scholarly journals A mathematical model for stratification of LADA risk groups

2014 ◽  
Vol 17 (1) ◽  
pp. 15-20
Author(s):  
Tatiana M. Tikhonova

Aim. To stratify risk groups via discriminant analysis based on the most clinically relevant indications of LADA onset derived from medical history.Materials and Methods. Present study included 141 patients with diabetes mellitus (DM) of whom 65 had preliminary diagnosis of LADA, 40 patients were diagnosed with type 1 diabetes mellitus (T1DM) and 36 ? with type 2 diabetes mellitus (T2DM). Discriminant analysis was performed to evaluate the differences between the clinical onsets in study groups.Results. Aside from torpid onset with early evidence for insulin resistance, clinical characteristics of LADA included diagnosis during random examination, progressive loss of body mass, hyperglycemia greater than 14 mmol/L at the diagnosis and, possibly, ketonuria without history of acute ketoacidosis.Conclusion. Discriminant analysis is beneficial in stratifying risk groups for the development of LADA.

2002 ◽  
Vol 49 (6) ◽  
pp. 11-16
Author(s):  
Ye. V. Surkova ◽  
M. Yu. Drobizhev ◽  
O. G. Melnikova ◽  
T. A. Zakharchuk ◽  
I. I. Dedov

The fact that there is a high prevalence of depressions among patients with diabetes mellitus (DM) is well known. However, the relationships between the nosological entities of depressions and the clinical characteristics of DM are little studied. The study was undertaken to search for such relationships. A hundred and fifty outpatients with DM (out of them 38 males, Type 2 DM was diagnosed in 102 patients) the median age was 54.0 years (25 and 75 percentiles: 43.0-61.5), the median duration of diabetes was 7.2years (2.0-15.0); the median level of HbAlc was 8.6% (7.49.7%). Depression was revealed in 50 (33%) patients. Their comparison with patients without depression indicated that there was no association with the main clinical characteristics of MD (the type and duration of the disease, the prevalence of acute and chronic complications, insulin therapy). At the same time, a comparison of three groups of patients with the major clinical forms (nosogenic, cyclothymic, and dysthymic) of diagnosed depression by using x2 revealed the following associations: between DM-1 and cyclothymic depression and between DM-2 and nosogenic and dysthymic depression (р = 0.01). Cyclothymic and dysthymic depression showed no associations with clinical characteristics of DM. The prevalence of nosogenic depression was significantly higher in patients with a history of second-three grade diabetic retinopathy (p = 0.02), arterial hypertension (p = 0.001), proteinuria (p = 0.02), myocardial infarction (p = 0.04), and foot ulcerative defects (p = 0.04). The results show that nosogenic depression are mental responses to the severe course of DM, namely to the severity of micro- and macrovascular complications. The associations between the types of DM and the clinical types of depression -cyclothymia and dysthymia - await further study. Overall general predisposition may be discussed as a possible explanation.


Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


2020 ◽  
Vol 26 (3) ◽  
pp. 305-311
Author(s):  
Janaki D. Vakharia ◽  
Sungeeta Agrawal ◽  
Janine Molino ◽  
Lisa Swartz Topor

Objective: To determine the relationship between family history of diabetes mellitus (DM) and diabetic ketoacidosis (DKA) recurrence in youth with established type 1 diabetes mellitus (T1DM). Methods: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January, 2009, and December, 2014. We compared patients with recurrent (≥2 admissions) and nonrecurrent DKA (1 admission) and investigated patient level factors, including family history, that may be associated with DKA recurrence in pediatric patients with established T1DM. Results: Of the 131 subjects in the study, 51 (39%) subjects were in the recurrence group. Age ≥15 years old, public health insurance, and family history of T1DM or type 2 diabetes mellitus were associated with recurrent DKA admissions in both univariable and multivariable analyses. Family history was associated with DKA recurrence, with an incidence rate ratio of 1.5 (95% confidence interval = 1.0 to 2.3; P = .03). The association was not explained by type of familial diabetes, first degree relative status, or whether the family member lived in the household. Conclusion: Recognition that a positive family history of DM may be associated with a higher risk for DKA recurrence in patients with established T1DM may allow for targeted education and focus on a previously unidentified population at increased risk for DKA. Understanding the mechanism underlying the effect of family history of diabetes on the rates of DKA in patients with established T1DM may allow for improved identification and education of patients who may be at risk for DKA recurrence. Abbreviations: CI = confidence interval; DKA = diabetic ketoacidosis; EHR = electronic health record; IBD = inflammatory bowel disease; IRR = incidence rate ratio; T1DM = type 1 diabetes mellitus; T2DM = type 2 diabetes mellitus


PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222607 ◽  
Author(s):  
Jakub Dworzański ◽  
Bartłomiej Drop ◽  
Ewa Kliszczewska ◽  
Małgorzata Strycharz-Dudziak ◽  
Małgorzata Polz-Dacewicz

2017 ◽  
Vol 25 (4) ◽  
pp. 443-449
Author(s):  
Claudia Camila Peruzzo Lopes ◽  
Priscila do Monte Ribeiro Busato ◽  
Maira Fernanda Michelin Mânica ◽  
Marcela Chiquetto de Araújo ◽  
Muriel Machado Marquez Zampiva ◽  
...  

2019 ◽  
pp. 01-06
Author(s):  
Argel de Jesús Concha May ◽  
Guillermo Padrón Arredondo

Introduction: Hypertriglyceridemia (HTG) is the underlying cause of pancreatitis in 7% of the general population and is the third cause after gallstones and alcohol. HTG may be associated with acute pancreatitis as an epiphenomenon or as a precipitant thereof. Generally, more than 75% of pancreatitis induced by hypertriglyceridemia is due to secondary causes and although these are not sufficient to elevate triglycerides to cause pancreatitis, a preexisting defect is required to obtain a TG>1000 mg/dL to induce acute pancreatitis. Material and Method: To identify the prevalence morbidity and mortality of acute pancreatitis due to hypertriglyceridemia, a retrospective and cross-sectional observational clinical study was performed for a period of five years. Results: During the study period, 100 cases of acute pancreatitis of various etiologies were collected, 29 (29%) of which corresponded to acute pancreatitis of hypertriglyceridemic origin; history of risk: type 1 Diabetes mellitus one case (3.4%); Type 2 Diabetes mellitus 27 cases (24%); history of alcoholism nine cases (31%); positive smoking 4 cases (13.8%); hypertriglyceridemia 27 cases (94%); obesity 17 cases (59%); lipemic serum 19 cases (65.5%), and In-hospital stays average six days. Mortality in one case. Discussion: In the Mexican national survey of ENASUT 2012, it was found by age group that hypercholesterolemia is highest in the age groups of 50-69 years of age. (Table 1) The frequency of hyperlipidemia in patients with pancreatitis ranges from 12 to 38%, and of hypertriglyceridemia, between 4 and 53%; what is important is to define whether its presence is primary or causal, or secondary or consequence of other clinical conditions such as Diabetes mellitus, alcohol abuse, pregnancy or use of medications. The triglycerides were obtained on routine laboratory tests in our hospital and their values were steadily elevated and the hipertrigliceridemic acute pancreatitis is the principal cause instead the alcoholic acute pancreatitis. Keywords: Pancreatitis acute;Hypertriglyceridemic; Prevalence; Morbidity; Mortality


2019 ◽  
Vol 4 (2) ◽  
pp. 56-60
Author(s):  
Malihe Mohammadi ◽  
Seyedeh Solmaz Moosavi

Introduction: The association between the incidence of glutamic acid decarboxylase antibodies(GADAs) and risk of diabetes in pregnant women is controversial. Here, our aim was to investigate the incidence and clinical relevance of GADA and its association with development of post-delivery diabetes in women with gestational diabetes mellitus (GDM).Methods: This cohort study was conducted in Torbat–e Heydarieh (Khorasan Razavi, Iran) from October 2015 to March 2017. A total of 147 pregnant women with GDM were included in case group. The control group consisted of 147 healthy controls. A GAD diagnostic kit (Diametra Co.,Italy) was used for diagnosis of GADA. The history of insulin therapy and the development of diabetes one year after delivery were investigated.Results: Of 147 pregnant women with GDM, 9 (6.1%) had GADA in their sera. 14.3% (21 out of 147) of women with GDM had history of insulin therapy. 33.3% (7 of 21) of women who had received insulin developed diabetes one year after delivery. Type 1 and type 2 diabetes were observed in, respectively, 1 (0.7%) and 7 (4.8%) of women with GDM at one year after delivery.At one year after delivery, no women in GADA negative women was diagnosed with type 1 diabetes. However, type 2 diabetes was observed in 2.9% of GADA negative pregnant women.Type 1 and type 2 diabetes were also noticed in, respectively, 11.1% and 33.3% of GADA positive mothers at one year after delivery.Conclusion: The prevalence of GADA was 6.1% in diabetic pregnant women. The GADA positivity and history of insulin therapy during pregnancy were significant risk factors for diabetes at one year after delivery. In addition, development of type 1 diabetes was higher in GADA positive pregnant women with GDM than GADA negative women.


2021 ◽  
Vol 12 ◽  
Author(s):  
Farzad Asadi ◽  
Savita Dhanvantari

Patients with diabetes mellitus exhibit hyperglucagonemia, or excess glucagon secretion, which may be the underlying cause of the hyperglycemia of diabetes. Defective alpha cell secretory responses to glucose and paracrine effectors in both Type 1 and Type 2 diabetes may drive the development of hyperglucagonemia. Therefore, uncovering the mechanisms that regulate glucagon secretion from the pancreatic alpha cell is critical for developing improved treatments for diabetes. In this review, we focus on aspects of alpha cell biology for possible mechanisms for alpha cell dysfunction in diabetes: proglucagon processing, intrinsic and paracrine control of glucagon secretion, secretory granule dynamics, and alterations in intracellular trafficking. We explore possible clues gleaned from these studies in how inhibition of glucagon secretion can be targeted as a treatment for diabetes mellitus.


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