scholarly journals Evaluation of Diabetes Control Status in Children Aged 3 to 18 Years with Type 1 Diabetes: Retrospective Study

2021 ◽  
Author(s):  
Mahtab Ordooei ◽  
Reihaneh Azizi ◽  
Simin Amir Shahkarami
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Statistical Tests ◽  
Diabetes Control ◽  
Maturity Stage ◽  
High Blood Glucose ◽  
Duration Of Diabetes ◽  
Significant Difference ◽  
The Mean

Introduction: Diabetes mellitus is one of the most common metabolic diseases that is associated with many complications. Type 1 diabetes is an autoimmune disease caused by a lack of insulin production due to high blood glucose levels. It is the third most severe and chronic childhood illness, affecting approximately 15 million children worldwide. Given the importance of controlling type 1 diabetes, especially in children, in this study we aimed to examine the status of diabetes control in children 3 to 18 with type 1 diabetes. Methods: This study was a retrospective analytical cross-sectional study. The study population included 121 children aged 3-18 years with type 1 diabetes referred to Yazd Diabetes Center in 2018 to 2019. The information, including age, sex, BMI, patient maturity stage, duration of diabetes, mean A1C, daily insulin dose, number of blood glucose measurements per day and number of DKA attacks were extracted. The collected data were entered into SPSS version 16, using statistical tests were analyzed. Results: The results showed that the mean age of participants was 12.92± 3.96 years and the mean of A1c in patients was 8.63 ± 1.94. The results of our study on diabetes control status in the studied patients showed that 38.8% of patients had partial diabetes control status, 32.2% had good diabetes control status and 28.9% had poor diabetes control status. In addition, according to the results of the study, there was no statistically significant difference was found  among the frequency distribution of diabetes control status in terms of variables of puberty stage (p = 0.228), BMI (p = 0.508), age (p = 0.275), daily dose of bisal / bolus insulin (p = 0.479), dose Daily NPH / regular insulin (p = 0.386), number of blood glucose checks (p = 0.090), number of hospitalizations due to DKA (p = 0.539), duration of diabetes (p = 0.093) and gender (p = 0.263). . Conclusion: According to the results of the study, it can be concluded that none of the studied variables affect the control status of diabetes in children aged 3-18 years with type 1 diabetes.

Humor and A1C: the interaction between humor and diabetes control

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
David S. Greene ◽  
Nancy Dunavant King
Keyword(s):  
Type 1 Diabetes ◽  
American Diabetes Association ◽  
Good Control ◽  
Diabetes Control ◽  
Humor Styles ◽  
Psychological Benefits ◽  
Significant Difference ◽  
Aggressive Humor ◽  
College Educated

Abstract There is increasing evidence of specific medical and psychological benefits associated with humor within diabetes populations. The benefits of maintaining good diabetes control are also well established. The more general relationship between humor and diabetes control however remains unexplored. The purpose of this study was to examine if there was a difference between people with diabetes with an A1C ≤ 6.99% versus those ≥7.0% on four disparate types of humor. The sample consisted of 284 participants, 65.5% with type 1 diabetes, 68.3% female, 89.1% Caucasian, and 68.7% college educated. Participants completed the Humor Styles Questionnaire (HSQ) and were divided into two groups, A1C ≤ 6.99% and A1C ≥ 7.0%. The A1C ≤ 6.99% group scored significantly higher on both types of positive humor, affiliative humor (P < 0.01) and self-enhancing humor (P < 0.05). There was no significant difference between participants on either type of negative humor, aggressive humor (P > 0.05) or self-defeating humor (P > 0.05). Results indicate that good control (A1C ≤ 6.99%) is associated with positive humor. These findings provide evidence that there is an association between American Diabetes Association recommended levels of control and positive humor styles. Implications regarding positive humor and good diabetes control are discussed.

scholarly journals Clinical significance of intramammary arterial calcifications in diabetic women

2004 ◽  
Vol 61 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Zorica Milosevic ◽  
Jelica Bjekic ◽  
Stanko Radulovic ◽  
Branislav Goldner
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Control Group ◽  
Duration Of Diabetes ◽  
Diabetic Macroangiopathy ◽  
Indirect Sign ◽  
Significant Difference

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.

scholarly journals 0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A352-A353
Author(s):  
S Griggs ◽  
N S Redeker ◽  
S Jeon ◽  
M Grey
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Glucose Variability ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
High Blood Glucose ◽  
Short Sleep

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia &lt;70mg/dL (β=-0.15, p&lt;0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia &lt;54mg/dL with more severe low blood glucose indices (β=0.35, p&lt;0.01 and β=0.34, p&lt;0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 & P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

scholarly journals Comparing two treatment approaches for patients with type 1 diabetes during aerobic exercise: a randomised, crossover study

2020 ◽  
Author(s):  
Varun Vartak ◽  
Lynne Chepulis ◽  
Matt Driller ◽  
Ryan Paul
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Aerobic Exercise ◽  
Blood Lactate ◽  
Perceived Exertion ◽  
Trial Registration ◽  
Glucose Levels ◽  
Significant Difference ◽  
Mild Hypoglycaemia

Abstract In a randomised, counterbalanced, crossover design, eight men with type 1 diabetes (T1D; mean ± SD age: 27.6 ± 11.4 years) reduced insulin (INS) by 50% of their normal dose or consumed carbohydrates equivalent to 1 g of carbohydrate/kg of their body weight without the usual insulin bolus (CARBS) over two sessions, held a week apart. Each session included standardised meals, a 45-minute treadmill-walk at 7.24 km.h-1 and a six-minute walk test (6MWT). Rate of perceived exertion (RPE), blood glucose, blood ketone and blood lactate measures were taken before, during and immediately after the aerobic exercise. The distance covered in metres and the predicted VO2 max (mL⋅kg−1⋅min−1) were also calculated for the 6MWT. Participants completing the INS intervention spent more time in normoglycaemia (242 ± 135 min vs 88 ± 132 min; P < 0.01) and less time in hyperglycaemia (41 ± 95 min vs 154 ± 125 min; P = 0.01) as compared to the CARBS intervention. Mild hypoglycaemia occurred in two participants during INS and no participants during CARBS. Furthermore, there was no significant difference for blood lactate, ketone, RPE, distance covered and predicted VO2 max between interventions. Based on this pilot study, INS intervention appears to be the best approach for maintaining blood glucose levels in those with T1D during aerobic exercise, though this does need evaluating in other groups, including women, children and those with sub-optimal glycaemic control. Trial registration: ACTRN12619001397101p. Registered 09 September 2019, http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378264

Evaluation of the relationship between short-term glycemic control and netrin-1, a urinary proximal tubular injury marker in children with type 1 diabetes

2019 ◽  
Vol 32 (8) ◽  
pp. 851-856
Author(s):  
Seyit Ahmet Uçaktürk ◽  
Eda Mengen ◽  
Selin Elmaoğulları ◽  
Çiğdem Yücel ◽  
Aslıhan A. Yılmaz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Early Period ◽  
Tubular Damage ◽  
Healthy Controls ◽  
Tubular Injury ◽  
Short Term ◽  
Duration Of Diabetes ◽  
The Relationship

Abstract Background Diabetic nephropathy (DN) is a significant cause of morbidity and mortality in young adults with type 1 diabetes (T1D). Microalbuminuria (MA) is generally considered as the earliest manifestation of DN. However, it has been shown that MA may be temporary and not reflect permanent renal failure. For this reason, sensitive markers are needed for the detection of kidney damage in the early period. Urinary tubular injury markers increase in the early period of diabetes. These tubular markers are rather indicators of acute renal damage. The objective of this study was to measure the urinary netrin-1 level, a marker of tubular injury in children with normoalbuminuric (NA) T1D, and to determine its relationship with short-term fluctuations in blood glucose using fructosamine levels. Methods Netrin-1 levels in spot urine samples from 82 children with T1D (median age 13.6 years) without MA or hypertension and from 59 healthy controls (median age 11.3 years) with a similar distribution of age and body mass index (BMI) were compared. The relationship of the netrin-1 levels with diabetes parameters such as fructosamine, hemoglobin A1c (HbA1c) or duration of diabetes was investigated. Results Urinary netrin-1 level was found to be higher in patients with T1D than in healthy controls (590 [interquartile range (IQR) = 811] pg/mg-creatinine [pg/mg-cr] and 396 [IQR = 742] pg/mg-cr, respectively) (p = 0.03). Urinary netrin-1 was found to correlate with HbA1c (p = 0.007, r = 0.320) and fructosamine (p = 0.04, r = 0.310) but not with average HbA1c in the last year (p = 0.14, r = −0.19), duration of diabetes (p = 0.83, r = 0.02) or other diabetes indices. Conclusions These results support the idea that tubular damage occurs early in the course of diabetes. However, the fact that netrin-1 is related to fructosamine and HbA1c but not to the duration of diabetes or average HbA1c in the last year may suggest that the tubular damage markers are affected by short-term fluctuations in blood glucose.

74-LB: Impact of Mild and Moderate High Blood Glucose Excursions on Daily Living in Adults with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 74-LB
Author(s):  
ALLYSON HUGHES ◽  
JEOFFREY BISPHAM ◽  
COLLEEN GAREY ◽  
JINGWEN LIU ◽  
LILY FULLER ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Daily Living ◽  
High Blood Glucose

scholarly journals Comparing Two Treatment Approaches for Patients with Type 1 Diabetes During Aerobic Exercise: a Randomised, Crossover Study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Varun Vartak ◽  
Lynne Chepulis ◽  
Matthew Driller ◽  
Ryan G. Paul
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Aerobic Exercise ◽  
Perceived Exertion ◽  
Trial Registration ◽  
Clinical Trial Registry ◽  
Glucose Levels ◽  
Significant Difference ◽  
Mild Hypoglycaemia

Abstract Background In a randomised, counterbalanced, crossover design, eight men with type 1 diabetes (T1D; mean ± SD age, 27.6 ± 11.4 years) reduced insulin (INS) by 50% of their normal dose or consumed carbohydrates equivalent to 1 g of carbohydrate per kilogramme of their body weight without the usual insulin bolus (CARBS) over two sessions, held a week apart. Each session included standardised meals, a 45-min treadmill walk at 7.24 km h−1 and a 6-min walk test (6MWT). Rate of perceived exertion (RPE), blood glucose, ketone and lactate measures were taken before, during and immediately after the aerobic exercise. The distance covered in metres and the predicted VO2 max (mL kg−1 min−1) were also calculated for the 6MWT. Results Participants completing the INS intervention spent more time in normoglycaemia (242 ± 135 min vs 88 ± 132 min; P < 0.01) and less time in hyperglycaemia (41 ± 95 min vs 154 ± 125 min; P = 0.01) as compared to the CARBS intervention. Mild hypoglycaemia occurred in two participants during INS and no participants during CARBS. Furthermore, there was no significant difference for blood lactate, ketone, RPE, distance covered and predicted VO2 max between interventions. Conclusion Based on this pilot study, INS intervention appears to be the best approach for maintaining blood glucose levels in those with T1D during aerobic exercise, though this does need evaluation in other groups, including women, children and those with suboptimal glycaemic control. Trial Registration Australian New Zealand Clinical Trial Registry, ACTRN12619001397101p. Registered 09 September 2019.

scholarly journals Risk-Averse Food Recommendation Using Bayesian Feedforward Neural Networks for Patients with Type 1 Diabetes Doing Physical Activities

2020 ◽  
Vol 10 (22) ◽  
pp. 8037
Author(s):  
Phuong Ngo ◽  
Miguel Tejedor ◽  
Maryam Tayefi ◽  
Taridzo Chomutare ◽  
Fred Godtliebsen
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Physical Activities ◽  
Personalized Recommendation ◽  
Neural Network Models ◽  
High Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background. Since physical activity has a high impact on patients with type 1 diabetes and the risk of hypoglycemia (low blood glucose levels) is significantly higher during and after physical activities, an automatic method to provide a personalized recommendation is needed to improve the blood glucose management and harness the benefits of physical activities. This paper aims to reduce the risk of hypoglycemia and hyperglycemia (high blood glucose levels), and empowers type 1 diabetes patients to make decisions regarding food choices connected with physical activities. Methods. Traditional and Bayesian feedforward neural network models are developed to provide accurate predictions of the blood glucose outcome and the risks of hyperglycemia and hypoglycemia with uncertainty information. Using the proposed models, safe actions that minimize the risk of both hypoglycemia and hyperglycemia are provided as food recommendations to the patient. Results. The predicted blood glucose responses to the optimal and safe food recommendations are significantly better and safer than by taking random food. Conclusions. Simulations conducted on the state-of-the-art UVA/Padova simulator combined with Brenton’s physical activity model show that the proposed methodology is safe and effective in managing blood glucose during and after physical activities.

scholarly journals Corneal Endothelial Morphology in Children with Type 1 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Mohamed Anbar ◽  
Hatem Ammar ◽  
Ramadan A. Mahmoud
Keyword(s):  
Type 1 Diabetes ◽  
Endothelial Cell ◽  
Corneal Thickness ◽  
Diabetic Group ◽  
Control Group ◽  
Normal Children ◽  
Duration Of Diabetes ◽  
Diabetic Children ◽  
The Mean

Aim. To investigate corneal endothelial cell morphological in children with type 1 diabetes and to determine the systemic and local factors that contribute to these changes.Methods. One hundred sixty eyes of 80 children with type 1 diabetes and 80 eyes of 40 normal children as a control during the period from July 2015 to February 2016 underwent full clinical and ophthalmologic examination. We measured the central corneal thickness (CCT), endothelial cell density (ECD), ploymegathism, and pleomorphism using a noncontact specular microscope.Results. The mean age of the diabetic children was8.22±3.11years. The mean duration of type 1 diabetes was3.51±2.23years. The mean CCT was significantly higher:537±33.41microns (right eye), in the diabetic group compared to the control group. The mean ECD in patients with type 1 diabetes was3149.84±343.75cells/mm2(right eye), and it was significantly lower than in the control group. Furthermore, pleomorphism was significantly lower48.73±5.43% (right eye), in the diabetic group compared to the control group. The mean polymegathism was significantly higher37.96±5.61% (right eye), in the diabetic group compared to the control group. All of these changes are significantly correlated only with the duration of diabetes.Conclusions. Diabetic children have thicker corneas, lower ECD, an increased polymegathism, and a decreased pleomorphism. The duration of diabetes is the factor that affects all of these changes. To what extent these changes affect visional function on long term needs to be investigated in further studies.

scholarly journals Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus

2018 ◽  
Vol 2018 ◽  
Author(s):  
Sebastian Hörber ◽  
Sarah Hudak ◽  
Martin Kächele ◽  
Dietrich Overkamp ◽  
Andreas Fritsche ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Atypical Antipsychotics ◽  
List Type ◽  
High Blood Glucose ◽  
Increased Risk ◽  
New Onset

Summary Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine. Past history revealed a paranoid schizophrenia diagnosed 10 years ago and for which the patient was treated with risperidone for many years. Acute treatment with intravenous fluids, intravenous insulin infusion and sodium bicarbonate improved the symptoms. Further laboratory investigations confirmed diagnosis of autoimmune type 1 diabetes. After normalization of blood glucose levels, the patient could soon be discharged with a subcutaneous insulin therapy. Learning points: Diabetic ketoacidosis as first manifestation of type 1 diabetes can occur with markedly elevated blood glucose concentrations in elder patients. Atypical antipsychotics are associated with hyperglycemia and an increased risk of new-onset diabetes. First report of risperidone-associated diabetic ketoacidosis in new-onset type 1 diabetes. Patients treated with atypical antipsychotics require special care and regular laboratory examinations to detect hyperglycemia and diabetic ketoacidosis. In cases when the diagnosis is in doubt, blood gas analysis as well as determination of C-peptide and islet autoantibodies can help to establish the definite diabetes type.

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