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 Clinical Profile of Type 1 Diabetes Mellitus in Saudi Children: a Hospital Based Study

2016 ◽  
Vol 22 (4) ◽  
Author(s):  
Muhammad Rafique ◽  
Fouzia Ishaq ◽  
Muhammad Khalid Masood ◽  
Youssef Ali Mohamad Al-Qahtani ◽  
Walaa Ibrahim Ahmed Assiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Middle Age ◽  
Age Group ◽  
Newly Diagnosed ◽  
Duration Of Symptoms ◽  
Presenting Symptoms

<p><strong>Abstract</strong></p><p><strong>Objective:</strong>  To determine the clinical characteristics of newly diagnosed type 1 diabetes mellitus (T1DM) in children under15 years of age. Cross sectional study conducted at Aseer Central Hospital Abha, South-western Saudi Arabia from June 2011 – May 2015.</p><p><strong>Patients and Methods:</strong><strong>  </strong>Study included 141 Saudi children, &lt; 15 years old with newly diagnosed T1DM. The demographic and laboratory data were collected from file records. The patients were divided into younger (&lt; 5 yr), middle (5 – 10 yr) and older (&gt;10 – 15 yr) age groups. Data were analyzed by using SPSS version 16.</p><p><strong>Results:</strong><strong>  </strong>Age of 141 children at onset of T1DM (mean ± SD) was 6.5 ± 3.2 years and majority 62 (44%) belonged to middle age group. Older 43 (30.5%) age group had female predominance (2:1) (p &lt; 0.0001). Diabetic ketoacidosis (DKA) (39%), obesity (11%) and male predominance (2.6:1) were found in younger 36 (25.5%) age group (p &lt; 0.0001). Family history (F/Hx) of T1DM 29 (20.6%) and HbA1c (10.36 ± 1.8%) successively increased with advancing age of patients. Main presenting symptoms like polyuria (96%), polydipsia (85%), weight loss (62%), nocturia (47%), polyphagia (28%) and DKA (22%),were significantly more frequent in children with F/Hx of T1DM (p &lt; 0.0001). Duration of symptoms at first presentation was 17.3 ± 10.7 days and daily insulin requirement was found 0.82 ± 0.2 units/ Kg.</p><p><strong>Conclusion:</strong><strong>  </strong>Polyuria, polydipsia, weight loss, noctu-ria and polyphagia were the main presenting symptoms and more frequent in middle age group children especially having F/Hx of T1DM. Under five years, obese and male children were found at higher risk for DKA development. Girls usually present late in adolescent age.</p>

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 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.

scholarly journals Influence of the Type of Basal Insulin and Other Variables on Clinical Outcomes in Children with Newly Diagnosed Type 1 Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Ruth M. Garrison ◽  
Jeremy L. Johnson ◽  
Michelle E. Condren ◽  
Kevin C. Farmer ◽  
David H. Jelley
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Basal Insulin ◽  
Retrospective Chart Review ◽  
Severe Hypoglycemia ◽  
First Year ◽  
Newly Diagnosed ◽  
Diabetes Clinic ◽  
Pediatric Diabetes

Background. Basal insulin detemir and glargine each have characteristics that may make them a superior choice in children and adolescents with type 1 diabetes, but there is a paucity of data on glycemic results in this population. Objective. Examination of variables associated with achievement of HbA1c goal in children and adolescents with newly diagnosed type 1 diabetes. Methods. The primary outcome, factors associated with achievement of HbA1c goal, was examined in a retrospective chart review. Variables, including type of basal insulin, were collected during the first year of diagnosis of patients in a pediatric diabetes clinic. Secondary outcomes included change in HbA1c, severe hypoglycemic events, and episodes of DKA. Results. 94 patients were included in the study. HbA1c at diagnosis was found to be a significant predictor of achievement of goal at 3 months (P=0.002) and of change in HbA1c at 3 and 12 months (P<0.001 for each). Severe hypoglycemia and episodes of DKA were uncommon. Conclusions. Choice of basal insulin was not found to be a predictor of achieving HbA1c goal or of change in HbA1c over the course of the first year of diagnosis with type 1 diabetes.

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 Future glycemic control of children diagnosed with type 1 diabetes mellitus at toddler and preschool/school age

2019 ◽  
Vol 32 (9) ◽  
pp. 929-933
Author(s):  
Tim R.J. Aeppli ◽  
Fiona L. Mahler ◽  
Daniel Konrad
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Age Groups ◽  
First Year ◽  
School Age ◽  
Age Group ◽  
Group 1

Abstract Background The main objective of this study was to compare future glycemic control in children diagnosed with type 1 diabetes mellitus (T1DM) at toddler age and preschool/school age. In addition, we aimed to examine risk factors known to be associated with future glycated hemoglobin A1c (HbA1c) levels in children diagnosed with T1DM. Methods This is a retrospective cohort study of 85 patients diagnosed with T1DM at toddler age (group 1; 0–2.9 years; n = 36) or preschool/school age (group 2; 5–6.9 years; n = 49) who were followed up at the University Children’s Hospital in Zurich for at least 10 consecutive years or until the age of 15 years. Results The mean HbA1c level in the first year after diagnosis had a highly predictive value about glycemic control in the following 6 years. In addition, a longer duration of T1DM was associated with higher HbA1c values. HbA1c values did not differ significantly within 11 years after diagnosis between children in the two age groups. Neither was a difference found when comparing the two groups in respect to their chronological age, although a trend was noted (p = 0.09). This trend is very likely due to a longer duration of diabetes in group 1. Conclusions HbA1c level in the first year predicts glycemic control for the next 6 years and deterioration of HbA1c values can be noted with longer duration of T1DM. Moreover, our study demonstrated similar future glycemic control in patients diagnosed with T1DM at toddler age and preschool/school age.

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