scholarly journals Specific features of pregnancy in patients with type 1 diabetes in the prepubertal period. Results of a 15-year long clinical observation

2009 ◽  
Vol 12 (4) ◽  
pp. 28-31
Author(s):  
Lyubov' Leonidovna Bolotskaya ◽  
Natalya Vladimirovna Efremova ◽  
Yury Ivanovich Suntsov
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Insulin Dose ◽  
Research Centre ◽  
Nocturnal Hypoglycemia ◽  
Significant Difference ◽  
Before And After ◽  
Pregnancy And Delivery ◽  
The Difference

Aim. To evaluate effect of different factors on pregnancy course in patients with type 1 diabetes mellitus developing in the prepubertal period. Materials and methods. The study based at Endocrinological Research Centre included 77 women with prepubertal diabetes 18 of whom developedpregnancy that ended in delivery. Results. As per 2009, the age of the patients is 26,6?4,6 years. They became pregnant at 23,2?3,3 years and had had diabetes since the age of9,6?4,8 years. Their HbA1c level before and after pregnancy was 8,6?1,4 and 6,8?1,6% respectively, the difference being insignificant (p=0,3).Significant difference was documented between these HbA1c levels and that during pregnancy (p=0,0004 and 0.003 respectively). Nine (56,2%) patientsused ultrashort-acting insulin analogs and the remaining 7 (43,7%) recombinant human insulins. The mean insulin dose was 43,7?11 U/din the 1st trimester, 51,8?13,7 U/d in the 2bd trimester, and 45,3?10,8 U/d after delivery. 16 (88%) of the patients reported frequent hypoglycemia,five (27,8%) of them had episodes of severe daytime and nocturnal hypoglycemia. 11 (61%) developed microvascular diabetic complications beforepregnancy, with 9 (50%) having DR and 4 (22,2%) DN (microalbuminuria). The delivery occurred on weeks 36-37 in 7 (38,9%) women. Naturaland cesarean section deliveries took place in one and 17 (94,4%) patients respectively. Conclusion. Long-term follow-up of patients wit DM1 in accordance with algorithms of specialized medical aid to DM1 patients in Russia at a multidisciplinaryendocrinological centre decreases the risk of pregnancy and delivery complications and that of microvascular diabetic complications

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

scholarly journals A pilot interventional study to evaluate the impact of cholecalciferol treatment on HbA1c in type 1 diabetes (T1D)

2017 ◽  
Vol 6 (4) ◽  
pp. 225-231 ◽  
Author(s):  
R Perchard ◽  
L Magee ◽  
A Whatmore ◽  
F Ivison ◽  
P Murray ◽  
...  
Keyword(s):  
Vitamin D ◽  
Type 1 Diabetes ◽  
South Asian ◽  
Negative Relationship ◽  
Late Winter ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

Background Higher 25(OH)D3 levels are associated with lower HbA1c, but there are limited UK interventional trials assessing the effect of cholecalciferol on HbA1c. Aims (1) To assess the baseline 25(OH)D3 status in a Manchester cohort of children with type 1 diabetes (T1D). (2) To determine the effect of cholecalciferol administration on HbA1c. Methods Children with T1D attending routine clinic appointments over three months in late winter/early spring had blood samples taken with consent. Participants with a 25(OH)D3 level <50 nmol/L were treated with a one-off cholecalciferol dose of 100,000 (2–10 years) or 160,000 (>10 years) units. HbA1c levels before and after treatment were recorded. Results Vitamin D levels were obtained from 51 children. 35 were Caucasian, 11 South Asian and 5 from other ethnic groups. 42 were vitamin D deficient, but 2 were excluded from the analysis. All South Asian children were vitamin D deficient, with mean 25(OH)D3 of 28 nmol/L. In Caucasians, there was a negative relationship between baseline 25(OH)D3 level and HbA1c (r = −0.484, P < 0.01). In treated participants, there was no significant difference in mean HbA1c at 3 months (t = 1.010, P = 0.328) or at 1 year (t = −1.173, P = 0.248) before and after treatment. One-way ANCOVA, controlling for age, gender, ethnicity, BMI and diabetes duration showed no difference in Δ HbA1c level. Conclusion We report important findings at baseline, but in children treated with a stat dose of cholecalciferol, there was no effect on HbA1c. Further studies with larger sample sizes and using maintenance therapy are required.

scholarly journals FUNCTIONING OF NO-CYCLE IN THE SALIVA OF CHILDREN WITH TYPE 1 DIABETES MELLITUS

2021 ◽  
Vol 78 (4) ◽  
pp. 34-39
Author(s):  
Iryna Kuz ◽  
Oleh Akimov ◽  
Vitalii Kostenko ◽  
Olga Sheshukova ◽  
Alina Maksymenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
No Synthase ◽  
Tissue Homogenate ◽  
Before And After ◽  
Systemic Factor ◽  
The Difference ◽  
Microsoft Office

Introduction. The presence of type 1 diabetes mellitus in children is a major risk factor for periodontal disease. The aim of research work was to determine the activity of NO-synthase and arginase in saliva in children age with insulin-dependent diabetes mellitus. Materials and methods We examined 82 children including 56 children with type 1 diabetes mellitus and 26 children without somatic diseases. NO-synthase (NOS) activity was determined by the difference in nitrite concentration before and after incubation of tissue homogenate. Determining arginase activity was based on analysis the difference in the concentration of L-ornithine before and after incubation in phosphate buffer solution. Statistical processing was performed using Microsoft Office Excel. Research results and their discussion The violation of the indicators’ balance between groups 1 and 3 showed us a decrease in regenerative capacity in the mucous membrane in persons with type 1 diabetes mellitus. Increased ARG activity in group 4 children may lead to rivarly between NOS and ARG for L-arginine. Increased ARG activity in groups 2 and 4 compared with group 1 indicated an adaptive response aimed at repairing gum damage. Based on this, increased NO production from NOS is a consequence of insulin deficiency (systemic factor). Conclusions. The combination of systemic factor (type 1 diabetes mellitus) and local (chronic catarrhal gingivitis) leads to dysregulation of the NO-cycle and increasing of competition between NOS and ARG. ФУНКЦИОНИРОВАНИЕ NO-ЦИКЛА В СЛЮНЕ У ДЕТЕЙ С САХАРНЫМ ДИАБЕТОМ І ТИПА Кузь И.А., Акимов О.Е., Костенко В.А., Шешукова О.В., Максименко А.И., Писаренко Е.А. Полтавский государственный медицинский университет Вступление. Наличие у детей сахарного диабета І типа является основным фактором риска заболеваний пародонта. Целью исследования было определение активности NO-синтазы и аргиназы в слюне у детей с инсулинозависимым сахарным диабетом. Материалы и методы. Обследовано 82 ребенка, в том числе 56 детей с сахарным диабетом І типа и 26 детей без соматических заболеваний. Активность NO-синтазы (NOS) определяли по разнице в концентрации нитрита до и после инкубации гомогената ткани. Определение активности аргиназы основывалось на анализе разницы в концентрации L-орнитина до и после инкубации в фосфатном буферном растворе. Статистическая обработка проводилась с использованием Microsoft Office Excel. Результаты исследований и их обсуждение. Нарушение баланса показателей между 1 и 3 группами свидетельствовало о снижении регенерационной способности слизистой оболочки у лиц с сахарным диабетом І типа. Повышенная активность ARG у детей группы 4 может привести к неравенству между NOS и ARG для L-аргинина. Повышенная активность ARG в группах 2 и 4 по сравнению с группой 1 указала на адаптивный ответ, направленный на восстановление повреждений десен. Исходя из этого, повышенная продукция NO из NOS является следствием дефицита инсулина (системный фактор). Выводы. Сочетание системного фактора (сахарный диабет І типа) и местного (хронический катаральный гингивит) приводит к нарушению регуляции NO-цикла и усилению конкуренции между NOS и ARG.

scholarly journals A Pilot Study of Flat and Circadian Insulin Infusion Rates in Continuous Subcutaneous Insulin Infusion (CSII) in Adults with Type 1 Diabetes (FIRST1D)

2020 ◽  
pp. 193229682090619
Author(s):  
Siân Rilstone ◽  
Monika Reddy ◽  
Nick Oliver
Keyword(s):  
Type 1 Diabetes ◽  
Pilot Study ◽  
Insulin Infusion ◽  
Insulin Dose ◽  
Total Daily Dose ◽  
Subcutaneous Insulin ◽  
Basal Rate ◽  
Absolute Change ◽  
Significant Difference

Background: Initiation of continuous subcutaneous insulin therapy (CSII) in type 1 diabetes requires conversion of a basal insulin dose into a continuous infusion regimen. There are limited data to guide the optimal insulin profile to rapidly achieve target glucose and minimize healthcare professional input. The aim of this pilot study was to compare circadian and flat insulin infusion rates in CSII naïve adults with type 1 diabetes. Methods: Adults with type 1 diabetes commencing CSII were recruited. Participants were randomized to circadian or flat basal profile calculated from the total daily dose. Basal rate testing was undertaken on days 7, 14 and 28 and basal rates were adjusted. The primary outcome was the between-group difference in absolute change in insulin basal rate over 24 hours following three rounds of basal testing. Secondary outcomes included the number of basal rate changes and the time blocks. Results: Seventeen participants (mean age 33.3 (SD 8.6) years) were recruited. There was no significant difference in absolute change in insulin basal rates between groups ( P = .85). The circadian group experienced significant variation in the number of changes made with the most changes in the morning and evening ( P = .005). The circadian group received a greater reduction in total insulin (−14.1 (interquartile range (IQR) −22.5-12.95) units) than the flat group (−7.48 (IQR −11.90-1.23) units) ( P = .021). Conclusion: The initial insulin profile does not impact on the magnitude of basal rate changes during optimization. The circadian profile requires changes at specific time points. Further development of the circadian profile may be the optimal strategy.

scholarly journals Study protocol: Minimum effective low dose: anti-human thymocyte globulin (MELD-ATG): phase II, dose ranging, efficacy study of antithymocyte globulin (ATG) within 6 weeks of diagnosis of type 1 diabetes

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053669
Author(s):  
Charlotte S Wilhelm-Benartzi ◽  
Sarah E Miller ◽  
Sylvaine Bruggraber ◽  
Diane Picton ◽  
Mark Wilson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Antithymocyte Globulin ◽  
Low Dose ◽  
Insulin Dose ◽  
Double Blind ◽  
C Peptide ◽  
Link Type ◽  
Significant Difference ◽  
Allocation Ratio

IntroductionType 1 diabetes (T1D) is a chronic autoimmune disease, characterised by progressive destruction of the insulin-producing β cells of the pancreas. One immunosuppressive agent that has recently shown promise in the treatment of new-onset T1D subjects aged 12–45 years is antithymocyte globulin (ATG), Thymoglobuline, encouraging further exploration in lower age groups.Methods and analysisMinimal effective low dose (MELD)-ATG is a phase 2, multicentre, randomised, double-blind, placebo-controlled, multiarm parallel-group trial in participants 5–25 years diagnosed with T1D within 3–9 weeks of planned treatment day 1. A total of 114 participants will be recruited sequentially into seven different cohorts with the first cohort of 30 participants being randomised to placebo, 2.5 mg/kg, 1.5 mg/kg, 0.5 mg/kg and 0.1 mg/kg ATG total dose in a 1:1:1:1:1 allocation ratio. The next six cohorts of 12–15 participants will be randomised to placebo, 2.5 mg/kg, and one or two selected middle ATG total doses in a 1:1:1:1 or 1:1:1 allocation ratio, as dependent on the number of middle doses, given intravenously over two consecutive days. The primary objective will be to determine the changes in stimulated C-peptide response over the first 2 hours of a mixed meal tolerance test at 12 months for 2.5 mg/kg ATG arm vs the placebo. Conditional on finding a significant difference at 2.5 mg/kg, a minimally effective dose will be sought. Secondary objectives include the determination of the effects of a particular ATG treatment dose on (1) stimulated C-peptide, (2) glycated haemoglobin, (3) daily insulin dose, (4) time in range by intermittent continuous glucose monitoring measures, (5) fasting and stimulated dry blood spot (DBS) C-peptide measurements.Ethics and disseminationMELD-ATG received first regulatory and ethical approvals in Belgium in September 2020 and from the German and UK regulators as of February 2021. The publication policy is set in the INNODIA (An innovative approach towards understanding and arresting Type 1 diabetes consortium) grant agreement (www.innodia.eu).Trial registration numberNCT03936634; Pre-results.

scholarly journals Physiological Characteristics of Type 1 Diabetes Patients during High Mountain Trekking

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Bartłomiej Matejko ◽  
Andrzej Gawrecki ◽  
Marta Wróbel ◽  
Jerzy Hohendorff ◽  
Teresa Benbenek-Klupa ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Dose ◽  
Time Frame ◽  
Physiological Characteristics ◽  
High Mountain ◽  
Good Glycemic Control ◽  
Glucose Levels ◽  
Daily Insulin Dose ◽  
Significant Difference

In this study, the aim was to provide observational data from an ascent to the summit of Mount Damavand (5670 meters above sea level (m.a.s.l), Iran) by a group of people with type 1 diabetes (T1DM), with a focus on their physiological characteristics. After a 3-day expedition, 18 T1DM patients, all treated with personal insulin pumps, successfully climbed Mount Damavand. Information was collected on their physiological and dietary behaviors, as well as medical parameters, such as carbohydrate consumption, glucose patterns, insulin dosing, and the number of hypo- and hyperglycemic episodes during this time frame. The participants consumed significantly less carbohydrates on day 3 compared to day 1 (16.4 vs. 23.1 carbohydrate units; p=0.037). Despite this, a gradual rise in the mean daily glucose concentration as measured with a glucometer was observed. Interestingly, the patients did not fully respond to higher insulin delivery as there was no significant difference in mean daily insulin dose during the expedition. There were more hyperglycemic episodes (≥180 mg/dL) per patient on day 3 vs. day 1 (p<0.05) and more severe hyperglycemic episodes (>250 mg/dL) per patient on days 2 (p<0.05) and 3 (p<0.05) vs. day 1. In summary, high mountain trekking is feasible for T1DM patients with good glycemic control and no chronic complications. However, some changes in dietary preferences and an observable rise in glucose levels may occur. This requires an adequate therapeutic response.

The Empowerment Ladder: Understanding transition across leadership stages in individuals with type 1 diabetes and other noncommunicable diseases

2021 ◽  
pp. 001789692098383
Author(s):  
Mark Thomaz Ugliara Barone ◽  
Matheus Chaluppe ◽  
Pedro Ripoli ◽  
Bruna Talita Patricio ◽  
Bruna Letícia Souza Lima ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Active Role ◽  
Health Condition ◽  
Noncommunicable Diseases ◽  
Youth Leaders ◽  
Before And After ◽  
The Difference ◽  
Stage 1 ◽  
Internal And External Factors

Background: Acceptance and adjustment to lifelong noncommunicable diseases (NCDs) pose a great challenge for individuals living with these conditions. Diabetes is one of the most prevalent NCDs, with type 1 diabetes usually diagnosed during childhood. Self-leadership is linked to internal and external factors that may motivate individuals with NCDs to play an active role as changemakers in their community or society. The Young Leaders in Diabetes (YLD) training, created to equip young people with skills that would benefit the population to which they belong, uses the Empowerment Ladder as a framework to identify their position relative to three leadership stages (self, community and society). Objective: To describe the stages and the ‘climbing’ process of the Empowerment Ladder and assess its suitability as a framework for use in a leadership training context. Method: From among 29 youth leaders who participated, 15 were selected (5 men and 10 women) and had their community engagement and activity analysed before and after training. Individuals were positioned on the Empowerment Ladder according to their past and current roles and activities. The difference between pre- and post-training test grades (delta scores) was calculated. Results: Post-training scores were significantly higher than pre-training scores (8.9 ± 0.54 vs 7.6 ± 1.08, p = .00084). Most individuals moved to a higher step on the Empowerment Ladder; however, three individuals, with delta scores lower than the median (0.1, 0.15 and 0.85) remained at their pre-YLD training level. Only one individual moved from Stage 1 (self) to Stage 3 (society). Another individual occupied two different steps at Stages 1 and 2 simultaneously because, although they demonstrated community leadership, they had not yet accepted their own health condition. Conclusion: The Empowerment Ladder proved a useful tool for identifying stages from self to broader levels of leadership in individuals living with type 1 diabetes. These initial findings need to be validated with a larger population, which includes other NCD groups.

scholarly journals Continuous Glucose and Heart Rate Monitoring in Young People with Type 1 Diabetes: An Exploratory Study about Perspectives in Nocturnal Hypoglycemia Detection

Metabolites ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 5
Author(s):  
Valeria Calcaterra ◽  
Pietro Bosoni ◽  
Lucia Sacchi ◽  
Gian Vincenzo Zuccotti ◽  
Savina Mannarino ◽  
...  
Keyword(s):  
Heart Rate ◽  
Type 1 Diabetes ◽  
Exploratory Study ◽  
Glucose Monitoring ◽  
Nocturnal Hypoglycemia ◽  
Significant Difference ◽  
Study Support ◽  
Almost All ◽  
Fitness Trackers

A combination of information from blood glucose (BG) and heart rate (HR) measurements has been proposed to investigate the HR changes related to nocturnal hypoglycemia (NH) episodes in pediatric subjects with type 1 diabetes (T1D), examining whether they could improve hypoglycemia prediction. We enrolled seventeen children and adolescents with T1D, monitored on average for 194 days. BG was detected by flash glucose monitoring devices, and HR was measured by wrist-worn fitness trackers. For each subject, we compared HR values recorded in the hour before NH episodes (before-hypoglycemia) with HR values recorded during sleep intervals without hypoglycemia (no-hypoglycemia). Furthermore, we investigated the behavior after the end of NH. Nine participants (53%) experienced at least three NH. Among these nine subjects, six (67%) showed a statistically significant difference between the before-hypoglycemia HR distribution and the no-hypoglycemia HR distribution. In all these six cases, the before-hypoglycemia HR median value was higher than the no-hypoglycemia HR median value. In almost all cases, HR values after the end of hypoglycemia remained higher compared to no-hypoglycemia sleep intervals. This exploratory study support that HR modifications occur during NH in T1D subjects. The identification of specific HR patterns can be helpful to improve NH detection and prevent fatal events.

scholarly journals Serological markers of coeliac disease in the children and adolescents with type 1 diabetes mellitus

2011 ◽  
Vol 57 (5) ◽  
pp. 9-14
Author(s):  
E O Khennessi ◽  
Ia S Zvereva ◽  
S M Stepanova ◽  
A V Il'in ◽  
T L Kuraeva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Coeliac Disease ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Deficiency Anemia ◽  
Research Centre ◽  
Serological Markers ◽  
Significant Difference

We have studied the frequency of antibodies, markers of coeliac disease, in the children presenting with type 1 diabetes mellitus and obtained clinical and metabolic characteristics of seropositive and seronegative groups. The study included 499 diabetic children and adolescents admitted to the Pediatric Department of the Endocinological Research Centre. They were examined for the presence of anti-gliadin antibodies (anti-GL) and antibodies against tissue transglutaminase (anti-TG). These serological markers of coeliac disease were detected in 7.4% of the patients. More specific anti-TG occurred in 3.2% of the cases. As many as 29.7% of the seropositive patients with DM1 had gastrointestinal symptoms, such as stool disturbances, abdominal distension and pain, vomiting, and reduced appetite. Similar symptoms were documented in 11.7% of the seronegative children. Iron deficiency anemia was diagnosed in 24.3 and 8.6% of the seropositive and seronegative patients respectively (p<0.05). There was no significant difference between the children with type 1 diabetes mellitus having serological markers of coeliac disease and the seronegative patients in terms of anthropometric characteristics, plasma levels of glycated hemoglobin and vitamin D. It is concluded that the presence of serological markers of coeliac disease is association with a number of clinical manifestations confirms the necessity of immunological screening for coeliac disease among patients with DM1.

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