693-P: Oxidative–Antioxidant Balance after Maximum Intensity Exercise in Men with Type 1 Diabetes Treated with a Personal Insulin Pump vs. Healthy Control

Background & Introduction: Due to the increasing prevalence of type-1-diabetes an increasing number of studies draws investigation draws attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintanable condition, with the affected children and their families facing a lifelong challenge. Our research focuses on the factors influencing adherence. Methods & Results: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al, 2019) (DAF 2017; N=114). The influence of socio-demographic variables and those related to the disease (age at the diagnosis, time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) were measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018. The effect of using insulin pump as therapy is significant and positive (0.36. p=0.045). The adherence of the patients using insulin pump is higher while the effect of the age at the diagnosis has a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of the those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected. Conclusions: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.

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HLA class I genes modulate disease risk and age at onset together with DR-DQ in Chinese patients with insulin-requiring type 1 diabetes

Diabetologia ◽

10.1007/s00125-021-05476-6 ◽

2021 ◽

Author(s):

Ziyu Jiang ◽

Wenqian Ren ◽

Hua Liang ◽

Jinhua Yan ◽

Daizhi Yang ◽

...

Keyword(s):

Type 1 Diabetes ◽

Disease Risk ◽

Hla Class I ◽

Class I ◽

Chinese Patients ◽

Onset Age ◽

Disease Heterogeneity ◽

Negatively Associated ◽

Healthy Control

Abstract Aims/hypothesis The study aimed to investigate the effects of HLA class I genes on susceptibility to type 1 diabetes with different onset ages, in addition to the well-established effects of HLA class II genes. Methods A total of 361 patients with type 1 diabetes (192 patients with onset <18 years and 169 patients with onset ≥18 years) and 500 healthy control participants from China were enrolled and genotyped for the HLA-A, -B, -C, -DQA1, -DQB1 and -DRB1 genes using next-generation sequencing. Results The susceptible DR3 (β = −0.09, p = 0.0009) and DR4-DQ8 (β = −0.13, p = 0.0059) haplotypes were negatively associated with onset age, while the protective DR11 (β = 0.21, p = 0.0314) and DR12 (β = 0.27, p < 0.0001) haplotypes were positively associated with onset age. After adjustment for linkage disequilibrium with DR-DQ haplotypes, A*11:01:01 was positively associated with onset age (β = 0.06, p = 0.0370), while the susceptible C*15:02:01 was negatively associated with onset age (β = −0.21, p = 0.0050). The unit for β was double square-root (fourth root) transformed years of change in onset age associated with per copy of the HLA haplotype/allele. In addition, B*46:01:01 was protective (OR 0.41, 0.46; pc [corrected for multiple comparisons] = 0.0044, 0.0040), whereas A*24:02:01 (OR 2.71, 2.25; pc = 0.0003, 0.0002) and B*54:01:01 (OR 3.96, 3.79; pc = 0.0018, 0.0004) were predisposing in both the <18 group and the ≥18 group compared with healthy control participants. In the context of DR4-DQ4, A*11:01:01 (61.29% vs 28.26%, pc = 0.0144) was increased while the predisposing A*24:02:01 (19.35% vs 47.83%, pc = 0.0403) was decreased in patients with onset ≥18 years when compared with patients with onset <18 years. Conclusions/interpretation In addition to DR-DQ haplotypes, novel HLA class I alleles were detected to play a role in susceptibility to type 1 diabetes with different onset ages, which could improve the understanding of disease heterogeneity and has implications for the design of future studies. Graphical abstract

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Glycemic Control in Transition‐Aged Versus Early Adults with Type 1 Diabetes and the Effect of a Government‐Funded Insulin Pump Program

Diabetic Medicine ◽

10.1111/dme.14618 ◽

2021 ◽

Author(s):

Shane P Mooney ◽

Gillian L Booth ◽

Rayzel Shulman ◽

Yingbo Na ◽

Alanna Weisman ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Insulin Pump

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Pump It Up! A randomized clinical trial to optimize insulin pump self-management behaviors in adolescents with type 1 diabetes

Contemporary Clinical Trials ◽

10.1016/j.cct.2021.106279 ◽

2021 ◽

Vol 102 ◽

pp. 106279

Author(s):

Holly K. O'Donnell ◽

Tim Vigers ◽

Suzanne Bennett Johnson ◽

Laura Pyle ◽

Nancy Wright ◽

...

Keyword(s):

Clinical Trial ◽

Type 1 Diabetes ◽

Randomized Clinical Trial ◽

Insulin Pump ◽

Self Management ◽

Management Behaviors

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The effectiveness of running virtual clinics as part of insulin pump services for patients with type 1 diabetes

Endocrine and Metabolic Science ◽

10.1016/j.endmts.2021.100083 ◽

2021 ◽

Vol 3 ◽

pp. 100083

Author(s):

Beth Mumford ◽

Victoria Oldham ◽

Dawn Lee ◽

Julie Jones ◽

Gautam Das

Keyword(s):

Type 1 Diabetes ◽

Insulin Pump

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Differential Expression of Inflammatory Markers in Hypoglycemia Unawareness Associated with Type 1 Diabetes: A Case Report

Brain Sciences ◽

10.3390/brainsci11010017 ◽

2020 ◽

Vol 11 (1) ◽

pp. 17

Author(s):

Yousef Al Zoubi ◽

Bashair M. Mussa ◽

Ankita Srivastava ◽

Abdul Khader Mohammed ◽

Elamin Abdelgadir ◽

...

Keyword(s):

Type 1 Diabetes ◽

Case Report ◽

Differential Expression ◽

Insulin Pump ◽

Mrna Level ◽

Insulin Injection ◽

Hypoglycemia Unawareness ◽

Tnf Α ◽

Ifn Γ

The recurrence of hypoglycemic episodes leads to attenuation of the normal counter-regulatory mechanisms that are controlled by the hypothalamus, which results in hypoglycemia unawareness (HU). In this case report, we described for the first time the differential expression of TNF-α, IL-1β, IL-6, and IFN-γ in a blood sample that was taken from a 27-year-old patient with type 1 diabetes mellitus (T1DM) who was diagnosed with HU. The anti-diabetic regimen is currently based on insulin injection, but the patient is planning to start the use of an insulin pump to have better control of glucose levels. Our results showed a trend toward an increase in the expression of IL-1β, IL-6, and IFN-γ in T1DM patient with HU. However, the mRNA level of TNF-α showed a significant decrease. These observations suggest that systemic inflammation could be an underlying cause of HU.

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