scholarly journals Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 710
Author(s):  
Valeria Calcaterra ◽  
Annalisa De Silvestri ◽  
Laura Schneider ◽  
Miriam Acunzo ◽  
Viola Vittoni ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Acanthosis Nigricans ◽  
Normal Weight ◽  
Excess Weight ◽  
Glucose Disposal ◽  
Model Assessment ◽  
Predisposing Factor ◽  
Estimated Glucose Disposal Rate

Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects with obesity in order to define the interplay between IR and excess weight. We considered 138 pediatric patients who presented with T1D and 162 with obesity. As controls, 100 healthy normal-weight subjects were included. A physical examination with the detection of AN and biochemical assessments was performed. IR was calculated by using the homeostasis model assessment for IR in patients with obesity and the estimated glucose disposal rate in T1D. The AN prevalence was higher in T1D and obese subjects compared with controls in whom AN was not detected (p = 0.02 and p < 0.001, respectively). A greater number of AN cases were observed in subjects with obesity compared with T1D (p < 0.001). Patients with AN were older than subjects without AN (p = 0.005), and they had higher body mass index (BMI) values, waist circumference (WC), fasting triglycerides and blood pressure (all p < 0.001). Thirty-five patients with AN exhibited IR with an association between AN presence and IR in patients with obesity (p < 0.001). In T1D, there was an association between AN and being overweight/obese (p = 0.02), independently of IR. AN is a dermatological condition associated with obesity. In T1D, the presence of AN was significantly associated with overweight status or obesity but not IR. The presence of AN in the absence of IR supports the interplay role between impaired insulin signaling, IR and excess weight in the pathogenic mechanism.

Insulin Resistance in Adults with Type 1 Diabetes is Associated with Lower Vitamin D Serum Concentration

2019 ◽  
Author(s):  
Mikołaj Kamiński ◽  
Aleksandra Uruska ◽  
Anita Rogowicz-Frontczak ◽  
Dawid Lipski ◽  
Paweł Niedźwiecki ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Type 1 Diabetes ◽  
Serum Level ◽  
Serum Concentration ◽  
Test Group ◽  
Glucose Disposal ◽  
Endogenous Insulin ◽  
Estimated Glucose Disposal Rate

Abstract Aim Type 1 diabetes mellitus (T1DM) is a disease characterized by an absolute deficiency of endogenous insulin secretion. Insulin resistance (IR) may develop among patients with T1DM. Vitamin D deficiency was reported to be a risk factor in the development of IR. The aim of the study was to assess the relationship between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and IR among patients with T1DM. Methods The test group consisted of 110 adult patients [males=65 (59%)] with T1DM. Participants were recruited in Poland between 1st October and 30th April in 2015/2016 and 2016/2017. VD serum level was assessed by ELISA array. IR was assessed by estimated Glucose Disposal Rate (eGDR). Results In the study group 21 (19%) patients were recognized as IR according to eGDR cut-offs (<7.5 mg/kg/min), 52 (47.3%) patients had VD deficiency (25(OH)D<20 ng/ml), 16 (14.5%) patients had 25(OH)D<10 ng/ml. Only 6 (5%) participants reported VD supplementation. Patients with IR, according to eGDR cut-off revealed significantly lower 25(OH)D serum level 15.7 (9.2–28.4) vs. 22.1 (13.0–38.4) ng/ml; p=0.04 as compared to patients without IR. R Spearman analysis found a positive relationship between VD and eGDR (Rs=0.27; p<0.01). Logistic regression analysis revealed significant relationship between the presence of IR and VD serum level/presence of 25(OH)D serum level below 10 ng/ml, both models adjusted to sex, age, BMI, LDL and triglycerides, accordingly (OR=0.95, CI: 0.90–0.99; p=0.04) and (OR=4.19, CI: 1.04–16.93; p=0.04). Conclusion The serum concentration of Vitamin D is negatively associated with insulin resistance in patients with T1DM and may have clinical implications.

scholarly journals Estimated Glucose Disposal Rate (eGDR) – A Marker for the Assessment of Insulin Resistance in Type 1 Diabetes Mellitus

2016 ◽  
Vol 23 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Mihaela L. Bîcu ◽  
Daniel Bîcu ◽  
Sigina Gârgavu ◽  
Magdalena Sandu ◽  
Mihaela I. Vladu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Glucose Disposal ◽  
Chronic Complications ◽  
Important Indicator ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

AbstractBackground and Aims: Studies have shown an increased incidence of chronic complications in people with type 1 diabetes mellitus (T1DM) with insulin resistance (IR) compared to people with T1DM without IR. Estimated glucose disposal rate (eGDR) is an important indicator of IR in patients with T1DM, lower eGDR levels indicating greater IR. It was shown that T1DM patients with chronic complications (diabetic retinopathy - DR, diabetic peripheral neuropathy - DPN or diabetic kidney disease - DKD) exhibit higher IR compared to patients without chronic complications. The aim of our study was to evaluate eGDR as a marker for the assessment of IR in T1DM patients.Materials and Methods: The study was observational, cross-sectional and included 140 T1DM patients with diabetes duration>10 years. The collected data were analyzed using the Statistic Package for Social Sciences (SPSS) version 22 software (IBM Corporation, Armonk, NY, USA).Results: eGDR presented statistically significant correlations (p<0.05) with the presence of metabolic syndrome (MS), obesity, chronic complications of T1DM, cardiovascular risk (CVR) and smoking status in patients with T1DM duration >10 years.Conclusions: eGDR represents a reliable marker for assessing the IR in T1DM.

scholarly journals Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes

Diabetes Care ◽  
2013 ◽  
Vol 36 (8) ◽  
pp. 2280-2285 ◽  
Author(s):  
E. J. Epstein ◽  
J. L. Osman ◽  
H. W. Cohen ◽  
S. N. Rajpathak ◽  
O. Lewis ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Glucose Disposal ◽  
Multiethnic Population ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

Estimated Glucose Disposal Rate as a Predictor of All-Cause Mortality in Type 1 Diabetes—A 10-Year Follow-Up Study

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1694-P
Author(s):  
MONIA GAROFOLO ◽  
ALESSANDRA BERTOLOTTO ◽  
FABRIZIO CAMPI ◽  
DANIELA LUCCHESI ◽  
LAURA GIUSTI ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Disposal ◽  
Follow Up Study ◽  
All Cause Mortality ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

scholarly journals Association of estimated glucose disposal rate and chronic diabetic complications in patients with type 1 diabetes

2021 ◽  
Author(s):  
César Ernesto Lam‐Chung ◽  
Néstor Martínez Zavala ◽  
Raúl Ibarra‐Salce ◽  
Francisco Javier Pozos Varela ◽  
Tania S. Mena Ureta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Glucose Disposal ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

scholarly journals Insulin secretion and sensitivity in the prediction of type 1 diabetes in children with advanced β-cell autoimmunity

2013 ◽  
Vol 169 (4) ◽  
pp. 479-485 ◽  
Author(s):  
Heli T Siljander ◽  
Robert Hermann ◽  
Anne Hekkala ◽  
Jyrki Lähde ◽  
Laura Tanner ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Young Children ◽  
Disease Susceptibility ◽  
Insulin Response ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Β Cell ◽  
Intravenous Glucose

ObjectiveReduced early insulin response has been shown to predict type 1 diabetes (T1D) in first-degree relatives of diabetic patients, while its role, as well as that of insulin resistance, has remained poorly defined in young children representing the general population. The predictive values of these markers and their relation to other risk factors of T1D were assessed in children with advanced β-cell autoimmunity, i.e. persistent positivity for two or more autoantibodies.Design and methodsIntravenous glucose tolerance tests (IVGTTs) were carried out in 218 children withHLA-DQB1-conferred disease susceptibility and advanced β-cell autoimmunity. Baseline, metabolic and growth data were compared between children progressing to diabetes and those remaining unaffected. Hazard ratios for the disease predictors and the progression rate of T1D were assessed.ResultsChildren developing T1D were younger at seroconversion, progressed more rapidly to advanced β-cell autoimmunity and had lower first-phase insulin response (FPIR) and homeostasis model assessment index for insulin resistance (HOMA-IR) than those remaining non-diabetic. The levels of HOMA-IR/FPIR, islet cell antibodies, insulin autoantibodies (IAA) and islet antigen 2 antibodies (IA-2A) were higher in progressors. BMI SDS, FPIR, age at IVGTT and levels of IAA and IA-2A were predictive markers for T1D.ConclusionsYoung age, higher BMI SDS, reduced FPIR and higher levels of IAA and IA-2A predicted T1D in young children withHLA-DQB1-conferred disease susceptibility and advanced β-cell autoimmunity. Disease risk estimates were successfully stratified by the assessment of metabolic status and BMI. The role of insulin resistance as an accelerator of the disease process was minor.

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