Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fernando A. Munoz ◽  
Cindy Chin ◽  
Samantha A. Kops ◽  
Katie Kowalek ◽  
Michael D. Seckeler
Keyword(s):  
Length Of Stay ◽  
Healthcare Utilization ◽  
Type I Diabetes ◽  
Hospital Charges ◽  
Type I ◽  
Bonferroni Correction ◽  
Psychiatric Illnesses ◽  
Severe Diabetes ◽  
Increased Risk

AbstractObjectivesType I diabetes mellitus (T1DM) is one of the most common chronic diseases of childhood. Diabetic ketoacidosis (DKA) in this population contributes to significant healthcare utilization, including emergency room visits, hospitalizations, and ICU care. Comorbid psychiatric illnesses (CPI) are additional risks for increased healthcare utilization. While CPI increased risk for DKA hospitalization and readmission, there are no data evaluating the relationship between CPI and hospital outcomes. We hypothesized that adolescents with T1DM and CPI admitted for DKA have increased length of stay (LOS) and higher charges compared to those without CPI.MethodsRetrospective review of 2000–2012 Healthcare Cost and Utilization Project’s (HCUP) Kids’ Inpatient Databases (KID). Patients 10–21 years old admitted with ICD-9 codes for DKA or severe diabetes (250.1–250.33) with and without ICD-9 codes for depression (296–296.99, 311) and anxiety (300–300.9). Comparisons of LOS, mortality, and charges between groups (No CPI, Depression and Anxiety) were made with one way ANOVA with Bonferroni correction, independent samples Kruskal-Wallis test with Bonferroni correction and χ2.ResultsThere were 79,673 admissions during the study period: 68,573 (86%) No CPI, 8,590 (10.7%) Depression and 12,510 (15.7%) Anxiety. Female patients comprised 58.2% (n=46,343) of total admissions, 66% of the Depression group, and 71% of the Anxiety group. Patients with depression or anxiety were older and had longer LOS and higher mean charges (p<0.001 for both).ConclusionComorbid depression or anxiety are associated with significantly longer LOS and higher charges in adolescents with T1DM hospitalized for DKA. This study adds to the prior findings of worse outcomes for patients with both T1DM and CPI, emphasizing the importance of identifying and treating these comorbid conditions.

scholarly journals Platelet Activation and Platelet–Leukocyte Aggregates in Type I Diabetes Mellitus

2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 230S-239S ◽  
Author(s):  
Asmaa M. Zahran ◽  
Omnia El-Badawy ◽  
Ismail L. Mohamad ◽  
Deiaaeldin M. Tamer ◽  
Safwat M. Abdel-Aziz ◽  
...  
Keyword(s):  
Platelet Activation ◽  
Type I Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Control Group ◽  
Type I ◽  
Platelet Activity ◽  
Increased Risk

Hyperglycemia alone may not explain the increased risk of cardiovascular diseases (CVDs) in patients with type 1 diabetes (T1D) compared with type 2. This study emphases on the evaluation of some platelet activity markers in patients with T1D, with relevance to some metabolic disorders as hyperlipidemia and hyperglycemia. This study was performed on 35 patients with T1D and 20 healthy controls. All participants were subjected to full history taking, clinical examination and assay of glycated hemoglobin (HbA1c), and lipid profile. The expression of CD62P and CD36 on platelets and the frequency of platelet–monocyte, and platelet–neutrophil aggregates were assessed by flow cytometry. Patients showed significantly higher expression of CD62P and CD36 than the control group. Platelets aggregates with monocytes were also higher among patients than the control group. Levels of CD36+ platelets, CD62P+ platelets, and platelet–monocyte aggregates revealed significant correlations with the levels of HbA1c, total cholesterol, low-density lipoprotein, and triglycerides. Hyperlipidemia and hyperglycemia accompanying T1D have a stimulatory effect on platelet activation which probably makes those patients vulnerable to CVD than nondiabetics.

scholarly journals Vitamin D and Type I Diabetes

2018 ◽  
Vol 12 (1) ◽  
pp. 289-299 ◽  
Author(s):  
Silvia Savastio ◽  
Francesco Cadario ◽  
Sheila Beux ◽  
Alberto Giorgis ◽  
Giulia Genoni ◽  
...  
Keyword(s):  
Vitamin D ◽  
Immune Response ◽  
Type 1 Diabetes ◽  
Autoimmune Diseases ◽  
Immune Modulation ◽  
Type I Diabetes ◽  
Type I ◽  
Increased Risk ◽  
Vitamin D Levels

Vitamin D is a fat-soluble vitamin that plays an important role in bone metabolism but is also endowed with the capability of modulating inflammatory and immune function. Recent studies reported a relationship between low vitamin D levels and several autoimmune diseases such as Type 1 Diabetes. Vitamin D regulates the expression of over 200 genes, also related to immune modulation, suggesting a putative role in these diseases pathogenesis. This review overviews the most recent advances on the association between vitamin D and increased risk of Type 1 Diabetes as well as between vitamin D and either glucose homeostasis or insulin sensitivity. The effects of vitamin D in modulating the immune response and balancing anti-inflammatory cytokines, suggest that vitamin D system may represent an unforeseen target for the design of novel strategies for the treatment of patients with autoimmune diseases and in particular Type 1 Diabetes.

Antidiabetic effect of Psychotria malayana Jack in induced type 1 diabetic rat

MEDISAINS ◽  
2020 ◽  
Vol 18 (1) ◽  
pp. 19
Author(s):  
Fairuz Fairuz ◽  
Hasna Dewi ◽  
Humaryanto Humaryanto
Keyword(s):  
Blood Glucose ◽  
Side Effects ◽  
Type I Diabetes ◽  
Langerhans Cell ◽  
Diabetic Rat ◽  
Type I ◽  
Antidiabetic Effect ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: Therapies for hyperglycemic treatment, including insulin and oral diabetes medications, have been confirmed to cause several side effects. Thus, finding new drugs with fewer side effects is of high importance. Salung leaf herb (Psychotria malayana Jack) reported used in traditional societies as a treatment for diabetes. However, the scientific proof of this plant for diabetes treatment is still lacking.Objective: To evaluate the antidiabetic effect of the P. malayana jack in induced type 1 diabetic rats by assessing blood glucose level and pancreatic cells in white rats.Methods: Alloxan used to induce type I diabetes. Rats randomly divided into six groups. A Group P1 received 250 mg/kg BW; group P2 received 500 mg/kg BW, group P3 received 1000 mg/kg BW. While group 4 basal received no treatment, group 5 received distilled water as a negative control, and group 6 received glibenclamide as a positive control. Medications are given for six days. Glucose levels were measured, and observation of pancreatic Langerhans cell damages.Results:  A decrease in blood glucose levels observed in all treatment groups. The most significant reduction (49.76%; 1000 mg/kg BW) occurred in the P3 group. Morphological features of pancreatic Langerhans cell damage were slightly high in the P1 group.Conclusion: P. malayana Jack can consider having an antidiabetic effect in a type 1 diabetic rat by reducing blood glucose levels.

scholarly journals Exploring perceptions and use of the patient portal by young adults with type 1 diabetes: A qualitative study

2020 ◽  
Vol 26 (4) ◽  
pp. 2586-2596
Author(s):  
Kathy K Marsh ◽  
Ruth A Bush ◽  
Cynthia D Connelly
Keyword(s):  
Qualitative Study ◽  
Emerging Adults ◽  
Chronic Conditions ◽  
Type I Diabetes ◽  
Chronically Ill ◽  
Chronic Illnesses ◽  
Self Management ◽  
Type I ◽  
Patient Portal

Emerging adults have been raised in the digital age and are therefore prime candidates for using a patient portal to manage chronic conditions. The limited body of research both identifies the underutilization of the patient portal and suggests increased use of the portal for the chronically ill as a tool to alleviate caregiver stress, as well as a potential modality to assist emerging adults to manage their chronic illnesses. This qualitative study was completed to obtain an understanding of emerging adults familiarity with the electronic patient portal and to elicit the perception of the usefulness of the portal to support self-management of type I diabetes. Findings provide a preliminary understanding of how a sampling of emerging adults with type I diabetes uses, perceives the benefits of, and wants to improve technology for diabetes self-management.

scholarly journals Health related quality of life among children with Type I diabetes, Assiut city, Egypt

2017 ◽  
Vol 7 (10) ◽  
pp. 73 ◽  
Author(s):  
Marzoka A. Gadallah ◽  
Taghreed Abdul-Aziz M. Ismail ◽  
Naglaa Saad Abdel Aty
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Health Insurance ◽  
Type I Diabetes ◽  
Type I ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Objective: Health related quality of life (HRQOL) is a multidimensional construct that includes physical and psychosocial functioning, has emerged as an important outcome in pediatric population with chronic health conditions. The study objectives are to measure the quality of life among children with type I diabetes compared to healthy peers and to determine factors affecting the QOL among children with type I diabetes.Methods: Analytic cross sectional study was conducted in Sidi Galal health insurance outpatient clinic for children with type 1 diabetes mellitus and a comparison group of healthy peers was taken from other outpatient clinics. A total of four hundred and twelve children, aged from 8-18 years with type 1 diabetes and four hundred and twelve healthy peers matched in age and sex were interviewed. Three tools were used for this study: Demographic questionnaire, Socio-economic scale, and Peds QL4.0 Generic Core Scale was used to measure HRQOL.Results: The mean age of studied children was 12.9 ± 3.2. More than 60% of children with diabetes had uncontrolled glycemic level and 60% of them were in low socio-economic level. Children with diabetes had significantly lower HRQOL than healthy children in all domains. Age, glycemic control status and birth order of the diabetic children showed no significance difference regarding the QOL. Disease duration affected only the emotional function of the QOL and females showed significantly higher score regarding school functioning. Social, school and the total QOL scores were significantly higher among children with highly educated mothers while father's education affected the emotional, school and total QOL scores. Children in the middle and high social class showed significantly higher scores regarding social, school and total QOL. Presence of diabetic parent positively affected the social functioning while had negative effect on the school function of children with type I diabetes.Conclusions and recommendations: Diabetes is negatively affecting all the QOL functioning of the children. We recommend that Integrated programs between child's home, school and health insurance clinics for educating and supporting children with diabetes to improve their HRQOL.

Suppressor of cytokine signaling 2 (SOCS2) deletion protects against multiple low dose streptozotocin-induced type 1 diabetes in adult male mice

2016 ◽  
Vol 26 (1) ◽  
Author(s):  
Amira Alkharusi ◽  
Mercedes Mirecki-Garrido ◽  
Zuheng Ma ◽  
Fahad Zadjali ◽  
Amilcar Flores-Morales ◽  
...  
Keyword(s):  
Type I Diabetes ◽  
Janus Kinase ◽  
Cytokine Signaling ◽  
Type I ◽  
Suppressor Of Cytokine Signaling ◽  
Β Cell ◽  
Diabetes In Mice ◽  
Socs Proteins ◽  
Stat Pathway

AbstractDiabetes type 1 is characterized by the failure of beta cells to produce insulin. Suppressor of cytokine signaling (SOCS) proteins are important regulators of the Janus kinase/signal transducer and activator of transcription (JAK-STAT) pathway. Previous studies have shown that GH can prevent the development of type I diabetes in mice and that SOCS2 deficiency mimics a state of increased GH sensitivity.The elevated sensitivity of SOCS2We show that 6-month-old SOCS2Knockdown of SOCS2 makes mice less sensitive to MLDSTZ. These results are consistent with the proposal that elimination of SOCS2 in pancreatic islets creates a state of β-cell hypersensitivity to GH/PRL that mimics events in pregnancy, and which is protective against MLDSTZ-induced type I diabetes in mice. SOCS2-dependent control of β-cell survival may be of relevance to islet regeneration and survival in transplantation.

scholarly journals Influence of fibrillin-1 genotype on aortic stiffness in men: a note of caution

2006 ◽  
Vol 100 (4) ◽  
pp. 1431-1432
Author(s):  
Yasmin ◽  
Ian B. Wilkinson ◽  
Kevin M. O’Shaughnessy
Keyword(s):  
Mechanical Properties ◽  
Pulse Pressure ◽  
Aortic Stiffness ◽  
Collagen Type ◽  
Collagen Type I ◽  
Type I ◽  
Increased Risk ◽  
Fibrillin 1 ◽  
Echo Tracking

Aortic stiffness is a predictor of cardiovascular mortality. The mechanical properties of the arterial wall depend on the connective tissue framework, with variation in fibrillin-1 and collagen I genes being associated with aortic stiffness and/or pulse pressure elevation. The aim of this study was to investigate whether variation in fibrillin-1 genotype was associated with aortic stiffness in men. The mechanical properties of the abdominal aorta of 79 healthy men (range 28–81 yr) were investigated by ultrasonographic phase-locked echo tracking. Fibrillin-1 genotype, characterized by the variable tandem repeat in intron 28, and collagen type I alpha 1 genotype characterized by the 2,064 G\?\T polymorphism, were determined by using DNA from peripheral blood cells. Three common fibrillin-1 genotypes, 2-2, 2-3, and 2-4, were observed in 50 (64%), 10 (13%), and 11 (14%) of the men, respectively. Those of 2-3 genotype had higher pressure strain elastic modulus and aortic stiffness compared with men of 2-2 or 2-4 genotype ( P = 0.005). Pulse pressure also was increased in the 2-3 genotype ( P = 0.04). There was no significant association between type 1 collagen genotype and aortic stiffness in this cohort. In conclusion, the fibrillin-1 2-3 genotype in men was associated with increased aortic stiffness and pulse pressure, indicative of an increased risk for cardiovascular disease.

scholarly journals Causes of early-onset type 1 diabetes: toward data-driven environmental approaches

2008 ◽  
Vol 205 (13) ◽  
pp. 2953-2957 ◽  
Author(s):  
Pierre Bougnères ◽  
Alain-Jacques Valleron
Keyword(s):  
Type 1 Diabetes ◽  
Early Onset ◽  
Type I Diabetes ◽  
Metabolic Changes ◽  
Data Driven ◽  
Metabolic Phenotype ◽  
Type I ◽  
Β Cell ◽  
New Era

A new study reveals distinctive metabolic changes that precede the development of type 1 diabetes (T1D), tossing a stone into the quiet waters of T1D immunology and genetics. The causes of these metabolic changes and their relationship to autoimmunity and β cell destruction are not yet known, but the identification of a metabolic phenotype linked to susceptibility to type I diabetes may help pave the way to a new era of investigation of T1D causality.

scholarly journals Glioblastoma Multiforme in the Posterior Cranial Fossa in a Patient with Neurofibromatosis Type I

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Marike L. D. Broekman ◽  
Roelof Risselada ◽  
JooYeon Engelen-Lee ◽  
Wim G. M. Spliet ◽  
Bon H. Verweij
Keyword(s):  
Neurofibromatosis Type ◽  
Type I ◽  
High Grade ◽  
High Grade Astrocytoma ◽  
Increased Risk ◽  
Pilocytic Astrocytomas ◽  
Benign Nature ◽  
Cranial Fossa ◽  
The Brain

Patients with Neurofibromatosis type 1 (NF1) have an increased risk of developing neoplasms. The most common brain tumors, found in 15%–20% of NF1 patients, are hypothalamic-optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. These tumors generally have a benign nature. NF1 patients are predisposed to a 5-fold increased incidence of high-grade astrocytomas, which are usually located in supratentorial regions of the brain. We present an NF1 patient who developed a high-grade astrocytoma in the posterior fossa and discuss possible pathophysiological mechanisms.

Sign in / Sign up

Export Citation Format

Share Document