scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background: The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods: Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results: 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion: Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

An Approach to diabetic ketoacidosis in an emergency setting.

2020 ◽  
Vol 15 ◽  
Author(s):  
Dario Pitocco ◽  
Mauro Di Leo ◽  
Linda Tartaglione ◽  
Emanuele Gaetano Rizzo ◽  
Salvatore Caputo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Blood Glucose Concentration ◽  
Diabetic Complication ◽  
Emergency Setting ◽  
Online Activity

Background: Diabetic Ketoacidosis (DKA) is one of the most commonly encountered diabetic complication emergencies. It typically affects people with type 1 diabetes at the onset of the disease. It can also affect people with type 2 diabetes, although this is uncommon. Methods: Research and online content related to diabetes online activity is reviewed. DKA is caused by a relative or absolute deficiency of insulin and elevated levels of counter regulatory hormones. Results: Goals of therapy are to correct dehydration, acidosis and to reverse ketosis, gradually restoring blood glucose concentration to near normal. Conclusion: Furthermore it is essential to monitor potential complications of DKA and if necessary, to treat them and any precipitating events.

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 Immune checkpoint inhibitors: an emerging cause of insulin-dependent diabetes

2019 ◽  
Vol 7 (1) ◽  
pp. e000591 ◽  
Author(s):  
Anupam Kotwal ◽  
Candace Haddox ◽  
Matthew Block ◽  
Yogish C Kudva
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Immune Checkpoint ◽  
Insulin Dependent Diabetes ◽  
Insulin Deficiency ◽  
Immune Mediated ◽  
Insulin Dependent ◽  
New Onset

ObjectiveInsulin-dependent diabetes can occur with immune checkpoint inhibitor (ICI) therapy. We aimed to characterize the frequency, natural history and potential predictors of ICI-induced diabetes.Research design and methodsWe reviewed 1444 patients treated with ICIs over 6 years at our cancer center, and from the 1163 patients who received programmed cell death protein 1 (PD-1) inhibitors, we identified 21 such cases, 12 of which developed new-onset insulin-dependent diabetes and 9 experienced worsening of pre-existing type 2 diabetes.ResultsICI-induced diabetes occurred most frequently with pembrolizumab (2.2%) compared with nivolumab (1%) and ipilimumab (0%). The median age was 61 years, and body mass index was 31 kg/m2, which are both higher than expected for spontaneous type 1 diabetes. Other immune-related adverse events occurred in 62%, the most common being immune mediated thyroid disease. New-onset insulin-dependent diabetes developed after a median of four cycles or 5 months; 67% presented with diabetic ketoacidosis and 83% with low or undetectable C-peptide. Autoantibodies were elevated in 5/7 (71%) at the time of new-onset diabetes. Diabetes did not resolve during a median follow-up of 1 year.ConclusionsPD-1 inhibitors can lead to insulin deficiency presenting as new-onset diabetes or worsening of pre-existing type 2 diabetes, with a frequency of 1.8 %. The underlying mechanism appears similar to spontaneous type 1 diabetes but there is a faster progression to severe insulin deficiency. Better characterization of ICI-induced diabetes will improve patient care and enhance our understanding of immune-mediated diabetes.

Advantages and Disadvantages of Realtime Continuous Glucose Monitoring in People with Type 2 Diabetes

2012 ◽  
Vol 08 (01) ◽  
pp. 22 ◽  
Author(s):  
M Susan Walker ◽  
Stephanie J Fonda ◽  
Sara Salkind ◽  
Robert A Vigersky ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Levels ◽  
Advantages And Disadvantages ◽  
Blood Glucose Levels

Previous research has shown that realtime continuous glucose monitoring (RT-CGM) is a useful clinical and lifestyle aid for people with type 1 diabetes. However, its usefulness and efficacy for people with type 2 diabetes is less known and potentially controversial, given the continuing controversy over the efficacy of self-monitoring of blood glucose (SMBG) in this cohort. This article reviews theextantliterature on RT-CGM for people with type 2 diabetes, and enumerates several of the advantages and disadvantages of this technology from the perspective of providers and patients. Even patients with type 2 diabetes who are not using insulin and/or are relatively well controlled on oral medications have been shown to spend a significant amount of time each day in hyperglycemia. Additional tools beyond SMBG are necessary to enable providers and patients to clearly grasp and manage the frequency and amplitude of glucose excursions in people with type 2 diabetes who are not on insulin. While SMBG is useful for measuring blood glucose levels, patients do not regularly check and SMBG does not enable many to adequately manage blood glucose levels or capture marked and sustained hyperglycemic excursions. RT-CGM systems, valuable diabetes management tools for people with type 1 diabetes or insulin-treated type 2 diabetes, have recently been used in type 2 diabetes patients. Theextantstudies, although few, have demonstrated that the use of RT-CGM has empowered people with type 2 diabetes to improve their glycemic control by making and sustaining healthy lifestyle choices.

scholarly journals SUN-655 Helicobacter Pylori Infection Is Not Associated with Diabetes Among a Cohort of Diabetic Patients in Alexandria City, Egypt

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mohamed Fahmy Amara
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Helicobacter Pylori ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Helicobacter Pylori Infection ◽  
Diabetes Group ◽  
Significant Difference

Abstract Abstract: Helicobacter Pylori infection is one of the most common bacterial infections in Egypt. A mounting body of evidence suggests the association of H Pylori infection with diabetes. H.Pylori is implicated in increasing insulin resistance and promoting chronic inflammation, resulting in the development of diabetes. This study aimed to estimate the prevalence of H.Pylori infection among a cohort of patients with diabetes in Alexandria city, Egypt and the possible role of this condition in the control of the glycemic profile. We also investigated the correlation between H.pylori infection and the presence of diabetes-related complications (diabetic nephropathy and retinopathy). The study was conducted on 300 subjects classified into three groups; Group (I): 100 patients with type 2 diabetes, Group (II): 100 subjects with type 1 diabetes, Group (III): 100 non-diabetic control subjects. Participants were subjected to detailed history taking and thorough clinical examination. Routine laboratory investigations were done, including HbA1c and fasting plasma glucose. Stool antigen test, on- site Helicobacter Pylori Ag Rapid Test-cassette was done. The mean duration of diabetes in type 2 diabetes was 8.18±5.87 years, while the mean duration in type 1 was 4.88± 3.02 years, which was statistically significante (p&lt; 0.05). The results of the presented study showed that there was no significant difference in the prevalence of Helicobacter Pylori infection between type 1 and type 2 patients with diabetes (31% Vs 38%, p=0.298), moreover; after adjustment for age, there was no significant difference in the prevalence of Helicobacter Pylori infection among either group with diabetes (Group 1 and group 2) compared to the control group, (p= 0.756 and 0.066) respectively. There was no statistically significant association between the presence of Helicobacter Pylori infection in both type 1 and type 2 diabetes, and an elevated HbA1c level above 6.5%.(p= 0.772 and p=0.524) respectively. The prevalence of diabetic nephropathy in patients with type 2 and type 1 diabetes was 5% and 3% respectively, which was non-statistically significant (p=0.721). While the prevalence of diabetic retinopathy was 11% among patients with type 2 compared to 1% among patients with type 1 diabetes, which was statistically significant (p=0.003). There was no statistically significant correlation between Helicobacter Pylori infection and the presence of diabetic nephropathy or diabetic retinopathy. Helicobacter Pylori infection was not associated with diabetes and did not affect the HbA1c level. Helicobacter Pylori infection was not correlated to the presence of either diabetic nephropathy or diabetic retinopathy among both patients with type 2 and type 1 diabetes. Nothing to Disclose: MA, MM, AH No Sources of Research Support

Diabetes Drugs

2006 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Sugar Content ◽  
Multisystem Disease ◽  
Oral Medications ◽  
High Sugar Content

Diabetes mellitus is a multisystem disease associated with the loss of control of physiological glucose concentrations in the blood. The disease is broadly broken down into two types based on factors that include age, acuteness of onset, underlying glucose-handling deficit, and therapy. Type 1 diabetes usually manifests acutely in the young, secondary to some underlying insult (possibly infectious) to the islet cells of the pancreas, resulting in an absolute lack of insulin. Type 2 diabetes is more frequently associated with maturity, obesity, and gradually increasing blood glucose concentrations; it may be asymptomatic for some time and discovered on routine glucose screening. In fact, as weight increases among the general population of the developed world, type 2 diabetes is becoming an epidemic. Type 1 diabetes always requires insulin replacement therapy, whereas type 2 can frequently be controlled with diet, weight loss, and oral medications that enhance residual pancreatic function. Diabetes has been known since antiquity. In fact, the term diabetes mellitus comes from the Greek meaning “siphon and honey” due to the excess excretion (siphon or faucet) of hyperglycemic (sweetened, or honeyed) urine. In ancient times, most cases of diabetes were of type 1, with acute onset in the young, which was often fatal. Type 2 diabetes was extremely rare when sources of nutrition were scarce and obesity was not prevalent. Diabetes was also known as “wasting” because diabetics were not able to metabolize the sugar content of food and eventually died from wasting away. Because of the effect of excess blood glucose, the blood of the diabetic is hyperosmolar (concentrated), and this triggers compensatory thirst (in an attempt to dilute the hyperglycemia and return the blood to a normal concentration). This excess thirst results in the common diabetic symptom of polydipsia (excessive drinking secondary to thirst, resulting in the urge to drink frequently) and polyuria (excess urination). Even before many modern diagnosis tools became available, savvy doctors could diagnose diabetic men just by looking at their shoes for the telltale white spots from urine with high sugar content. In fact, tasting urine samples of diabetics was a routine diagnostic tool for diabetes. Even the breath of a severe diabetic was sweet—a sickly smell as a result of acidosis. In addition, it has been mentioned that ants would track to the urine of diabetics.

scholarly journals Islet Transplantation to the Anterior Chamber of the Eye—A Future Treatment Option for Insulin-Deficient Type-2 Diabetics? A Case Report from a Nonhuman Type-2 Diabetic Primate

2020 ◽  
Vol 29 ◽  
pp. 096368972091325
Author(s):  
Sai Bo Bo Tun ◽  
Minni Chua ◽  
Riasat Hasan ◽  
Martin Köhler ◽  
Xiaofeng Zheng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Anterior Chamber ◽  
Islet Transplantation ◽  
Fasting Blood Glucose ◽  
Fasting Blood Glucose Level ◽  
Metabolic Markers

Replacement of the insulin-secreting beta cells through transplantation of pancreatic islets to the liver is a promising treatment for type-1 diabetes. However, low oxygen tension, shear stress, and the induction of inflammation lead to significant islet dysfunction and loss. The anterior chamber of the eye (ACE) has gained considerable interest and represents an alternative therapeutic islet transplantation site because of its accessibility, high oxygen tension, and immune-privileged milieu. We have previously demonstrated the feasibility of intraocular islet transplant in mouse and nonhuman primate models of type-1 diabetes and are now assessing its efficacy on glucose homeostasis in a nonhuman primate model of type-2 diabetes. We transplanted allogeneic donor islets (1,500 islet equivalents/kg) into the anterior chamber of one eye in a cynomolgus monkey with high-fat-diet-induced type-2 diabetes. Repeated examinations of the anterior and posterior segments of both eyes were done to monitor the engrafted islets and assess the overall ocular health. Fasting blood glucose level, blood biochemistry, and other metabolic parameters were routinely evaluated to determine the function of the islet graft and diabetes status. The transplanted islets were rapidly engrafted onto the iris and became vascularized 1 month after transplantation. We did not detect changes in intraocular pressure, cataract formation, ophthalmitis, or retinal vessel deformation. A significant lower fasting blood glucose level was observed while the graft was in place, and the transplantation reverts the progression of diabetes. The metabolic markers, hemoglobin A1C and fructosamine, demonstrated improvement following islet transplantation. As a conclusion, intraocular islet transplantation in one eye of a cynomolgus monkey with type-2 diabetes improved its overall plasma glucose homeostasis, as evidenced by short-term measures and long-term metabolic markers. These results further support the future application of the ACE as an alternative site for clinical islet transplants in the context of type-2 diabetes.

scholarly journals Diabetes and Sports

2016 ◽  
Vol 11 (1) ◽  
pp. 58-63
Author(s):  
Michael Yurkewicz ◽  
Michael Cordas ◽  
Amy Zellers ◽  
Michael Sweger
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Signs And Symptoms ◽  
The United States ◽  
Care Plan ◽  
Type I ◽  
Adequate Hydration

More than 29 million people in the United States have diabetes mellitus, including both type 1 and type 2 diabetes. The CDC also estimates that upward of 86 million people can be classified as prediabetic, with as many as 30% of these people transitioning into diabetes within the next 5 years. Individuals with type 1 diabetes account for roughly 5% of those patients. Dating back to 2008 and 2009, roughly 18 000 youth were diagnosed with type 1 diabetes each year. The prevalence of diabetes is well known; most of the studies that are completed today relate to the progression and/or treatment of those with type 2 diabetes. Yet most physicians will have to take care of a type 1 diabetic patient who will want to be active. Having a fundamental knowledge of how exercise affects insulin and blood glucose and how to manage these patients is important. Time must be taken to modify each treatment regimen for each individual. One cannot stress enough the importance of providing patient education, ensuring adequate hydration, recognizing signs and symptoms of hypoglycemia/hyperglycemia, and how to treat and prevent these serious complications. All patients must have a care plan and access to supplies during exercise. It is known that poorly controlled blood glucose can have detrimental consequences in the long term. The question is if type I diabetic athletes who are allowed to have higher blood glucose during exercise are at the same risk for these potential complications.

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