scholarly journals Impact of Type 1 Diabetes and Its Duration on Wall-to-lumen Ratio and Blood Flow in Retinal Arterioles

2021 ◽  
Author(s):  
Adrian Stefański ◽  
Joanna M Harazny ◽  
Jacek Wolf ◽  
Eliza Miszkowska-Nagórna ◽  
Bogumił Wolnik ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Control ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Retinal Arterioles ◽  
Retinal Capillary ◽  
Group A ◽  
Retinal Microcirculation ◽  
Group B

Abstract Background Subclinical damage to both the small and large vessels may contribute to the development and progression of cardiovascular disease. Scanning laser Doppler flowmetry (SLDF), an established method used to measure retinal microcirculation, has been successfully applied in hypertensive and post-stroke patients. To the best of our knowledge, no previous studies have assessed the impact of type 1 diabetes and its duration on retinal arteriole structure denoted by wall-to-lumen ratio (WLR) and retinal capillary flow (RCF). MethodsRetinal microcirculation was assessed in 158 patients with type 1 diabetes and 38 age-matched healthy controls. The diabetics were divided into 3 groups: group A with diabetes duration <12 months, group B with diabetes duration between 1 and 10 years, and group C >10 years of diabetes. Retinal capillary structure and perfusion were evaluated using a Heidelberg retina flowmeter and automatically analyzed with full-field perfusion imaging. Diabetes control was assessed by HbA1c measurement. ResultsBoth age and BMI were comparable in all the diabetic patients and the controls (mean age 24.8 ± 4.7 years, mean BMI 22.9 ± 4.1). The patients with newly diagnosed diabetes had the highest HbA1c (11.1%) whereas groups B and C were comparable in this respect (7.8% ± 1.9%; 8.0% ± 1.7%, respectively). In the univariate analyses, RCF was significantly higher in group A (297 ± 121 arbitrary units [AU]) vs group B (236 ± 52 AU; p = 0.007) and group C (236 ± 70 AU; p = 0.008) and comparable to that of the controls (p = 0.46). Additionally, the WLR was highest in group C compared to the other diabetic subgroups and controls (p = 0.47). ConclusionsNew-onset diabetes is associated with an increase in RCF, which then gradually decreased with the duration of the disease. Structural changes of the retinal arterioles estimated via WLR are evident later in the course of diabetes, especially when the disease duration exceeded 10 years. These results could not be explained by age or diabetes control. Our findings may have important implications for the understanding of the mechanisms underlying increased cardiovascular risk in type 1 diabetes.

scholarly journals Tumor Necrosis Factor Microsatellite Polymorphism Influences the Development of Insulin Dependency in Adult-Onset Diabetes Patients with the DRB1∗1502-DQB1∗0601 Allele and Anti-Glutamic Acid Decarboxylase Antibodies

2000 ◽  
Vol 85 (9) ◽  
pp. 3348-3351
Author(s):  
Hiroshi Obayashi ◽  
Goji Hasegawa ◽  
Michiaki Fukui ◽  
Kenji Kamiuchi ◽  
Akane Kitamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Tumor Necrosis ◽  
Acid Decarboxylase ◽  
Diabetic Patients ◽  
Adult Onset ◽  
Group A ◽  
Group B ◽  
Necrosis Factor

Abstract Recently, several studies have demonstrated that tumor necrosis factor microsatellite polymorphism (TNFa) contributes to the susceptibility of type 1 diabetes. This study investigates the influence of TNFa on the predisposition to insulin dependency in adult-onset diabetic patients with type 1 diabetes-protective human leukocyte antigen haplotypes. The TNFa of three groups of DRB1∗1502-DQB1∗0601-positive diabetic patients who had initially been nonketotic and noninsulin dependent for more than 1 yr was analyzed. Group A included 11 antibodies to glutamic acid decarboxylase (GADab)-positive patients who developed insulin dependency within 4 yr of diabetes onset. Group B included 11 GADab-positive patients who remained noninsulin dependent for more than 12 yr. Group C included 12 GADab-negative type 2 diabetes, and a control group included 18 nondiabetic subjects. In the group C and control subjects, DRB1∗1502-DQB1∗0601 was strongly associated with the TNFa13 allele. DRB1∗1502-DQB1∗0601 was strongly associated with the TNFa12 allele among the group A patients, but not among the group B patients. Interestingly, sera from all patients with non-TNFa12 and non-TNFa13 in group B reacted with GAD65 protein by Western blot. These results suggest that TNFa is associated with a predisposition to progression to insulin dependency in GADab/DRB1∗1502-DQB1∗0601-positive diabetic patients initially diagnosed with type 2 diabetes and that determination of these patients’ TNFa genotype may allow for better prediction of their clinical course.

scholarly journals Combined Aerobic and Resistance Training Performed under Conditions of Normobaric Hypoxia and Normoxia Has the Same Impact on Metabolic Control in Men with Type 1 Diabetes

2021 ◽  
Vol 18 (24) ◽  
pp. 13058
Author(s):  
Marta Wróbel ◽  
Dominika Rokicka ◽  
Artur Gołaś ◽  
Miłosz Drozd ◽  
Alicja Nowowiejska-Wiewióra ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Resistance Training ◽  
Diabetes Control ◽  
Maximum Oxygen Consumption ◽  
Anthropometric Parameters ◽  
Hypoxia Group ◽  
Group A ◽  
Term Type

(1) Background: The aim was to assess whether combined aerobic and resistance training performed under hypoxic and normoxic conditions had an impact on diabetes control, VO2max (maximum oxygen consumption), and echocardiological and anthropometric parameters in men with long-term type 1 diabetes. (2) Methods: Sixteen male participants (mean age: 37 years, mean HbA1c (glycated hemoglobin): 7.0%) were randomly assigned to two groups: training in normoxic conditions or training in conditions of altitude hypoxia. All subjects participated in 60 min combined aerobic and resistance training sessions twice a week for 6 weeks. At baseline and in the 6th week, echocardiography, incremental exercise test, and anthropometric and diabetes control parameters were assessed. (3) Results: After 6 weeks, there was no significant change in HbA1c value in any group. We noted a more stable glycemia profile during training in the hypoxia group (p > 0.05). Patients in the hypoxia group required less carbohydrates during training than in the normoxia group. A comparable increase in VO2max was observed in both groups (p > 0.05). There were no significant differences in cardiological and anthropometric parameters. (4) Conclusions: Combined aerobic and resistance training improved VO2max after 6 weeks regardless of the conditions of the experiments. This exercise is safe in terms of glycemic control in patients with well-controlled diabetes.

scholarly journals Assessment of Subclinical Left Ventricular Systolic and Diastolic Dysfunction in Patients with Type 1 DM with and without Good Metabolic Control

2021 ◽  
pp. 51-59
Author(s):  
Hesham Ali Elbahgy ◽  
Mohamed Khalfallah ◽  
Randa Mohamed Abdel-Meged ◽  
Mai M. Abd Elmoneim Salama
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Metabolic Control ◽  
Speckle Tracking ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Group A ◽  
Group B

Background: Diabetic patients with normal left ventricular ejection fraction (LVEF)are frequently associated with diastolic dysfunction. However, LVEF is known not to be a sensitive marker for the detection of subclinical LV systolic dysfunction. This study aimed to assess left ventricular systolic and diastolic function in asymptomatic type 1 diabetic patients by conventional, tissue Doppler and two-dimensional speckle tracking echocardiography to assess subclinical left ventricular systolic and diastolic dysfunction. Methods: Case-control study was conducted at 150 patients aged 15-35 y were subdivided into three equal groups: Group A: with type 1 diabetes mellitus (T1DM) with good metabolic control (Hb A1C <7.0), Group B: T1DM with poor metabolic control (Hb A1C>7.0), and Group C: Control group: included 50 normal healthy subjects. Results: Tissue Doppler, diastolic function and strain parameters, AP4C LS, AP2C LS, AP3C LS, and GLS were significantly impaired among the three groups. AP4C LS, AP2C LS, AP3C LS, and GLS were significantly lower in group B than group A and group C and was significantly lower in group A than group C, A velocity was significantly impaired among the three groups. A velocity was significantly higher in group B than group A and group C and was insignificantly impaired in group A than group C. Conclusion: Conventional echocardiography parameters were insignificantly different between the study groups. 2D speckle tracking and tissue Doppler echocardiography showed that subclinical left ventricular systolic function may be affected even before affection of diastolic function. Longer duration and poor glycemic control of diabetes significantly affect GLS.

scholarly journals Active Stromal Cell–Derived Factor 1α and Endothelial Progenitor Cells are Equally Increased by Alogliptin in Good and Poor Diabetes Control

2017 ◽  
Vol 10 ◽  
pp. 117955141774398 ◽  
Author(s):  
Roberto Negro ◽  
Eupremio Luigi Greco ◽  
Giacomo Greco
Keyword(s):  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Stromal Cell ◽  
Diabetes Control ◽  
Diabetic Patients ◽  
Endothelial Progenitor ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Group A ◽  
Stromal Cell Derived Factor ◽  
Group B

Background: It is postulated that the ability of dipeptidyl peptidase-4 inhibitors (DPP-4-i) to increase circulating endothelial progenitor cells (EPCs) may be at least partly mediated by active stromal cell–derived factor 1α (SDF-1α) (a pivotal mediator of stem cell mobilization from the bone marrow). As other DPP-4-i were demonstrated to increase EPC concentrations, in this study, we sought to investigate the ability of the DPP-4-i alogliptin in modifying EPCs and SDF-1α, in patients with good and poor diabetes control. Methods: Two groups of diabetic patients on metformin were divided by hemoglobin A1c (HbA1c): Group A—those with HbA1c ≤6.5% (28 patients) and Group B—those with HbA1c 7.5% to 8.5% (31 patients). Both groups received alogliptin 25 mg/daily for 4 months. At baseline and 4 months later, clinical, laboratory parameters, EPCs, and active SDF-1α were determined. Results: After 4-month treatment with alogliptin, either Group A or Group B showed reduced HbA1c levels and concomitant similar increase in EPCs and active SDF-1α. Conclusions: Alogliptin showed significant benefits in increasing EPCs and active SDF-1α either in good or poor diabetes control. The study demonstrated that similar to other DPP-4-i, also alogliptin is able to increase EPC concentrations, suggesting the existence of a class effect mediated by SDF-1α. The extent of increase in EPCs is independent from baseline diabetes control.

scholarly journals High Frequency of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Agnieszka Szypowska ◽  
Anna Ramotowska ◽  
Monika Grzechnik-Gryziak ◽  
Wojciech Szypowski ◽  
Anna Pasierb ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Fold Increase ◽  
Metabolic Decompensation ◽  
Newly Diagnosed ◽  
Similar Frequency ◽  
Group A ◽  
Group B ◽  
Hba1c Levels

Aim. The aim of this study was to evaluate the incidence of diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in 2006-2007 and 2013-2014.Method. The study group consisted of 426 children aged 0–18 years with type 1 diabetes onset admitted to our hospital in 2006-2007 (group A) and 2013-2014 (group B). The study comprised the analysis of medical and laboratory records from patients’ medical charts and the electronic database.Results. There was no difference between groups A and B in the percentage of children admitted with diabetic ketoacidosis (25% versus 28%, resp.,P=0.499). Among children with diabetic ketoacidosis, severe metabolic decompensation (pH < 7.1) appeared in similar frequency in groups A and B (28% versus 30%, resp.,P=0.110). In group B, children with diabetic ketoacidosis were statistically younger compared to patients without ketoacidosis(P=0.015)and had higher HbA1c levels(P=0.006). In both groups, a 2-fold increase in diabetic ketoacidosis was noted in children under the age of 3, compared to overall frequency.Conclusion. No decrease in diabetic ketoacidosis has been noted in the recent years. Although the prevalence and severity of diabetic ketoacidosis remain stable, they are unacceptably high. The youngest children are especially prone to ketoacidosis.

scholarly journals Development of Type 1 Diabetes in Wild Bank Voles Associated With Islet Autoantibodies and the Novel Ljungan Virus

2003 ◽  
Vol 4 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Bo Niklasson ◽  
Knud E. Heller ◽  
Bryan Schønecker ◽  
Mogens Bildsøe ◽  
Terri Daniels ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Clethrionomys Glareolus ◽  
Acid Decarboxylase ◽  
Specific Lysis ◽  
Bank Voles ◽  
Ljungan Virus ◽  
Group A ◽  
Group B

Wild bank voles (Clethrionomys glareolus) may develop diabetes in laboratory captivity. The aim of this study was to test whether bank voles develop type 1 diabetes in association with Ljungan virus. Two groups of bank voles were analyzed for diabetes, pancreas histology, autoantibodies to glutamic acid decarboxylase (GAD65), IA-2, and insulin by standardized radioligand-binding assays as well as antibodies to in vitro transcribed and translated Ljungan virus antigens. Group A represented 101 trapped bank voles, which were screened for diabetes when euthanized within 24 hours of capture. Group B represented 67 bank voles, which were trapped and kept in the laboratory for 1 month before being euthanized. Group A bank voles did not have diabetes. Bank voles in group B (22/67; 33%) developed diabetes due to specific lysis of pancreatic islet beta cells. Compared to nondiabetic group B bank voles, diabetic animals had increased levels of GAD65 (P< .0001), IA-2 (P< .0001), and insulin (P= .03) autoantibodies. Affected islets stained positive for Ljungan virus, a novel picorna virus isolated from bank voles. Ljungan virus inoculation of nondiabetic wild bank voles induced beta-cell lysis. Compared to group A bank voles, Ljungan virus antibodies were increased in both nondiabetic (P< .0001) and diabetic (P= .0015) group B bank voles. Levels of Ljungan virus antibodies were also increased in young age at onset of newly diagnosed type 1 diabetes in children (P< .01). These findings support the hypothesis that the development of type 1 diabetes in captured wild bank voles is associated with Ljungan virus. It is speculated that bank voles may have a possible zoonotic role as a reservoir and vector for virus that may contribute to the incidence of type 1 diabetes in humans.

scholarly journals Relationship of C-peptide levels to duration of Type 1 diabetes – A study from Sindh, Pakistan

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Asher Fawwad ◽  
Nazish Waris ◽  
Saima Askari ◽  
Graham Ogle ◽  
Muhammad Yakoob Ahmedani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetes Group ◽  
C Peptide ◽  
Duration Of Diabetes ◽  
Group A ◽  
Group B ◽  
Relationship Of

Objective: To determine the relationship of C-peptide levels with duration of type 1 diabetes mellitus. Methods: This prospective study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), Karachi-Pakistan from December 2013 to December 2015. A total of 184 subjects were recruited during the study period, 100 in Group-A and 84 in Group-B. Subjects clinically diagnosed with type 1 diabetes Mellitus (T1DM) were categorized into two groups based on duration of diabetes: Group-A (with ≤1-year duration of diabetes) and Group-B (with >1-year duration of diabetes). Ninety-nine of the 100 enrolled subjects in Group-A were diagnosed as having T1DM, with one subject who presented at 11.9 years of age and diagnosed with T2DM excluded from this study. Blood samples were drawn for biochemical parameters. Data for baseline characteristics and clinical parameters (HbA1c and C-peptide) were obtained from hospital management system of BIDE. Results: Fifty-seven (57.6%) subjects in Group-A, and 39 (46.4%) in Group-B were males. Mean±SD duration of diabetes (years) was 0.64±0.6 (range 0-1) in Group-A, and 7.65±5.5 (range 1-23) in Group-B. Family history of T1DM and T2DM was 1(1%) and 27(27.3%) in Group-A, and 8(9.52%) and 21(25%) in Group-B, respectively. Twenty-one (21.2%) subjects presented in diabetic ketoacidosis (DKA) in Group-A and 18(21.4%), in Group-B. Mean±SD for HbA1c was non-significantly higher in Group-A 11.12±2.31 compared to Group-B 10.42±1.45. Mean±SD for C-peptide was 1.91±1.53 ng/mL (0.60±0.481 nmol/L) in Group-A, and 1.82±1.01 (0.57±0.32 nmol/L) in Group-B (p=0.984). Conclusion: The study found that subjects with longer duration of T1DM had non-significantly decreased C-peptide levels compared to a group in which C-peptide was measured at or soon after diagnosis. Furthermore, C-peptide levels in many subjects with longer duration were higher than expected in classic T1DM. doi: https://doi.org/10.12669/pjms.36.4.1531 How to cite this:Fawwad A, Waris N, Askari S, Ogle G, Ahmedani MY, Basit A. Relationship of C-peptide levels to duration of Type 1 diabetes – A study from Sindh, Pakistan. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1531 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Central Corneal Thickness can be Related to Diabetic Peripheral Neuropathy in Children with Type 1 Diabetes

2019 ◽  
Vol 127 (10) ◽  
pp. 672-676 ◽  
Author(s):  
Krzysztof Jeziorny ◽  
Michal Fila ◽  
Aleksandra Pyziak-Skupien ◽  
Magdalena Kolodziej ◽  
Arleta Waszczykowska ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Neuropathy ◽  
Conduction Velocity ◽  
Central Corneal Thickness ◽  
Early Stage ◽  
Corneal Thickness ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Study Results

Abstract Aims Diabetic eye disease with its various manifestations as well as diabetic neuropathy may occur in patients with type 1 diabetes (T1D) after several years of diabetes duration. Pachymetry is a promising method evaluating central corneal thickness (CCT) in diabetic patients. The aim of the study was to evaluate the CCT values in children with T1D and its relationship to neurophysiological markers of diabetic neuropathy. Methods The study groups included 119 T1D children with average 5.3 years of diabetes duration and 38 age-matched controls. CCT index was measured with pachymeter in all subjects and in 19/119 of T1D patients the CCT values were referred to the ENG-EMG-SSR study results. Results In T1D patients the higher CCT values were observed as compared to healthy controls (p=0.037). Correlations between CCT values and both distal latency of the motor fibers of the median nerve (R=0.51; p=0.044) and conduction velocity of this nerve (R=−0.55; p=0.027) were noted. A conduction velocity of the sensory fibers of sural nerve correlated negatively with CCT index (R=−0.50; p=0.045) in the T1D patients. Conclusions CCT measurement may be helpful in the referral of the asymptomatic pediatric T1D patients to assess an early stage of diabetic neuropathy.

scholarly journals Central Part of the Auditory Analyser in Children with Type 1 Diabetes

2019 ◽  
Vol 26 (4) ◽  
pp. 36-44
Author(s):  
L. A. Lazareva ◽  
A. A. Tarasenko ◽  
I. Yu. Chernyak
Keyword(s):  
Type 1 Diabetes ◽  
Evoked Potentials ◽  
Clinical Manifestations ◽  
Stimulus Frequency ◽  
Control Group ◽  
Long Latency ◽  
Group A ◽  
Group B ◽  
Brainstem Evoked Potentials

Aim. The present article assesses the state of the central part of the auditory analyser in children with type 1 diabetes.Materials and methods. The study included 71 children with type 1 diabetes mellitus who were treated at the Endocrinology Department of the Children’s Territorial Clinical Hospital from September 2017 to February 2018. The children’s age ranged from 7 to 15 years (8±2.6). Group A comprised 34 children who were fi rst diagnosed with type 1 diabetes, with the duration of clinical manifestations not exceeding 3 months; whereas group B included 37 children who had been suffering from type 1 diabetes for 1–5 years. The control group was represented by 30 children of the same age group without a somatic pathology (group K). The functional state of the central part of the auditory analyser was assessed when studying brainstem evoked potentials of short, middle and long latency.Results. In the course of studying short-latency brainstem evoked potentials at a broadband-click stimulus frequency of 10 Hz and an intensity of 70 dB, the latent periods of peaks and peak-topeak intervals were analysed in groups A, B and K. Statistically signifi cant differences were observed for I and V latent periods of peaks, as well as for the I–V inter-peak interval. At a click stimulus intensity of 70 dB, peaks and peak-to-peak intervals of middle-latency brainstem evoked potentials revealed differences in the values of NO, PO, Na, Pa and NO–PO between the groups of patients with type 1 diabetes and the control group. Greater statistical differences, as compared to the control group, were observed in the latent periods of long-latency brainstem evoked potentials for interval P1 in group A and intervals P2 and N2 in group B (unfavourable course) during 100 dB stimulation at a repetition frequency of 1 Hz in a time window of 50 ms. The presence of differences between groups A and B in the parameters of peak P2 (p ≤ 0.07), as well as peak intervals P2–N2, N1–N2, N1–P1, N2–P2 and N1–P2, may indicate signifi cant differences in the centres of the auditory analyser (p ≤ 0.1). At the same time, the maximum activity of the studied parameters was found in the group of patients with newly diagnosed type 1 diabetes.Conclusions. The study of different types of brainstem evoked potentials, characterising the central parts of the auditory analyser, in children with type 1 diabetes allowed the authors to register functional disorders both in the brainstem segment and in the cortical structures. This fact indirectly indicates initial manifestations of diabetic neuropathy in the studied category of patients and can be used in the future for diagnosing CNS disorders.

scholarly journals Delayed pubertal onset and development in German children and adolescents with type 1 diabetes: cross-sectional analysis of recent data from the DPV diabetes documentation and quality management system

2007 ◽  
Vol 157 (5) ◽  
pp. 647-653 ◽  
Author(s):  
Tilman Rohrer ◽  
Eva Stierkorb ◽  
Sabine Heger ◽  
Beate Karges ◽  
Klemens Raile ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Sexual Maturity ◽  
Insulin Dose ◽  
Tanner Stage ◽  
Pubic Hair ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Pubertal Onset ◽  
Hair Development

AbstractObjectiveTo investigate the effect of type 1 diabetes on pubertal onset and development, and to identify factors potentially affecting puberty, including glycemic control, relative diabetes duration, body mass index standard delta score (BMI SDS), insulin dose, and intensity of insulin therapy.Research design and methodsInitiated in 1990, the Diabetes-Patienten-Verlaufsdaten (DPV) is an ongoing, prospective longitudinal follow-up program to benchmark the quality of diabetes care provided to, predominantly, pediatric patients. Data collection for this non-interventional audit was carried out at 202 German diabetes treatment centers. Patient recruitment was done by referral, clinic/hospital ascertainment, or self-report. Data were analyzed for subcohorts of 1218–2409 boys and 579–2640 girls from a cohort of 24 385 pediatric type 1 diabetic patients. Selection was based on ethnicity and availability of data on Tanner stage 2, or higher, of genital and pubic hair development (boys) or breast and pubic hair development, and menarche (girls).ResultsBoys showed significant (P<0.05) delay (years) in mean ages at onset of genital development (12.0 (±0.9) years) and pubarche (12.2 (±0.4) years). In girls, mean ages at thelarche (11.4 (±0.5) years), pubarche (11.5 (±0.1) years), and menarche (13.2 (±0.5) years) were significantly delayed compared with the general population. Sexual maturity (Tanner stage 5) was not delayed in either sex. Elevated glycohemoglobin and decreased BMI SDS were associated with significantly delayed pubertal onset, whereas relative diabetes duration and insulin dose were not.ConclusionsPubertal onset, but not sexual maturity, is delayed in children with type 1 diabetes. Delay increases with higher glycohemoglobin and lower BMI SDS.

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