1362-P: Puberty Changes Everything: Longitudinal Multitrajectory Modeling of Metabolic Control, Body Mass Index, and Insulin Dose among 9,239 Children with T1D from the DPV Registry

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1362-P
Author(s):  
ANKE SCHWANDT ◽  
OLIVER KUSS ◽  
DESIREE P. DUNSTHEIMER ◽  
BEATE KARGES ◽  
THOMAS M. KAPELLEN ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Metabolic Control ◽  
Body Mass ◽  
Insulin Dose ◽  
Control Body

scholarly journals Effects of Metformin Added to Insulin in Adolescents with Type 1 Diabetes: An Exploratory Crossover Randomized Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Daizhi Yang ◽  
Jinhua Yan ◽  
Hongrong Deng ◽  
Xubin Yang ◽  
Sihui Luo ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Type 1 Diabetes ◽  
Insulin Sensitivity ◽  
Body Mass ◽  
Autonomic Function ◽  
Insulin Dose ◽  
Glucose Variability

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3   years , body mass index 18.17 ± 1.81   kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.

Serum leptin concentrations in children with type 1 diabetes mellitus: Relationship to body mass index, insulin dose, and glycemic control

Metabolism ◽  
2002 ◽  
Vol 51 (3) ◽  
pp. 292-296 ◽  
Author(s):  
Ashraf T. Soliman ◽  
Magdi Omar ◽  
Hala M. Assem ◽  
Ibrahim S. Nasr ◽  
Mohamed M. Rizk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Body Mass ◽  
Insulin Dose ◽  
Serum Leptin

scholarly journals Relation between Blood Pressure Control, Body Mass Index, and Intensity of Medical Treatment

2003 ◽  
Vol 26 (9) ◽  
pp. 711-715 ◽  
Author(s):  
Ikuo SAITO ◽  
Kazuko MURATA ◽  
Hiroshi HIROSE ◽  
Minako TSUJIOKA ◽  
Hiroshi KAWABE
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Medical Treatment ◽  
Body Mass ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Control Body

scholarly journals Maintenance of efficacy after duodenal– jejunal bypass liner explantation in the first NHS EndoBarrier service

2018 ◽  
Vol 18 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Robert EJ Ryder ◽  
Mahi Yadagiri ◽  
Susan P Irwin ◽  
Wyn Burbridge ◽  
Hardeep Gandhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Glycaemic Control ◽  
Systolic Blood Pressure ◽  
Insulin Therapy ◽  
Body Mass ◽  
Insulin Dose ◽  
Dose Requirement ◽  
Daily Insulin Dose ◽  
Jejunal Bypass

EndoBarrier®, a 60 cm endoscopically implanted proximal intestinal liner, reduces weight and HbA1c over 1 year. We report the outcomes of the first 12 patients who completed 6 months post EndoBarrier removal in the first NHS EndoBarrier service. All patients were obese (body mass index 41.7±9.8 kg/m2) with diabetes for 10–25 years and 75% were on insulin therapy. All patients (age 52.4±9.3 years) were advised to institute behavioural changes during the implant period (1 year) and maintain them thereafter. Implantation of EndoBarrier for 1 year reduced weight (17.6±8.9 kg, p<0.001), HbA1c (26.7±20.8 mmol/mol, 2.4±1.9%, p=0.001), systolic blood pressure (14.1±16.1 mmHg, p=0.011) and median total daily insulin dose from 104 to 48 Units/day (p=0.024) (n=9). Six months post EndoBarrier removal, 75% of patients sustained the metabolic improvement achieved with EndoBarrier; insulin dose requirement continued to fall and four of the nine insulin-treated patients discontinued insulin. Of the three patients whose weight/glycaemic control worsened, two had depression and one became immobile after explantation due to ill health unrelated to EndoBarrier treatment. Most (93.8%) of our patients stated that they would be extremely likely to recommend our service to friends and family. These data are encouraging for wider establishment of NHS EndoBarrier services.

scholarly journals Serum leptin levels in children and adolescents with insulin-dependent diabetes mellitus in relation to metabolic control and body mass index

1998 ◽  
pp. 501-509 ◽  
Author(s):  
W Kiess ◽  
M Anil ◽  
WF Blum ◽  
P Englaro ◽  
A Juul ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Children And Adolescents ◽  
Body Mass ◽  
Insulin Treatment ◽  
Insulin Dose ◽  
Tanner Stage ◽  
Dependent Diabetes Mellitus ◽  
Healthy Children ◽  
Newly Diagnosed ◽  
Serum Leptin

The ob protein, termed leptin, is produced by adipocytes and is thought to act as an afferent satiety signal regulating weight through suppressing appetite and stimulating energy expenditure in humans and/or rodents. Insulin has been found to be a potent stimulator of leptin expression in rodents. It is unclear at present whether this insulin action is a direct or an indirect effect. To investigate whether leptin concentrations in children and adolescents with type 1 diabetes (IDDM) were related to metabolic status, body weight, body mass index and insulin treatment, we have measured leptin concentrations in serum from 13 newly diagnosed IDDM patients before the beginning of insulin treatment (8 girls, 5 boys, aged 4.7-17.5 years) and in 134 patients with IDDM during treatment (64 girls, 70 boys, aged 2.6-20.1 years) using a specific radioimmunoassay. The data from patients with diabetes were compared with normative data that were derived from a large cohort of healthy children and adolescents. Serum from children with newly diagnosed diabetes had significantly lower levels of leptin (mean 1.28+/-1.60 ng/ml, range 0.14-6.13 ng/ml) compared with healthy children (n=710) (mean 2.2 ng/ml, range 0.26-14.4ng/ml) and compared with insulin-treated children and adolescents (mean 5.18+/-5.48 ng/ml, range 0.26-29.77 ng/ml) (P<0.0001) even after adjustment for gender and body mass index (BMI). Serum leptin levels in patients with IDDM were significantly correlated with BMI (r=0.42, P<0.0001). Multiple regression analysis showed that age and BMI were significantly correlated with leptin levels, while duration of diabetes, mean HbA1c levels, insulin dose and plasma glucose, triglyceride and cholesterol levels were not. Females had higher serum leptin concentrations than males even when adjusted for BMI (P<0.0001). Surprisingly and most importantly, leptin levels in insulin-treated young adult (Tanner stage 5) patients were significantly higher than values found in the healthy nondiabetic reference population when adjusted for sex, Tanner stage and BMI. These findings suggest that leptin levels in IDDM patients show a similar dependency on adipose tissue and age as in healthy, normal children. The data provide evidence that insulin may be of importance as a regulator of serum leptin levels in vivo not only in rodents but also in humans. It is hypothesized that the elevated BMI-adjusted leptin levels in adolescents with IDDM could indicate either that these patients may be oversubstituted by the intensified insulin therapy that they are receiving or that their body composition and body fat content may differ from that of healthy adolescents in the sense that they have a relative increase in fat mass.

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