scholarly journals Diagnosis and management of pediatric type 1 diabetes mellitus

2021 ◽  
Vol 64 (6) ◽  
pp. 425-431
Author(s):  
Jieun Lee
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Glycated Hemoglobin ◽  
Microvascular Complications ◽  
Accurate Diagnosis ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: In contrast to type 2 diabetes, type 1 diabetes mellitus (T1DM) requires insulin treatment to control blood glucose. As the incidence and prevalence of T1DM have steadily increased; therefore, T1DM is increasingly being diagnosed not only in children and adolescents, but also in adults. Therefore, the importance of accurate diagnosis and optimal management of T1DM is being recognized in clinical practice.Current Concepts: T1DM is caused by insulin deficiency, following the destruction of insulin-producing pancreatic <i>β</i>-cells. Diagnosis of diabetes is based on the following criteria: fasting blood glucose levels ≥126 mg/dL, random blood glucose levels ≥200 mg/dL accompanied by symptoms of hyperglycemia, an abnormal 2-hour oral glucose tolerance test, or glycated hemoglobin ≥6.5%. Accurate diagnosis of T1DM based on patients’ clinical characteristics, serum C-peptide levels, and detection of autoantibodies against <i>β</i>-cell autoantigens is important for optimum care and to avoid complications. A target glycated hemoglobin level is recommended in children, adolescents, and young adults with access to comprehensive care. The availability of insulin analogues and mechanical technologies (insulin pumps and continuous glucose monitors) has improved the management of T1DM, and these are useful for the prevention of microvascular complications. Screening for microvascular complications should commence at puberty or 5 years after diagnosis of T1DM.Discussion and Conclusion: Effective cooperation and coordination between patient, parents, and healthcare providers are necessary to achieve a successful transition from pediatric to adult care in patients with T1DM. Diabetic management for T1DM should be individualized based on patients’ lifestyle, as well as psychosocial, and medical circumstances.

scholarly journals The Effect of a Short Sprint on Postexercise Whole-Body Glucose Production and Utilization Rates in Individuals with Type 1 Diabetes Mellitus

2012 ◽  
Vol 97 (11) ◽  
pp. 4193-4200 ◽  
Author(s):  
A. J. Fahey ◽  
N. Paramalingam ◽  
R. J. Davey ◽  
E. A. Davis ◽  
T. W. Jones ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Whole Body ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Glucose Levels ◽  
Blood Glucose Levels

Context: Recently we showed that a 10-sec maximal sprint effort performed before or after moderate intensity exercise can prevent early hypoglycemia during recovery in individuals with type 1 diabetes mellitus (T1DM). However, the mechanisms underlying this protective effect of sprinting are still unknown. Objective: The objective of the study was to test the hypothesis that short duration sprinting increases blood glucose levels via a disproportionate increase in glucose rate of appearance (Ra) relative to glucose rate of disappearance (Rd). Subjects and Experimental Design: Eight T1DM participants were subjected to a euglycemic-euinsulinemic clamp and, together with nondiabetic participants, were infused with [6,6-2H]glucose before sprinting for 10 sec and allowed to recover for 2 h. Results: In response to sprinting, blood glucose levels increased by 1.2 ± 0.2 mmol/liter (P &lt; 0.05) within 30 min of recovery in T1DM participants and remained stable afterward, whereas glycemia rose by only 0.40 ± 0.05 mmol/liter in the nondiabetic group. During recovery, glucose Ra did not change in both groups (P &gt; 0.05), but glucose Rd in the nondiabetic and diabetic participants fell rapidly after exercise before returning within 30 min to preexercise levels. After sprinting, the levels of plasma epinephrine, norepinephrine, and GH rose transiently in both experimental groups (P &lt; 0.05). Conclusion: A sprint as short as 10 sec can increase plasma glucose levels in nondiabetic and T1DM individuals, with this rise resulting from a transient decline in glucose Rd rather than from a disproportionate rise in glucose Ra relative to glucose Rd as reported with intense aerobic exercise.

Relaxation training significantly reduced blood glucose levels in patients with type 1 diabetes mellitus

HORMONES ◽  
2020 ◽  
Vol 19 (2) ◽  
pp. 215-222
Author(s):  
Antonia A. Paschali ◽  
Lily Εvangelia Peppou ◽  
Marianna Benroubi
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Relaxation Training ◽  
Glucose Levels ◽  
Blood Glucose Levels

Modulation by blood glucose levels of activity and concentration of paraoxonase in young patients with type 1 diabetes mellitus

Metabolism ◽  
2001 ◽  
Vol 50 (6) ◽  
pp. 657-660 ◽  
Author(s):  
O. Kordonouri ◽  
R.W. James ◽  
B. Bennetts ◽  
A. Chan ◽  
Y.L. Kao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Type 1 Diabetes Mellitus ◽  
Young Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels

scholarly journals The effect of glycated hemoglobin variability on the development of microvascular complications in patients with type 1 diabetes

2020 ◽  
pp. 66-71
Author(s):  
L. L. Bolotskaya ◽  
Yu. Yu. Golubkina ◽  
A. A. Tolkacheva ◽  
L. N. Nikankina
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Type 1 Diabetes Mellitus ◽  
Glycated Hemoglobin ◽  
Microvascular Complications ◽  
National Standard ◽  
Hemoglobin Variability ◽  
Hba1c Variability

Introduction. The results of a 25-year observational program to assess the effect of glycated hemoglobin variability on the development of microvascular complications in patients with type 1 diabetes mellitus are presented.Objective: This study aimed to evaluate the effect of glycated hemoglobin (HbA1c) variability on the development of microvascular complications in patients with type 1 diabetes mellitus (DM1) and disease duration of 25 years.Materials and methods: A retrospective analysis of the database of patients with DM1 was performed from the moment of the disease manifestation until the time of the last visit. Determination of HbA1c level is carried out using parameters certified in accordance with the National Standard for Glycohemoglobin Standardization (NGSP) or the International Federation of Clinical Chemists (IFCC). HbA1c variability was determinated by average current HbA1c, average of longitudinal HbA1c (from the manifestation to the last visit – 2019), median and maximum of difference in changes of HbA1c (median and max∆HbA1c). Statistical analysis was performed by IBM SPSS Statistics ver.22. A statistically significant difference is the value p < 0.05.Results. A total of 88 patients were enrolled in this study, they were divided in 3 groups depending on the registered microvascular complications (MVC): without MVC (n = 38), isolated MVC (retinopathy or nephropathy) (n = 25) and multiple MVC (retinopathy and nephropathy) (n = 25). Clinical characteristics [median (25; 75 percentile)]: age of manifestation of DM1 is 9 years (5; 12), age of patients at the time of the last visit is 33 years (29; 35), duration of DM1 is 24 years (20; 27), body mass index 24 kg/m2 (21; 25). Medication: basal-bolus insulin therapy (n = 82) or pump insulin therapy (n = 6). The average level of longitudinal HbA1c for the three groups was: 8% (7.6; 8.9), 8.5% (7.9; 8.9), 8.6% (7.8; 10), p = 0.2. Average of current (at the time of the last visit) HbA1c – 8.2% (7.2; 9.0), 8.1% (7.5; 9.0), 8.4% (7.3; 9.7), p = 0.4. Statistically significant differences were determined in the group without complications and in the group with multiple complications between the levels of maxΔ HbA1c 2.3% (1.8; 2.8) vs 4.7% (3.2; 5.6), p < 0.0001 and median Δ HbA1c 0.7% (0.6; 0.9) vs 1.4% (1; 1.7), р < 0.0001. There were no statistically significant relationships between the maximum and medianΔ HbA1c in the groups without complications and in the group with isolated complications.Conclusions: Longitudinal HbA1c and current HbA1c are not associated with the development of microvascular complications. The potential role in the development of microvascular complications was determined for the maximum and median Δ HbA1c.

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