scholarly journals Children with type 1 diabetes of early age at onset – immune and metabolic phenotypes

2019 ◽  
Vol 32 (9) ◽  
pp. 935-941
Author(s):  
Madalena Sales Luis ◽  
Margarida Alcafache ◽  
Sara Ferreira ◽  
Ana Laura Fitas ◽  
Joana Simões Pereira ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Disease Onset ◽  
Inverse Correlation ◽  
Early Age ◽  
Insulin Requirements ◽  
Age Related ◽  
One Year ◽  
Immune Imbalance

Abstract Objectives We aimed to evaluate children with type 1 diabetes (T1D) with early age at onset (EAO) for clinical, immune and metabolic features in order to identify age-related disease phenotypes. Methods Comparative study of two groups of T1D children: EAO (≤5 years) and later age at onset (LAO; >5 years), regarding the presence of other autoimmune (AI) diseases, diabetes ketoacidosis and immunologic profile at onset and metabolic data 1 year after diagnosis. Statistical analysis was performed with significance set for p < 0.05. Results The study included 137 children (EAO = 52, mean age 3.6 ± 1.5 [mean ± standard deviation (SD)] and LAO = 85, mean age 10.4 ± 2.9). EAO was more associated with concomitant AI diseases (p = 0.032). Despite no differences in disease onset, EAO presented with lower C-peptide levels (p = 0.01) and higher absolute lymphocyte number (p < 0.0001), with an inverse correlation between these two variables (p = 0.028). Additionally, the EAO group had a higher frequency of serum detection of three antibodies (Abs) (p = 0.0008), specifically insulin Abs (p = 0.0001). One year after diagnosis, EAO had higher total daily insulin (TDI) dose (p = 0.008), despite similar hemoglobin A1c (HbA1c). Conclusions Our data show an association of EAO T1D with more AI diseases, higher number of Abs, lower initial insulin reservoir and higher insulin requirements 1 year after diagnosis. In this group, immune imbalance seems more evident and disease progression faster, probably reflecting distinct “immune environment” with different ages at disease onset. Further studies in the field of immunogenetics and immune tolerance are required, to improve patient stratification and find novel targets for therapeutic intervention.

scholarly journals Presumption of guilt for T cells in type 1 diabetes: lead culprits or partners in crime depending on age of onset?

Diabetologia ◽  
2020 ◽  
Vol 64 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Alexia Carré ◽  
Sarah J. Richardson ◽  
Etienne Larger ◽  
Roberto Mallone
Keyword(s):  
T Cells ◽  
Type 1 Diabetes ◽  
T Cell ◽  
Beta Cells ◽  
Disease Onset ◽  
Strong Support ◽  
Islet Autoimmunity ◽  
Relative Role ◽  
Age Related

AbstractAvailable evidence provides arguments both for and against a primary pathogenic role for T cells in human type 1 diabetes. Genetic susceptibility linked to HLA Class II lends strong support. Histopathology documents HLA Class I hyperexpression and islet infiltrates dominated by CD8+ T cells. While both hallmarks are near absent in autoantibody-positive donors, the variable insulitis and residual beta cells of recent-onset donors suggests the existence of a younger-onset endotype with more aggressive autoimmunity and an older-onset endotype with more vulnerable beta cells. Functional arguments from ex vivo and in vitro human studies and in vivo ‘humanised’ mouse models are instead neutral or against a T cell role. Clinical support is provided by the appearance of islet autoantibodies before disease onset. The faster C-peptide loss and superior benefits of immunotherapies in individuals with younger-onset type 1 diabetes reinforce the view of age-related endotypes. Clarifying the relative role of T cells will require technical advances in the identification of their target antigens, in their detection and phenotyping in the blood and pancreas, and in the study of the T cell/beta cell crosstalk. Critical steps toward this goal include the understanding of the link with environmental triggers, the description of T cell changes along the natural history of disease, and their relationship with age and the ‘benign’ islet autoimmunity of healthy individuals.

Early age of disease onset in African American type 1 diabetes patients is associated with DQB1∗0201 allele

2000 ◽  
Vol 61 (8) ◽  
pp. 816-819 ◽  
Author(s):  
Noureddine Berka ◽  
Gail N Bland ◽  
Debra P Gause ◽  
Paulette F Harris ◽  
El Hajja Erabhaoui ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
African American ◽  
Disease Onset ◽  
Early Age ◽  
Diabetes Patients

scholarly journals Clinical and demographic features among patients with type 1 diabetes mellitus in Henan, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liguo Yang ◽  
Guangxing Yang ◽  
Xialian Li
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Blood Glucose Control ◽  
Disease Onset ◽  
Overweight And Obesity ◽  
Adult Onset ◽  
C Peptide ◽  
Young Onset ◽  
Onset Group

Abstract Background The hallmark of type 1 diabetes (T1D) is an absolute lack of insulin. However, many studies showed a tendency to heterogeneity in TID. We aimed to investigate the demographic and clinical characteristics in T1D and the differences in young-onset and adult-onset patients. Methods This retrospective study was conducted among 1943 patients with clinically diagnosed T1D. Medical records on patients’ demographics, anthropometric measurements, and clinical manifestation were collected. According to the age at onset, the newly diagnosed patients were divided into the young-onset group (< 18 years, 234 patients, mean age 11 years) and adult-onset group (≥ 18 years, 219 patients, mean age 27 years). Pancreatic β-cell function was assessed by fasting C-peptide (FCP) and 2-h C-peptide (2-h CP). Results The median age of patients at disease onset was 22 years. The median duration of patients was 3 years. The overall median glycated hemoglobin (HbA1c) value was 10.3 % [89(mmol/mol)]. The prevalence of diabetic retinopathy was 25.1 %. The overall rate of DKA at onset in the new-onset patients was 59.6 %. The frequency of overall dyslipidemia was 37.8 %. The most frequent dyslipidemia was low high-density lipoprotein-cholesterol (HDL) (29 %). The proportion of patients with anti-glutamic acid decarboxylase (GADA), insulin antibody (IAA) and islet cell antibody (ICA) were 28.1 %, 6.4 % and 21.6 %, respectively. The mean HbA1c showed a downward trend with age. Increasing or decreasing trends of overweight and obesity in this population during the period 2012 to 2018 was not found. Compared with young-onset T1D, adult-onset patients comprised better islet function (FCP: 0.4 vs. 0.3 ng/ml, P < 0.001; 2-h CP: 0.9 vs. 0.7 ng/ml P < 0.001, respectively) and glycemic control [12.9 % (117mmol/mol) vs. 11.7 % (104mmol/mol), P < 0.001], higher prevalence of diabetes condition in the male gender (64.4 % vs. 51.3 %, P = 0.006), higher proportion of obesity or overweight (24.6 % vs. 9.5 %, P = 0.002), higher frequency of GADA (33.7 % vs. 23.3 %, P = 0.025), and lower frequency of diabetic ketoacidosis at disease onset (64.5 % vs. 43.5 %, P < 0.001). Conclusions This population was characterized by poor overall blood glucose control, high prevalence of DKA, dyslipidemia and diabetic retinopathy, and low prevalence of islet-related antibodies, and overweight or obesity. Adult-onset patients with T1D were not uncommon and had better clinical manifestations than young-onset patients. Any findings related to body mass index (BMI) and autoantibodies should be considered strictly exploratory due to excessive missing data.

scholarly journals Gender-Specific Risk Factors for the Development of Retinal Changes in Children with Type 1 Diabetes

2021 ◽  
Vol 11 (6) ◽  
pp. 588
Author(s):  
Marta Wysocka-Mincewicz ◽  
Joanna Gołębiewska ◽  
Marta Baszyńska-Wilk ◽  
Andrzej Olechowski
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Uric Acid ◽  
Serum Creatinine ◽  
Regression Models ◽  
Retinal Thickness ◽  
Disease Onset ◽  
Specific Risk ◽  
Gender Specific

The aim of the study was to determine gender-specific risk factor sets which could influence optical coherence tomography (OCT) results in children with type 1 diabetes (T1D). Material and Methods: 175 children with T1D without symptoms of diabetic retinopathy were enrolled, but 330 eyes were used for the final analysis (168 children, mean age 12.81 ± 3.63 years, diabetes duration 4.59 ± 3.71 years). The multivariate regression models for retinal thickness (foveal FT, and parafoveal PFT) and vascular densities (superficial and deep) were carried out separately for both genders using all metabolic and demographic parameters. Results: In the statistically significant multiple regression models for all analyzed OCT parameters for both genders, pH at the onset of diabetes were in existence, as well as for retinal thickness current HbA1c. Duration of continuous insulin infusion (CSII) was an important factor in all parameters, except PFT. For the girls, the most significant factors were daily insulin dose, uric acid, and triglycerides, but for the boys, it was serum creatinine, systolic pressure, and free thyroxine level. Conclusions: We detected significant risk factors set for development of OCT parameters changes, and they were not identical for both genders. Current metabolic control, diabetic ketoacidosis at the disease onset, serum creatinine and longer use of CSII are the most important factors for retinal thickness and vessel densities in both genders in children with type 1 diabetes. For the girls, elements of metabolic syndrome (uric acid and triglycerides) and parameters of insulin amount were more pronounced.

scholarly journals Neuropsychological Profiles of Children With Type 1 Diabetes 6 Years After Disease Onset

Diabetes Care ◽  
2001 ◽  
Vol 24 (9) ◽  
pp. 1541-1546 ◽  
Author(s):  
E. A. Northam ◽  
P. J. Anderson ◽  
R. Jacobs ◽  
M. Hughes ◽  
G. L Warne ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Disease Onset

Negative association between type 1 diabetes and HLA DQB1*0602-DQA1*0102 is attenuated with age at onset

1999 ◽  
Vol 26 (2-3) ◽  
pp. 117-127
Author(s):  
Jinko Graham ◽  
Ingrid Kockum ◽  
Carani B. Sanjeevi ◽  
Mona Landin-Olsson ◽  
Lennarth Nyström ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Negative Association

Vestibular Function in Children with Type 1 Diabetes: Videonystagmography Testing

2021 ◽  
pp. 1-9
Author(s):  
Sherifa A. Hamed ◽  
Ali F. ElHadad ◽  
Amira M. Oseily
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Multiple Logistic Regression Analysis ◽  
Age At Onset ◽  
Vestibular Function ◽  
Multiple Logistic Regression ◽  
Duration Of Illness ◽  
Control And Prevention ◽  
Hba1c Levels

<b><i>Background:</i></b> Vestibular system is critical for maintaining balance and learning complex tasks. This study aimed to determine the frequencies, types, and predictors of vestibular dysfunctions (VDs) in children with type 1 diabetes (T1D) using videonystagmography (VNG). <b><i>Patients and Methods:</i></b> This study included 65 patients (children with T1D = 40; controls = 25). The patients underwent VNG. <b><i>Results:</i></b> Patients (boys = 15; girls = 25) had a mean age of 14.05 ± 1.82 years and duration of illness of 6.30 ± 2.84 years. The majority had frequent attacks of diabetic ketoacidosis (DKA) (65%) and hypoglycemia (40%). Dizziness was reported in 20%. VNG abnormalities were reported in 70% (<i>n</i> = 28), of them 71.43 and 28.57% had central and peripheral VDs, respectively. Dizziness was associated with peripheral VD. Compared to patients without VDs, those with VDs were older and had earlier age at onset and longer duration of diabetes (&#x3e;5 years), higher levels of HbA1c (&#x3e;7%), higher frequencies of DKA and hypoglycemic attacks, comorbid medical conditions, and diabetic complications. Multiple logistic regression analysis showed that presence of VNG abnormalities (VDs) was independently correlated with diabetes duration &#x3e;5 years (odds ratio [OR] = 4.52 [95% confidence interval [CI] = 3.55–7.04], <i>p</i> = 0.001), HbA1c% levels &#x3e;7% (OR = 3.42 [95% CI = 2.84–5.75], <i>p</i> = 0.001), and presence of hypoglycemic attacks (OR = 4.65 [95% CI = 2.85–7.55]). <b><i>Conclusions:</i></b> -VDs are prevalent in children with T1D and correlated with the duration and severity of diabetes and the occurrence of hypoglycemic attacks. Therefore, optimizing glycemic control and prevention and treatment of diabetic complications and comorbidities are important. Multidisciplinary follow-ups are required for early detection and management of diabetic VDs.

Use and Perception of Telemedicine in People with Type 1 Diabetes during the COVID-19 Pandemic: A One Year Follow-Up

2021 ◽  
Author(s):  
Sam Scott ◽  
Federico Fontana ◽  
Simon Helleputte ◽  
Jordan Pickles ◽  
Markus Laimer ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
One Year
Sign in / Sign up

Export Citation Format

Share Document