Effect of vitamin D supplementation on HbA1c level in a cohort of type 1 diabetic patients

Background and objective: Glycemic control is essential to halt the progression of diabetic complications. Some studies previously showed the effect of vitamin D on pancreatic β-cell function and insulin secretion. This study aimed to assess the effect of vitamin D supplementation on HbA1c in patients with type 1 diabetes and vitamin D deficiency. Methods: This prospective quasi-experimental study was conducted in Erbil city from 1st September to 1st December 2019. In this study, 76 patients attending Layla Qasim diabetic center were tested. Only 50 patients were recruited that had vitamin D deficiency (25OHD: <20) and were aged less than 18 years. They received vitamin D supplementation for 12 weeks. HbA1c and vitamin D level was measured before and after supplementation. Results: Before vitamin D supplementation, the mean level of serum 25(OH)D among females (8.67 ± 2.56) was lower than males (14.31 ± 3.19). However, no association was found between the initial HbA1c level and gender. HbA1c level (mean = 8.24 ± 0.49) improved significantly after vitamin D supplementation to the level of 7.93 ± 0.67 (P = 0.032). There was a significant difference between groups of glycosylated hemoglobin levels of (first tertile<7.5%, second tertile 7.6%-9.9%, third tertile ≥10%) after 12 weeks of supplementation with vitamin D (P <0.001). Conclusion: Vitamin D supplementation in type 1 diabetic patients with vitamin D deficiency lead to significant improvement in HbA1c level. Keywords: Diabetes; Deficiency; Vitamin D.

Acetone Sensor Based on FAIMS-MEMS

In this paper, to address the problems of large blood draws, long testing times, and the inability to achieve dynamic detection of invasive testing for diabetes, stemming from the principle that type 1 diabetic patients exhale significantly higher levels of acetone than normal people, a FAIMS-MEMS gas sensor was designed to detect acetone, which utilizes the characteristics of high sensitivity, fast response, and non-invasive operation. It is prepared by MEMS processes, such as photolithography, etching, and sputtering, its specific dimensions are 4000 μm in length, 3000 μm in width and 800 μm in height and the related test system was built to detect acetone gas. The test results show that when acetone below 0.8 ppm is introduced, the voltage value detected by the sensor basically does not change, while when acetone gas exceeds 1.8 ppm, the voltage value detected by the sensor increases significantly. The detection accuracy of the sensor prepared by this method is about 0.02 ppm/mV, and the voltage change can reach 1 V with a response time of 3 s and a recovery time of 4 s when tested under 20 ppm acetone environment; this has good repeatability and stability, and has great prospects in the field of non-invasive detection of type 1 diabetes.

Study of Circulating Apelin in Type 1 Diabetic Patients and its Association with Glycemic Control in a Group of Egyptian Population

Background Type 1 diabetes mellitus (T1DM) is one of the most common chronic and metabolic diseases worldwide. The incidence of T1DM is reported to be increasing by 3-5% per year, and the number of people with diabetes is estimated to reach 380 million by 2025. Several studies have shown that TIDM is associated with metabolic abnormalities and alteration of adipose tissue hormones (adipokines). Apelin, one of the most abundantly expressed adipocytokine, is a bioactive peptide and produces its effects through a cell surface G protein-coupled receptor called APJ.The apelinergic system, is involved in a wide range of functions including regulation of body fluid homeostasis, cardiovascular system, angiogenesis and energy metabolism . Additionally, apelin participates in pathological processes, including obesity and diabetes. Apelin plays a beneficial role in energy metabolism. Objectives The aim of this study is to evaluate serum Apelin levels in patients with type 1 diabetes and to correlate the serum Apelin level and glycemic control. Patients and Methods This study was a cross sectional study. Participants were classified into two groups. The first group included 60 patient with T1DM recruited from Ain Shams University Endocrinology and Diabetes outpatient clinics in Cairo during the period from June 2019 to January2002 and the second group included 40 healthy controls. Serum apelin (APLN), FBS, 2hrPP, HbA1c, lipid profile and eGDR were measured for each case. Results Comparison between T1DM patients and controls revealed that serum apelin levels, were significantly increased in cases compared to controls. Negative correlations were found between Apelin and HbA1c% in the diabetic group as a marker for glycemic control so apelin may have a promising role as biomarkers in T1DM. Conclusion Our study showed that apelin concentrations were increased in type 1 diabetic patients compared to healthy controls. The potential association of apelin with insulin secretion and action may reveal new pathways in the pathogenesis of type 1 diabetes. Apelin in T1DM patients may be considered as promising adipokines for predicting glycemic control.

Changes and clinical significance of invariant natural killer T cells and their subsets in newly diagnosed type 1 diabetic patients

Objective:The aim of this study was to investigate the changes and clinical significance of the invariant natural killer T(iNKT) cells and their subsets in peripheral blood of newly diagnosed type 1 diabetic patients. Methods: 23 newly diagnosed type 1 diabetic patients and 17 healthy volunteers(from 2015 to 2019)were collected. Peripheral blood mononuclear cells (PBMC) were isolated by FICOII method, the ratio of main cell subsets of PBMC was determined by Flow cytometry. The changes of iNKT cells and their subsets (CD4 + , CD4-CD8-, CD8 + , CD4 + CD8 +) in peripheral blood as well as their correlation with clinical indexes were monitored. Results: Compared with the healthy group, the absolute TCRVβ11+iNKT cell number in the peripheral blood of newly diagnosed type 1 diabetic patients (p=0.03) was significantly higher. The absolute CD4+TCRVβ11iNKT cell number (p=0.00) , CD4+TCRVα24 +iNKT cells (p=0.01) , CD4+TCRVα24J18 +iNKT cells (p=0.00) ,CD8+TCRVβ11+iNKT cells(p=0.021) and CD4+CD8+ TCRVα24+iNKT cells (p=0.002) were significantly increased. The absolute CD4-CD8-TCRVα24+iNKT cell number (p=0.030) in T1DM patients was significantly lower than that in HC. In newly diagnosed type 1 diabetic patients, the absolute CD4+TCRVβ11+iNKT cell number was negatively correlated with BMI (p=0.001, r=-0.492) , and the absolute CD4+TCRVα24+iNKT cell number was negatively correlated with BMI (p=0.014, r=-0.387) , the absolute CD4+TCRVα24J18+iNKT cell number was negatively correlated with BMI (p=0.010, r=-0.402) and positively correlated with glycated hemoglobin (P=0.048, r=0.417). The absolute CD4+CD8+TCRVα24+iNKT cell number was positively correlated with 30 minutes and 1 hour postprandial C-peptide(p= 0.002, r=0.664; p= 0.002, r = 0.669) . Conclusion: Our data indicated a higher absolute iNKT cell number in T1DM patients compared with that in healthy patients, and was accompanied by changes in the number of cell subsets. The immune dysfunction mediated by iNKT cells may associate with the development of type 1 diabetes.