CINNAMON AS AN ENHANCER OF IGF-1 INSULIN RESPONSE AND METABOLIC CONTROL IN PATIENTS WITH DM2 WITHOUT GLYCEMIC CONTROL

Background/Aim. Despite of contemporary diabetes mellitus (DM) treatment, one half of patients do not achieve an optimal metabolic control. Considering great psychological burden of diabetic patients, the purpose of this study was to assess the effect of different insulin treatment regimens, glycemic control and the presence of vascular complications on self-reported well-being and quality of life (QoL) of subjects with type 1 DM. Methods. The patients with type 1 DM (n = 122) recruited from the outpatient Diabetes Endocrinology Clinic of Zvezdara University Medical Center were divided into 4 groups according to the specific treatment regimen: 26 were on continuous subcutaneous insulin infusion (CSII), 30 on conventional insulin therapy, 33 on multiple daily injections (MDI) with human insulins, and 33 on MDI with insulin analogues. QoL was assessed by self-reported well-being with the following questionnaires: WHO-5 item Well Being Index (WHO- 5), 36 item Short Form (SF-36) survey, and Insulin Treatment Appraisal Scale (ITAS). Objective metabolic control was assessed by glycosylated hemoglobin (HbA1c), lipid levels and the presence of vascular complications. Statistical analyses used in this crosssectional study included: descriptive statistics, Student?s t-test, Chisqare test, contingency tables, ANOVA and correlation methods. Results. The patients on CSII had significantly better metabolic control than all other treatment groups, especially when compared to the one on conventional therapy (CSII HbA1c 7.07 ? 1.48% vs conventional therapy, HbA1c 10.04 ? 1.44; p = 0.000). No significant difference in glycemic control was observed between patients on MDI with human insulins and insulin analogues. Good glycemic control significantly influenced the reported QoL. The patients with retinopathy and nephropathy reported significantly lower physical well-being, and the patients with polyneuropathy and cardiovascular complications reported also lower psychological well being. Conclusions. Insulin treatment regiment selection affects not only objective metabolic control, but also QoL.

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MON-086 Various Subcutaneous Continuous Glucose Monitors Comparably Lower HbA1c in Children

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.229 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Steven Gold ◽

Liam McGuirk ◽

James Haigney ◽

Jane Torres ◽

Tara Patale ◽

...

Keyword(s):

Glycemic Control ◽

Metabolic Control ◽

Glucose Monitoring ◽

Initial Visit ◽

High Hba1c ◽

The Difference ◽

Continuous Glucose Monitors ◽

Type 1 Dm ◽

Hba1c Levels

Abstract Background: Preliminary studies have demonstrated improvement in metabolic control of patients (PTs) using subcutaneous Continuous Glucose Monitoring systems (CGMs). In this study, we investigated the effect of CGMs on PTs’ glycemic control and compared the change in patient HbA1c levels between sensors. Objective: To determine how CGMs affect metabolic control in PTs and the effect of different sensors on glycemic control. Patients and Methods: 33 PTs with Type 1 diabetes mellitus (DM) who began using a CGM between 2017 and 2019 were selected for inclusion. CGM systems used included DexcomG6™, DexcomG5™, DexcomG4™, Enlite™, Guardian 3™, or Medtronic Sure-T™ sensors. Results: The mean (MN) age of PTs at initial visit was 15.3 ± 5.1 yrs and the MN age at second visit was 15.8 ± 5.1 yrs. The MN time between visits was 5.0 ± 2.4 months (mos). 6 PTs had follow up (F/U) times less than 3 mos, 18 PTs had F/U times between 3 and 6 mos, 6 PTs had F/U times between 6 and 9 mos, and 3 PTs had F/U times greater than 9 mos. The MN and median (MD) HbA1c at the initial visit for all PTs was 8.28% ± 1.48 and 8.10%, respectively. The MN and MD HbA1c at final F/U for all PTs was 7.57% ± 1.11 and 7.50%, respectively. The difference in MN HbA1c was significant (p<0.001). The MN and MD HbA1c at the initial visit for PTs with a F/U time less than 3 mos was 7.55% ± 0.77 and 7.75%, respectively. The MN and MD HbA1c at F/U for these PTs was 7.20% ± 0.79 and 7.20%, respectively. The difference in MN HbA1c was significant (p<0.05). The MN and MD HbA1c at the initial visit for all PTs with a F/U time greater than 3 mos was 8.44% ± 1.53 and 8.10%, respectively. The MN and MD HbA1c at F/U for these PTs was 7.66% ± 1.15 and 7.50%, respectively. The difference in MN HbA1c was significant (p<0.001). The MN change of HbA1c between visits was not significant between PTs who had 3–6 mo, 6–9 mo, and 9+ mo F/U times (p=0.96) 15 PTs had HbA1c levels less than or equal to 8.0%. The MN and MD HbA1c at initial visit for these PTs was 7.20% ± 0.41 and 7.30%, respectively. The MN and MD HbA1c at F/U for these PTs was 6.75% ± 0.47 and 6.80%, respectively. The difference in MN HbA1c was significant (p<0.001). 20 PTs had HbA1c levels greater than 8.0% at initial visit. The MN and MD HbA1c at the initial visit for these PTs was 9.18% ± 1.47 and 8.80%, respectively. The MN and MD HbA1c at F/U for these PTs was 8.26% ± 1.03 and 8.00%, respectively. The difference in MN HbA1c was significant (p<0.001). The MN change in HbA1c between the high HbA1c group (-.92% ± 1.02) and low HbA1c group (-0.45% ± 0.32) was not significant (p>0.05). 25 PTs used a Dexcom™ sensor while 8 PTs used a Medtronic™ sensor. The MN change in HbA1c was not significant between these brands (p>0.05). Conclusion: CGMs improve metabolic control in pediatric PTs with Type 1 DM regardless of initial HbA1c. Further, this improved control is sustained over time. Sensor brands appear to be equally effective at achieving this goal.

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Metabolic Control of the FreeStyle Libre System in the Pediatric Population with Type 1 Diabetes Dependent on Sensor Adherence

Journal of Clinical Medicine ◽

10.3390/jcm11020286 ◽

2022 ◽

Vol 11 (2) ◽

pp. 286

Author(s):

Isabel Leiva-Gea ◽

Maria F. Martos-Lirio ◽

Ana Gómez-Perea ◽

Ana-Belen Ariza-Jiménez ◽

Leopoldo Tapia-Ceballos ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Metabolic Control ◽

Pediatric Population ◽

Interventional Study ◽

Freestyle Libre ◽

Scan Rate ◽

The Impact ◽

The Relationship

Aims: To evaluate the relationship between daily sensor scan rates and changes in HbA1c and hypoglycemia in children. Methods: We enrolled 145 paediatric T1D patients into a prospective, interventional study of the impact of the FreeStyle Libre 1 system on measures of glycemic control. Results: HbA1c was higher at lower scan rates, and decreased as the scan rate increased to 15–20 scans, after which it rose at higher scan rates. An analysis of the change in hypoglycemia, based on the number of daily sensor scans, showed there was a significant correlation between daily scan rates and hypoglycemia. Subjects with higher daily scan rates reduced all levels of hypoglycaemia. Conclusions: HbA1c is higher at lower scan rates, and decreases as scan rate increases. Reductions in hypoglycemia were evident in subjects with higher daily scan rates.

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Cognitive functions and glycemic control in children and adolescents with type 1 diabetes

Psychological Medicine ◽

10.1017/s0033291709005777 ◽

2009 ◽

Vol 40 (1) ◽

pp. 95-103 ◽

Cited By ~ 35

Author(s):

S. Ohmann ◽

C. Popow ◽

B. Rami ◽

M. König ◽

S. Blaas ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glycemic Control ◽

Metabolic Control ◽

Child Behavior Checklist ◽

Diabetes Management ◽

Social Activity ◽

Self Report ◽

Patients With Diabetes

BackgroundThe relationship between metabolic control and cognitive function in adolescents with type 1 diabetes (DM type 1) is not clear. We compared the quality of glycemic control (GC) and cognitive measures in adolescents with DM type 1 to find out if the quality of diabetes management is related to cognitive impairment.MethodWe assessed executive functions (EFs) and other neuropsychological and psychosocial variables in 70 adolescent patients with DM type 1 and 20 age-matched controls. Patients were divided into two groups according to their last hemoglobin A1c (HbA1c): acceptable (HbA1c 5.9–8.0%, mean 6.9%, 36 patients, mean age 14 years) and non-optimal (HbA1c 8.2–11.6%, mean 9.3%, 34 patients, mean age 15.6 years).ResultsWe found impaired EFs, mainly problems of concept formation (p=0.038), cognitive flexibility (p=0.011) and anticipation (p=0.000), in the patients with DM type 1. Both groups did not differ in intelligence, most assessed EFs and adjustment to chronic illness (Youth Self-Report; YSR). Younger patients (<15 years) were cognitively less flexible. GC was worse in older patients and in patients with longer duration of the disease. We also found significant differences between patients with diabetes and controls concerning somatic complaints, internalizing problems (Child Behavior Checklist; CBCL) and social activity (CBCL and YSR).ConclusionsDM type 1 is associated with cognitive deficits in adolescents independent of the quality of metabolic control and the duration of the disease. These deficits are probably related to the disease, especially in patients with early-onset diabetes.

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Bidirectional Association between Metabolic Control in Type-2 Diabetes Mellitus and Periodontitis Inflammatory Burden: A Cross-Sectional Study in an Italian Population

Journal of Clinical Medicine ◽

10.3390/jcm10081787 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1787

Author(s):

Federica Romano ◽

Stefano Perotto ◽

Sara Elamin Osman Mohamed ◽

Sara Bernardi ◽

Marta Giraudi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Metabolic Control ◽

Poor Glycemic Control ◽

Italian Population ◽

Case Definitions ◽

Severe Periodontitis ◽

Bidirectional Association ◽

Inflammatory Burden

This study assessed the periodontal conditions of type 2 diabetes (T2DM) patients attending an Outpatient Center in North Italy and explored the associations between metabolic control and periodontitis. Periodontal health of 104 T2DM patients (61 men and 43 women, mean age of 65.3 ± 10.1 years) was assessed according to CDC/AAP periodontitis case definitions and Periodontal Inflamed Surface Area (PISA) Index. Data on sociodemographic factors, lifestyle behaviors, laboratory tests, and glycated hemoglobin (HbA1c) levels were collected by interview and medical records. Poor glycemic control (HbA1c ≥ 7%), family history of T2DM, and C-reactive protein levels were predictors of severe periodontitis. An increase in HbA1c of 1% was associated with a rise in PISA of 89.6 mm2. On the other hand, predictors of poor glycemic control were severe periodontitis, waist circumference, unbalanced diet, and sedentary lifestyle. A rise in PISA of 10 mm2 increased the odds of having HbA1c ≥ 7% by 2%. There is a strong bidirectional connection between periodontitis and poor glycemic control. The inflammatory burden posed by periodontitis represents the strongest predictor of poor glycemic control.

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Sex differences over time for glycemic control, pump use and insulin dose in patients aged 10–40 years with type 1 diabetes: a diabetes registry study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002494 ◽

2021 ◽

Vol 9 (2) ◽

pp. e002494

Author(s):

Claudia Boettcher ◽

Sascha R Tittel ◽

Thomas Meissner ◽

Bettina Gohlke ◽

Rainer Stachow ◽

...

Keyword(s):

Type 1 Diabetes ◽

Sex Differences ◽

Glycemic Control ◽

Metabolic Control ◽

Insulin Pump ◽

Insulin Dose ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Migrant Background

IntroductionTo evaluate sex differences in people with type 1 diabetes concerning changes in glycemic control and trends in insulin pump use and insulin dose over two decades in adolescents and one-and-a-half decades in adults.Research design and methodsPeople aged 10–20 years (data years 1999–2018) and 21–40 years (data years 2004–2018) with type 1 diabetes were identified in the Diabetes Prospective Follow-up Registry (DPV). All available patients’ data sets of the respective period were used for linear regression analyses to investigate trends in HbA1c, pump use, insulin doses and body mass index SD scores (BMI-SDS) in females and males. In addition, stratification by migrant background was made for the adolescent group.ResultsIn the youth group (n=68 662), both boys and girls showed an HbA1c decrease over the period examined. After stratification for migrant background, an HbA1c convergence between boys and girls was seen in those without migrant background as of 2016. Usage of insulin pumps increased continuously from 3% (boys and girls) to 47% (boys) and 54% (girls), respectively. The daily insulin dose in units per kilogram body weight and day increased continuously from 1999 to 2018. An insulin dose leveling between boys and girls occurred. BMI-SDS consistently increased in girls whereas only slight variations were observed in boys.The adult group (n=15 380) showed constant HbA1c sex differences from 2004 to 2018 with lower HbA1c level in females. The use of insulin pump therapy rose from 18% to 35% (males) and 30% to 50% (females).ConclusionsThe gap in metabolic control between boys and girls with type 1 diabetes seems to close, but predominantly in adolescents without a migrant background. Improved HbA1c was associated with increased insulin pump use, especially in girls.In adult patients, sex differences in metabolic control and insulin pump use persist: women show constantly lower HbA1c values and higher insulin pump use.

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The Status of Metabolic Control in Patients With Diabetes Attending Primary Care Clinics in Madinah, Saudi Arabia

10.21203/rs.3.rs-998248/v1 ◽

2021 ◽

Author(s):

Eman Mohammed ALFADHLI ◽

Ghada Mohamed SOBHY ◽

Ruqaya Saleh MASOUD ◽

Yaseera Ali GADI ◽

Amal Mohammed Surrati ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Saudi Arabia ◽

Glycemic Control ◽

Metabolic Control ◽

Diabetes Management ◽

Diabetes Duration ◽

Diabetic Patients ◽

Primary Care Clinics ◽

Patients With Diabetes

Abstract OBJECTIVE: Comprehensive control of diabetes and its related comorbidities is essential to avoid diabetes complications and reduce diabetes care expenses. Nevertheless, several reports have uncovered the gap in diabetes management and confirmed the suboptimal glycemic control globally. This study aims to assess the metabolic control among patients with diabetes attending primary care clinics (PCCs) in Madinah, Saudi Arabia. METHODS: A cross-sectional study was conducted at 15 PCCS in Madinah, Saudi Arabia. Consecutive 692 adult diabetic patients who attended the clinics between January 2016 to December 2017 were included. The primary outcome measures were achieving blood glucose, blood pressure, and lipids goals. The achievement of adequate metabolic control followed the American diabetes association (ADA) guidelines. RESULT: Majority (98%) of the patients had type 2 diabetes (T2DM) with a mean age of 55.1±11.6 years and a mean diabetes duration of 11.02±7.8 years. The mean HbA1c was 8.39±1.7, and glycemic goals (HbA1C < 7%) were achieved in 15.7%. Achievement of LDL, triglyceride, and HDL goals were as follow; 46.4%. 53.3%, 70.8%, respectively. 66.3% of subjects achieved systolic blood pressure, and 88.7% achieved diastolic blood pressure goals. Younger age, longer diabetes duration, and higher LDL levels were associated with poor glycemic control. CONCLUSION: Glycemic control is inadequate among patients with diabetes following at the PCCs in Madinah, Saudi Arabia. A patient-centered approach and individualized management plan considering all risk factors are required.

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Current evidence regarding Low-carb diets for the metabolic control of type-2 diabetes

Current Diabetes Reviews ◽

10.2174/1573399816666201123104358 ◽

2020 ◽

Vol 16 ◽

Author(s):

Adriana Andrade Sousa ◽

Guilherme Renke ◽

Aluysio Leal Jr ◽

Marcela Mascarenhas Braga Rassi ◽

Cristianne Serafim Feuser ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Control ◽

Insulin Response ◽

Nutritional Therapy ◽

Postprandial Glucose ◽

Current Evidence ◽

Eating Pattern ◽

Carbohydrate Ingestion ◽

Carb Diet

: The management of diabetes requires a medical nutritional therapy as an essential part of this treatment. There should be no "one-size-fits-all" eating pattern for different patient´s profiles with diabetes. It´s clinically complex to suggest an ideal percentage of calories from carbohydrates, protein and lipids recommended for all patients with diabetes. Among the eating patterns that have shown beneficial effects on metabolic control of patients with type 2 diabetes is the Low-Carb diet, since the carbohydrate ingestion is viewed as the most important determinant of postprandial glucose and insulin response. In this context, theoretically it could make sense to reduce the daily amount of carbohydrates ingested, willing to achieve lower levels of HbA1c. There could be associated risks to this approach. The adherence to a Low-Carb Diet is here also discussed. This narrative review works on the current evidence for answering these questions regarding Low-Carb Diet as a possible alternative eating pattern for type 2 diabetes.

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