prescription Monitoring ◽

Drug Utilization Evaluation ◽

Diabetes Patients

Diabetes is a chronic and potentially disabling disease that represents an important public health and clinical concern. The study was designed to assess the drug utilization evaluation of anti-diabetic medications through prescription monitoring in a tertiary care hospital at capital city Dehradun in a northern state Uttarakhand. Prescriptions from patients of diabetes were selected for the study and data was collected from patients using a questionnaire format. All the necessary and relevant information will be collected from out-patient prescriptions, laboratory data reports and also by verbal communication with patients. Out of total 100 prescriptions of diabetic patients, it was found that gender wise distribution of diabetic patients was more in females (64%) as compared to males (36%). Among 100 patients, type 1 diabetes occurred in 16% patients and type 2 diabetes occurred in 84% patients. It was also analyzed that both type 1 and type 2 diabetes were mostly occurred in females. Among type 2 diabetes patients, Glimepiride were mostly prescribed in 42% patients, followed by Metformin in 22% patients and Gliclazide in 20% while in type 1 diabetes patients, Human Insulin were prescribed in 16% patients. Prescription analysis showed that maximum prescriptions (50%) contain two drugs per prescription while six drugs per prescription were shown by only 2% prescriptions. This study may provide further help to prescribers for improvement in current prescribing trends in the management of diabetes mellitus.

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