scholarly journals Beyond Genetic Borders: Sardinian Exposure And Type 1 Diabetes

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Type 1 Diabetes ◽  
Environmental Factors ◽  
Diabetic Patients ◽  
Β Cells ◽  
Autoimmune Destruction ◽  
The People ◽  
Technological Advances ◽  
Chronic Childhood

Type 1 diabetes mellitus (T1D), one of the most chronic childhood disease, results from an autoimmune destruction of pancreatic β cells producing insulin, with insulin deficiency. Recently significant technological advances have been achieved in treatment and quality of life in diabetic patients but the causes are still uncertain, so it is still very difficult to foresee the possible prevention of this disease. The genetic factors alone do not explain the high risk of T1D, sharply increased over the last 40 years in Sardinia, with the second highest risk in the world after Finland, even as many of the people genetically predisposed to T1D do not develop the disease [1]. It is still unknown why some people develop T1D although it is agreed that genetic, non-genetic and probably epigenetic environmental factors all together contribute to the disease. The environmental factors are probably very important for both the development and the increase of T1D. The epigenetic factor possible interrelationships are to be cleared at most.

scholarly journals Increased Incidence of Type 1 Diabetes during the COVID-19 Pandemic in Romanian Children

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 973
Author(s):  
Adrian Vlad ◽  
Viorel Serban ◽  
Romulus Timar ◽  
Alexandra Sima ◽  
Veronica Botea ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Background Information ◽  
First Year ◽  
Age Group ◽  
Newly Diagnosed ◽  
Β Cells ◽  
Specific Antibodies ◽  
Autoimmune Destruction ◽  
Geographical Regions

Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996–2015 and 0.8% in the interval 2015–2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p < 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.

scholarly journals Remission Phase in Paediatric Type 1 Diabetes: New Understanding and Emerging Biomarkers

2017 ◽  
Vol 88 (5) ◽  
pp. 307-315 ◽  
Author(s):  
Mireia Fonolleda ◽  
Marta Murillo ◽  
Federico Vázquez ◽  
Joan Bel ◽  
Marta Vives-Pi
Keyword(s):  
Type 1 Diabetes ◽  
Immunological Tolerance ◽  
Exogenous Insulin ◽  
Β Cells ◽  
Clinical Onset ◽  
Autoimmune Destruction ◽  
Glucose Dysregulation ◽  
Children And Young Adults ◽  
Remission Phase

Type 1 diabetes (T1D) is a metabolic disease of unknown aetiology that results from the autoimmune destruction of the β-cells. Clinical onset with classic hyperglycaemic symptoms occurs much more frequently in children and young adults, when less than 30% of β-cells remain. Exogenous insulin administration is the only treatment for patients. However, due to glucose dysregulation, severe complications develop gradually. Recently, an increase in T1D incidence has been reported worldwide, especially in children. Shortly after diagnosis, T1D patients often experience partial remission called “honeymoon phase,” which lasts a few months, with minor requirements of exogenous insulin. In this stage, the remaining β-cells are still able to produce enough insulin to reduce the administration of exogenous insulin. A recovery of immunological tolerance to β-cell autoantigens could explain the regeneration attempt in this remission phase. This mini-review focuses on the remission phase in childhood T1D. Understanding this period and finding those peripheral biomarkers that are signs of immunoregulation or islet regeneration could contribute to the identification of patients with a better glycaemic prognosis and a lower risk of secondary complications. This remission phase could be a good checkpoint for the administration of future immunotherapies.

Type 1 Diabetic Serum Interferes with Pancreatic β-cell Ca2+ -Handling

2007 ◽  
Vol 27 (6) ◽  
pp. 321-326 ◽  
Author(s):  
N. Dekki ◽  
R. Nilsson ◽  
S. Norgren ◽  
S. M. Rössner ◽  
I. Appelskog ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Ethnic Background ◽  
Diabetic Patients ◽  
Pancreatic Β Cell ◽  
Newly Diagnosed ◽  
Β Cells ◽  
Β Cell ◽  
First Degree Relatives ◽  
Type 1 Diabetic Patients

The aim of this study was to clarify the frequency of patients with type 1 diabetes that have serum that increases pancreatic β-cell cytoplasmic free Ca2+ concentration, [Ca2+]i, and if such an effect is also present in serum from first-degree relatives. We also studied a possible link between the serum effect and ethnic background as well as presence of autoantibodies. Sera obtained from three different countries were investigated as follows: 82 Swedish Caucasians with newly diagnosed type 1 diabetes, 56 Americans with different duration of type 1 diabetes, 117 American first-degree relatives of type 1 diabetic patients with a mixed ethnic background and 31 Caucasian Finnish children with newly diagnosed type 1 diabetes. Changes in [Ca2+]i, upon depolarization, were measured in β-cells incubated overnight with sera from type 1 diabetic patients, first-degree relatives or healthy controls. Our data show that there is a group constituting approximately 30% of type 1 diabetic patients of different gender, age, ethnic background and duration of the disease, as well as first-degree relatives of type 1 diabetic patients, that have sera that interfere with pancreatic β-cell Ca2+-handling. This effect on β-cell [Ca2+]i could not be correlated to the presence of autoantibodies. In a defined subgroup of patients with type 1 diabetes and first-degree relatives a defect Ca2+-handling may aggravate development of β-cell destruction.

scholarly journals Generation of pluripotent stem cells from patients with type 1 diabetes

2009 ◽  
Vol 106 (37) ◽  
pp. 15768-15773 ◽  
Author(s):  
René Maehr ◽  
Shuibing Chen ◽  
Melinda Snitow ◽  
Thomas Ludwig ◽  
Lisa Yagasaki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Disease Modeling ◽  
Ips Cells ◽  
Β Cells ◽  
Cell Replacement Therapy ◽  
Molecular Defects ◽  
Autoimmune Destruction ◽  
Induced Pluripotent ◽  
Adult Fibroblasts

Type 1 diabetes (T1D) is the result of an autoimmune destruction of pancreatic β cells. The cellular and molecular defects that cause the disease remain unknown. Pluripotent cells generated from patients with T1D would be useful for disease modeling. We show here that induced pluripotent stem (iPS) cells can be generated from patients with T1D by reprogramming their adult fibroblasts with three transcription factors (OCT4, SOX2, KLF4). T1D-specific iPS cells, termed DiPS cells, have the hallmarks of pluripotency and can be differentiated into insulin-producing cells. These results are a step toward using DiPS cells in T1D disease modeling, as well as for cell replacement therapy.

scholarly journals Autoimmune Markers in Diabetes

2011 ◽  
Vol 57 (2) ◽  
pp. 168-175 ◽  
Author(s):  
William E Winter ◽  
Desmond A Schatz
Keyword(s):  
Type 1 Diabetes ◽  
Clinical Medicine ◽  
Islet Autoantibodies ◽  
Islet Autoantibody ◽  
Β Cells ◽  
Β Cell ◽  
Autoimmune Destruction ◽  
Clinical Tools ◽  
Autoimmune Etiology

BACKGROUND Type 1 diabetes (T1DM) results from cell-mediated autoimmune destruction of the β cells of the islets of Langerhans. Autoantibodies directed against the islets are useful clinical tools that allow the recognition and confirmation of β-cell autoimmunity. CONTENT In this review we define the term “islet autoantibody,” describe the pathogenesis of autoantibody generation, and explain the uses of islet autoantibodies in clinical medicine and in research studies that concern the interruption or prevention of T1DM. We also discuss the biology of islet autoantibodies and their rates of appearance at the time of onset of T1DM and their appearance before the development of T1DM. SUMMARY The presence of islet autoantibodies in persons with diabetes confirms an autoimmune etiology. In nondiabetic individuals, islet autoantibodies are strong predictors of the later development of T1DM.

scholarly journals Review of Advanced Hydrogel-Based Cell Encapsulation Systems for Insulin Delivery in Type 1 Diabetes Mellitus

Pharmaceutics ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 597 ◽  
Author(s):  
Albert Espona-Noguera ◽  
Jesús Ciriza ◽  
Alberto Cañibano-Hernández ◽  
Gorka Orive ◽  
Rosa María Hernández ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Clinical Application ◽  
Cell Encapsulation ◽  
Β Cells ◽  
Minimally Invasive Surgical ◽  
Autoimmune Destruction ◽  
Cell Sources

: Type 1 Diabetes Mellitus (T1DM) is characterized by the autoimmune destruction of β-cells in the pancreatic islets. In this regard, islet transplantation aims for the replacement of the damaged β-cells through minimally invasive surgical procedures, thereby being the most suitable strategy to cure T1DM. Unfortunately, this procedure still has limitations for its widespread clinical application, including the need for long-term immunosuppression, the lack of pancreas donors and the loss of a large percentage of islets after transplantation. To overcome the aforementioned issues, islets can be encapsulated within hydrogel-like biomaterials to diminish the loss of islets, to protect the islets resulting in a reduction or elimination of immunosuppression and to enable the use of other insulin-producing cell sources. This review aims to provide an update on the different hydrogel-based encapsulation strategies of insulin-producing cells, highlighting the advantages and drawbacks for a successful clinical application.

scholarly journals 100 YEARS OF INSULIN: Arresting or curing type 1 diabetes: an elusive goal, but closing the gap

2021 ◽  
Vol 249 (2) ◽  
pp. T1-T11
Author(s):  
Pieter-Jan Martens ◽  
Conny Gysemans ◽  
Chantal Mathieu
Keyword(s):  
Type 1 Diabetes ◽  
Beta Cell ◽  
Cell Mass ◽  
Beta Cell Mass ◽  
Adaptive Immune System ◽  
Future Research ◽  
Diabetic Patients ◽  
Technological Advances ◽  
Current Therapies

Type 1 diabetes is one of the most common chronic diseases in children and adolescents, but remains unpreventable and incurable. The discovery of insulin, already 100 years ago, embodied a lifesaver for people with type 1 diabetes as it allowed the replacement of all functions of the beta cell. Nevertheless, despite all technological advances, the majority of type 1 diabetic patients fail to reach the recommended target HbA1c levels. The disease-associated complications remain the true burden of affected individuals and necessitate the search for disease prevention and reversal. The recognition that type 1 diabetes is a heterogeneous disease with an etiology in which both the innate and adaptive immune system as well as the insulin-producing beta cells intimately interact, has fostered the idea that treatment to specific molecular or cellular characteristics of the patient groups will be needed. Moreover, robust and reliable biomarkers to detect type 1 diabetes in the early (pre-symptomatic) phases are wanted to preserve functional beta cell mass. The pitfalls of past therapeutics along with the perspectives of current therapies can open up the path for future research.

scholarly journals Factors Predicting Glycemic Control in Type 1 Diabetic Patient

2016 ◽  
Vol 3 (1) ◽  
pp. 153-158 ◽  
Author(s):  
Meriem Yazidi ◽  
Mélika Chihaoui ◽  
Fatma Chaker ◽  
Ons Rjeb ◽  
Hédia Slimane
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Diabetes Onset ◽  
One Year ◽  
Type 1 Diabetic Patients

Background: Recent years have been marked by numerous advances in the quality of type 1 diabetes care. However, glycemic control remains suboptimal for many patients with type 1 diabetes. The aim of our study was to identify factors associated with poor glycemic control in type 1 diabetic patients. Methods: We studied in a retrospective manner, 188 type 1 diabetic patients, admitted to our department then followed up for at least one year. Results: There was a negative correlation between age at diabetes onset and HbA1c value (p=0.02). Adolescents had higher HbA1c value than adults (10.8±2.9% vs. 9.2±2.8%, p=0.02). No relationship was found between number of daily insulin injections and mean HbA1c value. Mean HbA1c was higher in patients with poor compliance to insulin therapy (11.1±3.3% vs. 8.9±2.4%, p<0.0001), in those with less than 3 clinic visits per year (10.7±3.5% vs. 9.0±2.1%, p=0.001), in subjects with lipohypertrophy (10.9±2.5% vs. 9.2±3.4%, p=0.008) and those with known celiac disease (14.5±5.2% vs. 9.6±2.9%, p=0.005). Conclusion: Several factors were associated with poor glycemic control in our type 1 diabetic patients. Most of them can be changed in particular by strengthening education strategies.

scholarly journals Flexible Insulin Therapy: Results of a Tunisian Experience

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Hajer Kandara ◽  
Chaima Jemai ◽  
Abdennebi Cyrine ◽  
Jemel Manel ◽  
Kammoun Ines
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Weight Gain ◽  
Insulin Therapy ◽  
Metabolic Diseases ◽  
Insulin Dose ◽  
Diabetic Patients ◽  
The Impact

Aims: To evaluate the adherence of type 1 diabetic patients to long-term flexible insulin therapy (FIT), and the impact of this approach on the glycemic balance, basal insuline dose and quality of life of patients. Methods: This is a rospective descriptive study, conducted between January and April 2017, including 50 patients with type 1 diabetes having following the FIT of department B of Endocrinology-Diabetology and Metabolic Diseases service B at the National Institute of Nutrition and Food Technology of Tunis. Results: The FIT decreased mean HbA1c from 8.96% to 7.57% (p=0.04) and mean basal insulin dose from 0.35 to 0.27 IU/kg /day. Hypoglycemia's frequency decreased from 3.2±2.1 to 0.93±2.1 episodes /patient /week (p=0.03), with improved quality of life. However, there was a significant weight gain (p=0.02). Conclusions: FIT allows for better glycemic control while reducing hypoglycemia, especially severe episodes, and improves the quality of life of patients with type 1 diabetes but seems to cause weight gain.

scholarly journals On type 1 diabetes mellitus pathogenesis

2018 ◽  
Vol 7 (1) ◽  
pp. R38-R46 ◽  
Author(s):  
Stavroula A Paschou ◽  
Nektaria Papadopoulou-Marketou ◽  
George P Chrousos ◽  
Christina Kanaka-Gantenbein
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Endocrine Pancreas ◽  
Latency Period ◽  
Β Cells ◽  
Autoimmune Destruction ◽  
Long Latency

Type 1 diabetes mellitus (T1DM) results from the autoimmune destruction of β cells of the endocrine pancreas. Pathogenesis of T1DM is different from that of type 2 diabetes mellitus, where both insulin resistance and reduced secretion of insulin by the β cells play a synergistic role. We will present genetic, environmental and immunologic factors that destroy β cells of the endocrine pancreas and lead to insulin deficiency. The process of autoimmune destruction takes place in genetically susceptible individuals under the triggering effect of one or more environmental factors and usually progresses over a period of many months to years, during which period patients are asymptomatic and euglycemic, but positive for relevant autoantibodies. Symptomatic hyperglycemia and frank diabetes occur after a long latency period, which reflects the large percentage of β cells that need to be destroyed before overt diabetes become evident.

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