scholarly journals Visual evoked potentials in children with type 1 diabetes mellitus

Author(s):  
Meenal Batta ◽  
Rajeev Sharma ◽  
Naveenta Gupta ◽  
Sonia Garg ◽  
Gurmeet Kaur ◽  
...  

Background: Insulin-dependent (type 1) diabetes mellitus is associated with different degrees of neuropathies affecting peripheral as well as central neural pathways. The subclinical neurological involvement in diabetic children can be assessed by changes appearing in the electrophysiological parameters like Visual Evoked Potentials (VEPs). The objective of the study was to assess the effect of type I diabetes melitus on the visual evoked potentials in children.Methods: This cross-sectional case-control study was done on 30 children with type 1 diabetes mellitus of minimum two years duration as cases and 30 age and gender matched euglycemic children with normal HbA1c taken as controls. Visual Evoked Potentials (VEPs) were done on both the groups of children and the latencies (ms) of waves -N75, P100, N145 and amplitude (μV) of wave P100 were recorded. The data was compiled in the pre-designed proforma and statistically analysed using student t-test.Results: The increase in the mean latencies of waveforms of VEPs N75, P100 and amplitude P100 were found to be highly significant statistically (p<0.001) in both the eyes among the children with type 1 diabetes mellitus. The mean latency of waveform N145 was found to be statistically insignificant in the two groups (p>0.05).Conclusions: The type 1 diabetes does affect the visual pathways in children. Visual Evoked Potentials are helpful in the detection of early changes in the conduction across the neural pathways in the sub-clinical diseases.

2019 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gürkan Gürbüz ◽  
Selvinaz Edizer ◽  
Aycan Ünalp ◽  
Özlem Nalbantoğlu ◽  
Selma Tunç ◽  
...  

2018 ◽  
Vol 7 (12) ◽  
pp. 1275-1279 ◽  
Author(s):  
Changwei Liu ◽  
Jingwen Wang ◽  
Yuanyuan Wan ◽  
Xiaona Xia ◽  
Jian Pan ◽  
...  

Background To investigate the relationship 25-hydroxy vitamin D (25OHD) level among children and in children with type 1 diabetes mellitus (T1DM). Methods A case–control study was conducted to compare the serum 25OHD levels between cases and controls. This study recruited 296 T1DM children (106 newly diagnosed T1DM patients and 190 established T1DM patients), and 295 age- and gender-matched healthy subjects as controls. Results The mean serum 25OHD in T1DM children was 48.69 ± 15.26 nmol/L and in the controls was 57.93 ± 19.03 nmol/L. The mean serum 25OHD in T1DM children was lower than that of controls (P < 0.01). The mean serum 25OHD level (50.42 ± 14.74 nmol/L) in the newly diagnosed T1DM children was higher than that (47.70 ± 15.50 nmol/L) in the established T1DM children but the difference was not statistically significant (P = 0.16). HbA1c values were associated with 25OHD levels in established T1DM children (r = 0.264, P < 0.01), and there was no association between 25OHD and HbA1c in newly diagnosed T1DM children (r = 0.164; P > 0.05). Conclusion Vitamin D deficiency is common in T1DM children, and it should be worthy of attention on the lack of vitamin D in established T1DM children.


2019 ◽  
Author(s):  
Joseph I. Wolfsdorf ◽  
Katharine Garvey

Type 1 diabetes mellitus is characterized by severe insulin deficiency, making patients dependent on exogenous insulin replacement for survival. These patients can experience life-threatening events when their glucose levels are significantly abnormal. Type 1 diabetes accounts for 5 to 10% of all diabetes cases, with type 2 accounting for most of the remainder. This review details the pathophysiology, stabilization and assessment, diagnosis and treatment, disposition and outcomes of patients with Type 1 diabetes mellitus. Figures show the opposing actions of insulin and glucagon on substrate flow and plasma levels; plasma glucose, insulin and C-peptide levels throughout the day; the structure of human proinsulin; current view of the pathogenesis of Type 1 autoimmune diabetes mellitus; pathways that lead from insulin deficiency to the major clinical manifestations of Type 1 diabetes mellitus; relationship between hemoglobin A1c values at the end of a 3-month period and calculated average glucose levels during the 3-month period; different combinations of various insulin preparations used to establish glycemic control; and basal-bolus and insulin pump regimens. Tables list the etiologic classification of Type 1 diabetes mellitus, typical laboratory findings and monitoring in diabetic ketoacidosis, criteria for the diagnosis of Type 1 diabetes, clinical goals of Type 1 diabetes treatment, and insulin preparations. This review contains 10 figures, 9 tables, and 40 references. Keywords: Type 1 diabetes mellitus, optimal glycemic control, hypoglycemia, hyperglycemia, polyuria, polydipsia, polyphagia, HbA1c, medical nutrition therapy, Diabetic Ketoacidosis


Author(s):  
Constanza Mosso ◽  
Victoria Halabi ◽  
Tamara Ortiz ◽  
Maria Isabel Hodgson

AbstractThe aim of this study was to assess dietary intake, nutritional status, body composition, and physical activity level in a group of Chilean children and adolescents with Type 1 diabetes mellitus (T1DM), compare these parameters with the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD), and determine the relationships between dietary intake, body composition, and diabetes control.A total of 30 patients with T1DM (aged 15.2±4.0 years) were included. Dietary intake was assessed using a 92-item quantitative food frequency questionnaire. Body composition was determined using dual-energy X-ray densitometry. Physical activity was assessed by means of a survey.The energy intake of these patients was derived from 21.4% protein, 48% carbohydrates, and 31.2% fat. The glycosylated hemoglobin (HbA1c) was significantly correlated with fat as grams per day (r: 0.363, p<0.05) and calories per day (r: 0.364, p<0.05). The mean body fat percentage in females was 31.2% and 20.2% in males (p < 0.01) and the mean amount of physical activity was 4.5±2.7 h per week.The study patients had a higher protein intake than recommended by ISPAD. Dietary carbohydrate intake was rather low, and dietary fat intake was the same as the limits recommended by ISPAD. Diabetic control was significantly correlated with protein, carbohydrates, fat, and sodium intake. The girls in the study had a higher percentage of body fat than the standard recommendations for their age. The level of physical activity was adequate.


2022 ◽  
Vol 40 ◽  
Author(s):  
Renata Aparecida e Silva ◽  
Aline De Piano Ganen ◽  
Vânia de Fátima Tonetto Fernandes ◽  
Nara Michelle de Araújo Evangelista ◽  
Carolina Costa Figueiredo ◽  
...  

ABSTRACT Objective: To evaluate sleep characteristics of children and adolescents with type 1 diabetes mellitus (T1DM) and their relationship with glycemic control. Methods: A cross-sectional study was conducted at a public hospital in São Paulo, Brazil. It included 86 patients with T1DM, aged between 10 and 18 years old, who were on insulin therapy, had performed at least three measurements of capillary blood glucose throughout the day, and had normal thyroid function. The clinical, anthropometric, and laboratory data of each patient were evaluated. The Pediatric Daytime Sleepiness Scale (PDSS) and the Munich Chronotype Questionnaire (MCTQ) were used to assess the sleep characteristics. Results: The mean level of glycated hemoglobin (HbA1c) was 9.2±2.1%, and it was higher in adolescents than in children. The mean score of PDSS was 13.9±4.7. Patients with HbA1c<7.5% had lower PDSS scores and longer sleep duration on weekdays than patients with HbA1c≥7.5%. HbA1c levels were negatively correlated with chronotype values and sleep duration on weekdays and positively correlated with social jet lag. Patients who had had T1DM for less than three years had a higher prevalence of daytime sleepiness. The regression analysis showed that higher HbA1c (≥7.5%) and shorter time since the diagnosis of T1DM increased the chance of daytime sleepiness, regardless of age and sex. Conclusions: Patients with higher HbA1c had more daytime sleepiness, a morning chronotype, shorter sleep duration on weekdays and a more significant social jet lag. The shorter diagnosis time for T1DM and greater levels of HbA1c increased the chance of daytime sleepiness.


2017 ◽  
Vol 89 (10) ◽  
pp. 17-21 ◽  
Author(s):  
L L Bolotskaya ◽  
E G Bessmertnaya ◽  
M V Shestakova ◽  
M Sh Shamkhalova ◽  
L V Nikankina ◽  
...  

Aim. To assess the time course of changes in the level of glycated hemoglobin (HbA1c) for 20 years after the onset of type 1 diabetes mellitus (T1DM) and to compare its correlation with the development of microvascular complications, such as diabetic retinopathy (DR) and diabetic nephropathy (DN). Subjects and methods. A total of 187 children with new-onset T1DM were registered in Moscow in 1994. During the 20-year follow-up study, these patients underwent regular check-ups at the Endocrinology Research Center, Ministry of Health of the Russian Federation, which included assessment of physical data, HbA1c 2-4 times a year, biochemical blood and albuminuria tests (once per year), and ophthalmologic examination (twice a year). A total of 155 people fully completed the 20-years follow-up study. Results. During the 20-year follow-up period after the onset of T1DM, 86 of the 155 patients developed microvascular complications: DR and DN in 86 (55.5%) and 24 (15.5%) cases, respectively; while DR concurrent with DN were noted in 20 patients. By the time of their last visit, 69 (44.5%) patients had no evidence suggesting the presence of microvascular complications. The level of HbA1c at the onset of the disease in patients who later developed the complications was higher than in those without complications (10.2±0.6 and 8.5±0.2%, respectively (p = 0.003). The statistically significant differences in HbA1c levels between the groups persisted during subsequent 15 years of follow-up, averaging 9.2±1.5, 9.7±0.9, and 8.1±0.7% after 5, 10, and 15 years, respectively, in the complication group and 7.1±0.3, 8.1±0.4, and 7.2±0.2% in the non-complication group (p < 0.01). Over the last 5 years of the follow-up, the mean HbA1c level between the groups was not significantly different, which at the end of the 20-year follow-up period was 7.8±0.3 and 7.4±0.6%, respectively (p > 0.05). The mean duration of T1DM, in which DR developed, was 9.6±6.2, 11.0±2.0, and 13.6±4.6 years for the non-proliferative, pre-proliferative, and proliferative stages, respectively. That of T1DM, in which DN developed, was 11.8±0.6 years for microalbuminuria and 16.1±1.3 years for macroalbuminuria. Conclusion. The 20-year clinical follow-up of patients who had fallen ill with T1DM in childhood showed that diabetic microangiopathies developed with the long-term preservation of poor blood glucose control (BGC) starting at the onset of the disease. At the same time, the complications progressed to more severe stages, despite a clear trend toward better BGC. This may be suggestive of the negative metabolic memory phenomenon, which necessitates stable BGC, starting at the onset of the disease, for the prevention of microvascular complications.


Medicina ◽  
2007 ◽  
Vol 43 (3) ◽  
pp. 242 ◽  
Author(s):  
Rytas Ostrauskas

Objective. The goal of this study was to summarize the data on the prevalence of type 1 diabetes mellitus among Lithuanian population aged more than 15 years. Material and methods. The data on patients aged more than 16 years were collected with the help of general practitioners, endocrinologists, and physicians-internists working in the diabetes care in all towns and regions of Lithuania. The data on patients aged 14 to 16 years were obtained from the National Register of Diabetes Mellitus in Childhood in Lithuania. Results. In Lithuania, on December 31, 1991, there were 2179 adolescent and adult patients with type 1 diabetes mellitus or 75.21 per 100 000 inhabitants of the same age group (95% Poisson CI 72.12–78.43), and at the end of 2004 – 3996 or 140.69 (95% Poisson CI 136.40– 145.12), respectively. During a 14-year period, the mean increase in the number of type 1 diabetic patients was 144.85±23.32 persons per year or 4.66±1.17% or 4.04±1.19 cases per 100 000 population (for males 85.54±10.82 or 5.06±1.02% or 6.81±1.57/100 000 and for females 54.23±9.05 or 3.93±0.86% or 3.56±1.05/100 000). Regression-based linear trends showed that the prevalence of type 1 diabetes mellitus among population aged more than 15 years had a tendency to increase. The prevalence rates of type 1 diabetes mellitus among adolescent and adult subjects, adjusted for Lithuanian male and female age groups, were 80.64/100 000 and 70.23/100 000 in 1991 (P<0.05) and 166.52 and 117.63 in 2004 (P<0.05), respectively. Conclusions. The prevalence of type 1 diabetes mellitus among Lithuanian females aged more than 15 years was lower than among males. The register provides the possibility of highly precise collection of the data on patients from various medical care units in Lithuania.


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