scholarly journals IGF-1 levels in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 53 (2) ◽  
Author(s):  
Thipani Angela ◽  
◽  
Chrismis Novalinda Ginting ◽  
Linda Chiuman ◽  
Sahna Ferdinand Ginting

Type 2 Diabetes Mellitus (Type 2 DM) is a metabolic disorder group with mechanisms that include hyperglycemia, insulin resistance and hyperinsulinemia. Type 2 DM has a close association with IGF-1, where the active form of the IGF-1 becomes elevated by reason of the fact that hyperinsulinemia inhibits the production of IGF-binding proteins (IGFBP) 1/IGFBP 2. The active form of IGF-1 has the ability to promote cell proliferation and inhibit apoptosis, hence becomes one of the risk factors for cancer cell growth. This was an analytical study conducted in August at the Harapan Bunda Clinic, Medan, Indonesia to determine the difference between the IGF-1 level and blood glucose level in type 2 DM patients in different age groups. Twenty subjects with Type 2 DM participated in this study and were divided based on their age into 35-50 years old or Group 1 and 51-65 year old group or Group 2. The IGF-1 levels in both groups were compared and analyzed using the T-test dependent method. Results showed that the IGF-1 and blood glucose levels were higher in Group 1 (35-50 years old) when compared to Group 2 and the difference was significant. The change in the IGF-1 level in diabetic patients cannot be determined only by the blood sugar level.

Author(s):  
C. Igbeneghu ◽  
J. M. Olisekodiaka ◽  
J. A. Onuegbu ◽  
O. H. Oyeyode

Aim: To determine whether Phenylthiocarbamide (PTC) taste blindness is associated with type 2 Diabetes Mellitus (DM) and possible relationship between intake of treatment medications and PTC taste sensitivity. Methodology: The study participants consisted of 100 type 2 DM patients on treatment (group 1) and 100 newly diagnosed type 2 DM patients not on drugs treatment (group 2). Apparently healthy individuals (100) served as controls (group 3). Informed consent was obtained from each participant at the commencement of the study. Tasters and non-tasters were determined using phenylthiocarbamide (PTC) taste strips (0.0143 mg/strip). Results: In group 1, 66% were non-tasters; in group 2, 60% were non-tasters while 37% in group 3 were non-tasters. Phenylthiocarbamide taste perception varied significantly among the 3 groups studied (p < 0.001). Non-tasters of PTC in groups 1 and 2 were not significantly different (p = 0.38). Non-tasters of PTC in groups 1 and 2 (p < 0.001; OR 3.30 and p = 0.001; OR 2.55 respectively) were significantly higher than non-tasters in the control (group 3). Conclusion: This study shows that inability to taste PTC is associated with type 2 DM. However, intake of DM treatment medications does not appear to have any significant influence on PTC taste sensitivity.


2020 ◽  
Vol 26 (2) ◽  
pp. 167-173
Author(s):  
Maryam Amir ◽  
Vaishali Sinha ◽  
Gaurav Kistangari ◽  
M. Cecilia Lansang

Objective: Basal/basal-bolus insulin with discontinuation of home oral antidiabetes medications (OADs) is the preferred method to achieve glycemic control in many hospitalized patients. We hypothesized that a subset of patients with type 2 diabetes mellitus (T2DM) can achieve an acceptable level of blood sugar control without cessation of their OADs when hospitalized. Methods: A retrospective chart review was conducted on patients with T2DM who were only on OADs at home, admitted to Fairview Hospital, a community hospital in the Cleveland Clinic Health System. We divided patients into those whose OADs were continued (group 1) and those whose OADs were discontinued (group 2), with or without the addition of insulin in the hospital. Blood glucose (BG) levels and patient characteristics were compared. Results: There were 175 patients, 73 in group 1 and 102 in group 2. The percentage of patients achieving all BG values within 100 to 180 mg/dL was the same between group 1 (21.9%) and group 2 (23.8%) ( P = .78). Mean BG was similar between group 1 and group 2 (146.1 ± 41.4 mg/dL versus 152.1 ± 38.9 mg/dL; P = .33), with no significant difference in terms of percentage of patients with hyperglycemia or hypoglycemia. A greater proportion of patients in group 1 had an uninterrupted feeding status, nonintensive care unit admission and no contrast dye exposure, and a shorter length of stay. Conclusion: Our study shows that patients with certain characteristics could achieve an acceptable level of glycemic control without cessation of their home OADs. Abbreviations: BG = blood glucose; DPP-4 = dipeptidyl dipeptidase 4; GFR = glomerular filtration rate; HbA1c = hemoglobin A1c; ICU = intensive care unit; LOS = length of stay; NPO = nil per os; OAD = oral antidiabetes medication; POC = point of care; T2DM = type 2 diabetes mellitus


2020 ◽  
pp. 10-11
Author(s):  
T.M. Bentsa ◽  
O.A. Pastukhova

Objective. Investigate directly the clinical efficacy of L-arginine aspartate in the treatment of patients with essential arterial hypertension (EAG) and type 2 diabetes mellitus (DM). Materials and methods. The study included 43 patients with EAG II in combination with type 2 DM. The mean age of patients was 55,7±0,6 years, of which 20 (46,5 %) were men and 23 (53,5 %) were women. The duration of the disease on the EAG averaged 8,4±0,4 years, on type 2 DM – 6,5±0,5 years. A comprehensive clinical, laboratory and instrumental examination was carried out. All patients were divided into two groups. Patients in both groups received ramipril 5-10 mg a day in combination with amlodipine 5-10 mg a day and antidiabetic drugs (metformin, gliclazide or a combination thereof) as basic therapy. Patients in group 2 (n=22) were additionally prescribed the drug L-arginine aspartate orally 3 g 3 times a day for 4 weeks. The course of treatment was repeated after 2 months. Results and discussion. In group 2 there was a more pronounced tendency to decrease the average daily and night blood pressure levels, in particular diastolic (3,2 and 2,9 mm Hg; p>0,05) and heart rate (by 17,3 %; p<0,05). The use of L-arginine aspartate significantly improved systolic (ejection fraction increased by 7,1 % vs 4,4 % in group 1; p<0,05) and left ventricular (LV) diastolic function (Em/Am increased by 48,8 % vs 34,7 % in group 1; p<0,05), a decrease in the size of the left atrium (10,2 % vs 8,3 % in group 1; p<0,05) and the reversal of LV hypertrophy (index LV myocardial mass decreased by 20,1 % against 15,9 % in group 1; p<0,05). Additional administration of L-arginine aspartate also led to a decrease in fasting and postprandial plasma glucose (4,9 % and 7,0 %; p<0,05, respectively) than the use of basic therapy alone. At the same time in group 2 there was a decrease in microalbuminuria by 27,6 % (p<0,05) and an increase in glomerular filtration rate by 11,4 % (p>0,05). Conclusions. L-arginine aspartate should be used in patients with EAG in combination with type 2 DM and microalbuminuria to increase the cardio- and nephroprotective efficacy of basic therapy.


2019 ◽  
Author(s):  
Yinhong Wang ◽  
Xuefei Tian ◽  
Hao Wang ◽  
Peiyao Ren ◽  
Gaofei Yan ◽  
...  

Abstract Background: Idiopathic membranous nephropathy (IMN), one of the most common causes resulting into nephrotic syndrome in adults, is usually clinically treated with steroids and/or other immunosuppressive agents. However, the treatment on the patients with IMN coexisting with type 2 diabetes mellitus (DM) is still challenging. There are few convincing literatures available on the efficacy and safety of therapeutic regimens in this subgroup of patients to guide clinical practice. Methods: We retrospectively collected and analyzed the data of twenty-three patients who underwent renal biopsies between January 2013 and March 2018 in our institute and were diagnosed with IMN coexisting with type 2 DM. Nine patients received prednisone combining with tacrolimus and mycophenolate mofetil (group 1), while 14 patients received prednisone and intravenous cyclophosphamide (group 2). The primary endpoint was measured by percentage of patients achieved complete remission (CR) or partial remission (PR), the secondary endpoints included changes of urinary protein excretion from baseline and treatment-related adverse events. Results: The remission rates were compared between the group 1 and the group 2 at both 6 months (44.4% versus 50%, P>0.05 ) and 12 months (77.8% versus 64.3%, P>0.05 ). Significant decrease in urinary protein excretion was observed in both groups during treatment, which was significantly greater in group 1 than that in group 2. No significant renal impairment was observed during the follow-up period. Infections and worsening glycemic control were the most common adverse effects of two therapy. Patients treated with prednisone plus cyclophosphamide were more likely to develop worsening diabetes, while infections tended to be more common in patients treated with prednisone combining with tacrolimus and mycophenolate mofetil. Conclusions: The combination therapy of prednisone, tacrolimus and mycophenolate mofetil is one of the effective and safe options for patients with IMN and type 2 DM.


2020 ◽  
pp. 1-4
Author(s):  
V Sandeep Kumar ◽  
Aishwarya Ganga S N. ◽  
Anand A. S.

Introduction: Neutrophilic leukocytosis is directly associated with the pathogenesis of atherosclerosis in patients with diabetes mellitus (DM). Increased white blood cell (WBC) count is related to cardiovascular disease in patients with type 2 diabetes mellitus; raised neutrophil lymphocyte ratio (NLR) is associated with metabolic syndrome. concerning a correlation between glycosylated haemoglobin (HbA1c) and NLR. Aims and objectives: The aim of the present study was to investigate the neutrophils lymphocyte ratio (NLR) and blood glucose regulation in type 2 diabetes patients. Methods: This prospective study of 6 months duration was conducted in patients with type 2 diabetes mellitus, divided into two groups according to HbA1c levels. group 1- HbA1c levels ≤ 7%; group 2-HbA1c levels > 7%. WBC, neutrophil and lymphocyte counts were determined by automated analyser, HbA1C was calculated using Afinion 2.Results: Of total 50 patients included, Random blood glucose, neutrophil , WBC counts ,NLR, HbA1C were significantly higher in group 2 compared to group 1.Conclusion:NLR of uncontrolled group (HbA1c>7%)was significantly higher than that of controlled group(HbA1C<7%) .We conclude that NLR gives us very good and similar results to know the early complications of uncontrolled DM.


2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mengyao Chao ◽  
Chunyan Wang ◽  
Xiaosheng Dong ◽  
Meng Ding

Objective. To investigate the effects of Tai chi in type 2 diabetes mellitus (type-2 DM) patients using systematic review and meta-analysis. Methods. Seven electronic resource databases were searched, and randomized controlled trials on the role of Tai chi in type-2 DM patients were retrieved. The meta-analysis was performed with RevMan 5.3, and research quality evaluation was conducted with the modified Jadad scale. Results. Fourteen studies, with 798 individuals related to the intervention of Tai chi on diabetes, were included. The results showed that, compared with nonexercise, Tai chi had the effect of lowering fasting blood glucose [MD = −1.39, 95% CI (−1.95, −0.84), P<0.0001] and the subgroup effect size decreased with the increase of total exercise amount, there is no significant difference between Tai chi and other aerobic exercises [MD = −0.50, 95% CI (−1.02, 0.02), P=0.06]; compared with nonexercise, Tai chi could reduce HbA1c [MD = −0.21, 95% CI (−0.61, 0.19), P=0.31], and the group effect size decreased with the increase of total exercise amount. The reducing HbA1c effect of Tai chi was better than that of other aerobic exercises, but the difference was at the margin of statistical significance [MD = −0.19, 95% CI (−0.37, 0.00), P=0.05]; compared with nonexercise, Tai chi had the effect of reducing 2 h postprandial blood glucose [MD = −2.07, 95% CI (−2.89, −1.26), P=0.0002], there is no significant difference between Tai chi and other aerobic exercises in reducing 2 h postprandial blood glucose [MD = −0.44, 95% CI (−1.42, 0.54), P=0.38]. Conclusion. Tai chi can effectively affect the management of blood glucose and HbA1c in type-2 DM patients. Long-term adherence to Tai chi has a better role in reducing blood glucose and HbA1c levels in type 2 DM patients.


2020 ◽  
Vol 1 (1) ◽  
pp. 17-22
Author(s):  
C K Akshaya ◽  

ABO and Rh blood group systems have been associated with a number of diseases including type-2 diabetes mellitus (T2DM). Epidemiological studies have inconsistently associated ABO and Rhesus (Rh) blood groups with T2DM risk. To assess the distribution of ABO and Rh blood groups among type-2 diabetic subjects and to check the potential association between ABO and Rh blood groups with T2DM. This small retrospective case-control study was conducted at DM WIMS Hospital, Wayanad. One-year data (from Jan-18 to Jan-19) of fasting, postprandial or random plasma/serum glucose, HbA1c, ABO and Rh blood groups of Non- diabetic and type -2 diabetic subjects were collected from the Hospital Clinical Laboratory Medicine department. Among 280 randomly selected data, 147 are non-diabetic subjects, and 133 are confirmed and known cases of type 2 diabetic mellitus. Subjects with Blood group B has the highest distribution percentage among group-2 (59.39%) in comparison with group-1 (34.02%), followed by A (19.55%), O (18.79%), AB (2.27%). Statistical analysis using Chi-square test among ABO and Rh blood groups between group-1 and group-2 showed a significant (p< 0.001) association of blood group “B +ve” and least association of blood group “O +ve” with T2DM. However, the Rh Blood groups evaluation for T2DM showed no clear association, as both Rh +ve and Rh -ve were uniformly distributed in the groups. The ABO and Rh blood groups may have a possible role to play in the development of T2DM. The subjects with B + ve blood group are at greater risk for T2DM and O + ve blood group individuals are at lower risk for T2DM. Keywords: Blood groups; ABO blood groups; Rh blood groups; Type 2 Diabetes Mellitus; distribution; association REFERENCES


2021 ◽  
Vol 9 (1) ◽  
pp. 21-27
Author(s):  
S.O. Rykov ◽  
K.V. Korobov ◽  
S.Yu. Mogilevskyy

Background. One of the early microvascular complications of type 2 diabetes mellitus (T2DM) is diabetic retino­pathy (DR). Its main cause is prolonged hyperglycemia, which triggers the development of microangiopathy. In this regard, the issue of damage to paired eyes and the spread of DR in the initial stages has not been fully clarified. The purpose: to study the peculiarities of lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 dia­betes mellitus. Materials and methods. We examined 91 patients with T2DM (182 eyes), who did not have retinopathy according to the International Diabetic Retinopathy Severity Scale of the American Academy of Ophthalmology (2002). Paired eyes were divided into three groups: group 1 included 132 paired eyes (66 patients) with 10 points according to the Early Treatment Diabetic Retinopathy Group Study (ETDRS); group 2 consisted of 25 eyes with 10 points on ETDRS, and group 3 — 25 paired eyes with retinal vascular anomalies (14–15 points on ETDRS). The patients were examined again after 1 year. According to the ETDRS, Airlie House classification, microaneurysms, microhemorrhages, intraretinal microvascular abnormalities, retinal vascular abnormalities, and retinal nonperfusion were detec­ted. Results. The majority (58.3 %) of paired eyes without initial changes (group 1) had no progression of DR within 1 year, 12.9 % had vascular anomalies (14–15 points on ETDRS), 13.6 % deve­loped mild, and 15.2 % — moderate non-proliferative DR. The highest progression of DR (88.0 % of eyes) was observed in eyes without diabetic vascular changes, which were paired to eyes with such changes (group 2) that was 2.1 times (p < 0.001) higher than the indicator of paired eyes without diabetic changes (group 1; 41.7 %). Most eyes that had mild vascular changes (group 3) progressed to moderate non-proliferative DR after 1 year, which was four times more often than in eyes that had no initial changes (60.0 versus 15.2 %; p < 0.001). DR in the eyes of group 3 with progression accounted for 43–47 points on EDTRS; the visual acuity of these eyes, both before and after 1 year, was significantly lower than in other groups, and the level of glycated hemoglobin in the blood of patients with such eyes was significantly higher. Conclusions. This study established the features of the progression of early stages of DR in patients with T2DM, and the significance of primary retinal vascular anomalies in the presence of which the progression of DR was faster.


2021 ◽  
Vol 17 (1) ◽  
pp. 1-8
Author(s):  
Serhat Özçelik ◽  
Mehmet Çelik ◽  
Aşkı Vural ◽  
Bünyamin Aydın ◽  
Melike Özçelik ◽  
...  

IntroductionTo evaluate the efficacy and safety of transition from premixed and intensive insulin to twice-daily insulin degludec/aspart (IDegAsp) co-formulation in patients with type 2 diabetes mellitus.Material and methodsIn this 12-week study, patients receiving twice-daily premixed insulin therapy in group 1 (n = 55) were switched to twice-daily IDegAsp. In group 2 (n = 60), patients on intensive insulin therapy were switched to IDegAsp injected twice a day. Inter- and intragroup comparisons were made.ResultsA total of 115 patients were included in the study. There was a significant improvement in glycaemic control, median daily total insulin dose, body mass, body mass index, and hypoglycaemic events in group 1 and group 2 with the switch to IDegAsp (p < 0.05). The decrease in median daily total insulin dose requirement in group 2 was higher than that of group 1 (p = 0.001). There was no difference between groups in terms of other parameters (p > 0.05).ConclusionsThe current analysis indicates that IDegAsp treatment improves outcomes, with the most notable differences observed in daily total insulin requirement, body mass, and hypoglycaemia.


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