To compare the incidence of end-stage renal disease (ESRD) between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.
Methods
This cohort study enrolled all 521 patients with childhood-onset type 1 diabetes with the year of onset from 1959 to 1996 in Hokkaido Prefecture, Japan. We calculated the ESRD incidence rate per 100,000 person-years by sex, onset year, onset age, and type 1 diabetes subtype (slowly progressive or acute-onset). We also constructed a Kaplan–Meier curve for ESRD by these risk factors.
Results
The data of 391 patients were gathered, among whom 66 developed ESRD. The ESRD incidence rate per 100,000 person-years was 525 among all patients; 538 and 503 among women (n = 235) and men (n = 156); 893, 413, and 225 for onset year of 1959–1979 (n = 107), 1980–1989 (n = 201), and 1990–1996 (n = 83); 420 and 715 for onset before (n = 243) and after (n = 148) puberty; and 1388 and 432 for the slowly progressive (n = 41) and acute-onset (n = 350) subtypes, respectively. The Kaplan–Meier curve also indicated a significantly higher incidence of ESRD in slowly progressive than in acute-onset type 1 diabetes.
Conclusion
The incidence of ESRD was higher in slowly progressive than acute-onset type 1 diabetes.
{"title":"Slowly progressive subtype of childhood-onset type 1 diabetes as a high-risk factor for end-stage renal disease: A cohort study in Japan","authors":"Hiroshi Yokomichi , Mie Mochizuki , Shigeru Suzuki , Yoshiya Ito , Tomoyuki Hotsubo , Nobuo Matsuura","doi":"10.1016/j.jdiacomp.2024.108922","DOIUrl":"10.1016/j.jdiacomp.2024.108922","url":null,"abstract":"<div><h3>Aim</h3><div>To compare the incidence of end-stage renal disease (ESRD) between slowly progressive type 1 diabetes and acute-onset type 1 diabetes.</div></div><div><h3>Methods</h3><div>This cohort study enrolled all 521 patients with childhood-onset type 1 diabetes with the year of onset from 1959 to 1996 in Hokkaido Prefecture, Japan. We calculated the ESRD incidence rate per 100,000 person-years by sex, onset year, onset age, and type 1 diabetes subtype (slowly progressive or acute-onset). We also constructed a Kaplan–Meier curve for ESRD by these risk factors.</div></div><div><h3>Results</h3><div>The data of 391 patients were gathered, among whom 66 developed ESRD. The ESRD incidence rate per 100,000 person-years was 525 among all patients; 538 and 503 among women (<em>n</em> = 235) and men (<em>n</em> = 156); 893, 413, and 225 for onset year of 1959–1979 (<em>n</em> = 107), 1980–1989 (<em>n</em> = 201), and 1990–1996 (<em>n</em> = 83); 420 and 715 for onset before (<em>n</em> = 243) and after (<em>n</em> = 148) puberty; and 1388 and 432 for the slowly progressive (<em>n</em> = 41) and acute-onset (<em>n</em> = 350) subtypes, respectively. The Kaplan–Meier curve also indicated a significantly higher incidence of ESRD in slowly progressive than in acute-onset type 1 diabetes.</div></div><div><h3>Conclusion</h3><div>The incidence of ESRD was higher in slowly progressive than acute-onset type 1 diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 1","pages":"Article 108922"},"PeriodicalIF":2.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.jdiacomp.2024.108921
Claudia R.L. Cardoso, Lucas da Silva Pereira, Nathalie C. Leite, Gil F. Salles
Aims
To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.
Methods
Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.
Results
Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).
Conclusions
In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.
{"title":"Prognostic importance of baseline and changes in serum uric acid for macro/microvascular and mortality outcomes in individuals with type 2 diabetes: The Rio de Janeiro type 2 diabetes cohort","authors":"Claudia R.L. Cardoso, Lucas da Silva Pereira, Nathalie C. Leite, Gil F. Salles","doi":"10.1016/j.jdiacomp.2024.108921","DOIUrl":"10.1016/j.jdiacomp.2024.108921","url":null,"abstract":"<div><h3>Aims</h3><div>To investigate the associations between baseline/changes in serum uric acid (sUA) and the risks for cardiovascular/microvascular outcomes and mortality in a type 2 diabetes cohort.</div></div><div><h3>Methods</h3><div>Baseline sUA was measured in 685 individuals, and 463 had a second sUA measurement during follow-up; sUA was analyzed as a continuous variable and categorized into sex-specific tertile subgroups and low/high levels (>4.5 mg/dl women; >5.5 mg/dl men). The risks associated with baseline sUA and its changes were examined by Cox analyses for all outcomes.</div></div><div><h3>Results</h3><div>Median follow up was 10.7 years, there were 173 major cardiovascular events (MACEs), 268 all-cause deaths, 127 microalbuminuria, 104 renal failure, 160 retinopathy and 178 peripheral neuropathy outcomes. Baseline sUA was predictor of all outcomes, except all-cause mortality and retinopathy. In tertile and high/low sUA analyses, the hazard ratios (HRs) varied from 1.6 (microalbuminuria development) to 2.4 (MACEs; cardiovascular mortality). There was interaction with sex for MACEs, an increased risk was observed in women (HR: 2.6), but not in men (HR: 1.2). Changes in sUA were associated with the renal failure (HR: 2.4).</div></div><div><h3>Conclusions</h3><div>In a prospective cohort, high baseline sUA was a predictor of cardiovascular, renal and peripheral neuropathy. However, sUA changes were only predictor of renal failure.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 1","pages":"Article 108921"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1016/S1056-8727(24)00242-3
{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(24)00242-3","DOIUrl":"10.1016/S1056-8727(24)00242-3","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108916"},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-19DOI: 10.1016/j.jdiacomp.2024.108907
Lijiahui Lin , Siyu Zhong , Ying Zhou , Jie Xia , Shanshan Deng , Tao Jiang , Aihua Jiang , Zhimei Huang , Jianping Wang
Objective
To investigate the effect of Dapagliflozin (Da) on the disorders of human umbilical vein endothelial cells (HUVECs) induced by high glucose and high fat (HG/HF).
Methods
Immunohistochemistry and immunofluorescence were used to detect the SGLT-2 expression in thoracic aortic tissues. After transfected with overexpressed plasmid SLC5A2, autophagy and cell functions of HUVECs were detected with the treatment of autophagy inhibitor 3-MA (5 mM). HUVECs were exposed to mannitol (MAN), glucose/palmitate (Hg/PA), and Hg/PA/Da for 24 h, and the proliferation of HUVECs was detected by CCK-8. The protein expression levels, endothelial cell functions (cell proliferation, migration, tubular formation, apoptosis, and autophagy) in endothelial cells were evaluated.
Results
The SGLT-2 expression was found in atherosclerotic human thoracic aorta tissues and HG/PA induced HUVECs (P < 0.05). After the overexpression of SGLT-2 in HUVECs, the proliferation, migration and tubule formation ability of HUVECs were inhibited, and autophagy and apoptosis were increased, which were reversed by 3-MA (P < 0.05). After the addition of Sodium-glucose co-transporters 2 inhibitor, Dapagliflozin, the proliferation of HUVECs, the tubule formation, autophagy, apoptosis and migration ability of cells inhibited by HG/PA were significantly improved (P < 0.05). Moreover, the increased protein expression levels of autophagy and apoptosis in HG/PA induced HUVECs were also decreased by the treatment of Dapagliflozin (P < 0.05).
Conclusions
Dapagliflozin can improve the dysfunction of high glucose/high fat-induced human umbilical vein endothelial cells by downregulate autophagy through inhibiting SGLT-2.
{"title":"Dapagliflozin improves the dysfunction of human umbilical vein endothelial cells (HUVECs) by downregulating high glucose/high fat-induced autophagy through inhibiting SGLT-2","authors":"Lijiahui Lin , Siyu Zhong , Ying Zhou , Jie Xia , Shanshan Deng , Tao Jiang , Aihua Jiang , Zhimei Huang , Jianping Wang","doi":"10.1016/j.jdiacomp.2024.108907","DOIUrl":"10.1016/j.jdiacomp.2024.108907","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effect of Dapagliflozin (Da) on the disorders of human umbilical vein endothelial cells (HUVECs) induced by high glucose and high fat (HG/HF).</div></div><div><h3>Methods</h3><div>Immunohistochemistry and immunofluorescence were used to detect the SGLT-2 expression in thoracic aortic tissues. After transfected with overexpressed plasmid SLC5A2, autophagy and cell functions of HUVECs were detected with the treatment of autophagy inhibitor 3-MA (5 mM). HUVECs were exposed to mannitol (MAN), glucose/palmitate (Hg/PA), and Hg/PA/Da for 24 h, and the proliferation of HUVECs was detected by CCK-8. The protein expression levels, endothelial cell functions (cell proliferation, migration, tubular formation, apoptosis, and autophagy) in endothelial cells were evaluated.</div></div><div><h3>Results</h3><div>The SGLT-2 expression was found in atherosclerotic human thoracic aorta tissues and HG/PA induced HUVECs (<em>P</em> < 0.05). After the overexpression of SGLT-2 in HUVECs, the proliferation, migration and tubule formation ability of HUVECs were inhibited, and autophagy and apoptosis were increased, which were reversed by 3-MA (<em>P</em> < 0.05). After the addition of Sodium-glucose co-transporters 2 inhibitor, Dapagliflozin, the proliferation of HUVECs, the tubule formation, autophagy, apoptosis and migration ability of cells inhibited by HG/PA were significantly improved (<em>P</em> < 0.05). Moreover, the increased protein expression levels of autophagy and apoptosis in HG/PA induced HUVECs were also decreased by the treatment of Dapagliflozin (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Dapagliflozin can improve the dysfunction of high glucose/high fat-induced human umbilical vein endothelial cells by downregulate autophagy through inhibiting SGLT-2.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 1","pages":"Article 108907"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-17DOI: 10.1016/j.jdiacomp.2024.108909
Maria S. Varughese , Ananth U. Nayak
{"title":"Diabetic macular edema: Variations in observations with intensive treatment optimizing glycemia","authors":"Maria S. Varughese , Ananth U. Nayak","doi":"10.1016/j.jdiacomp.2024.108909","DOIUrl":"10.1016/j.jdiacomp.2024.108909","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 1","pages":"Article 108909"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to examine the stepwise risk stratification for predicting major adverse cardiovascular events (MACE) in patients with DM and suspected coronary artery disease (CAD).
Method
1187 patients with suspected CAD enrolled in a prospective cohort study were examined. The patients were evaluated step-by-step with coronary artery calcification (CAC), coronary artery stenosis (CAS), and FFRCT analysis. Hazard ratio (HR) and 95 % confidence interval (CI) for incidence MACE were calculated by Cox Proportional Hazards model for adjustment of Framingham risk score.
Results
During a median follow-up of 4.0 years, MACE frequently occurred in DM patients than non-DM (15.9 % vs. 5.7 %). A lower CAC threshold with >0 or > 50 Agatston score was significantly associated with increased MACE in DM (HR [95 % CI], 3.62 [1.12–11.67] or 4.72 [2.11–10.55], respectively), but not in non-DM. DM patients with >50 CAC, CAS, and ≤ 0.71 FFRCT value showed the HR (95 % CI) for MACE was 9.84 (4.26–22.69) as compared with those with ≤50 CAC, whereas non-DM patients showed that it was 2.56 (1.02–6.43).
Conclusion
Step-by-step assessment using CAC, CAS, and FFRCT on top of clinical risk factors was useful for more accurate cardiovascular risk stratification in patients with DM.
{"title":"Stepwise cardiovascular risk stratification in patients with type 2 diabetes based on coronary CT assessment","authors":"Shinichi Wada , Yoshitaka Iwanaga , Michikazu Nakai , Teruo Noguchi , Yoshihiro Miyamoto","doi":"10.1016/j.jdiacomp.2024.108908","DOIUrl":"10.1016/j.jdiacomp.2024.108908","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to examine the stepwise risk stratification for predicting major adverse cardiovascular events (MACE) in patients with DM and suspected coronary artery disease (CAD).</div></div><div><h3>Method</h3><div>1187 patients with suspected CAD enrolled in a prospective cohort study were examined. The patients were evaluated step-by-step with coronary artery calcification (CAC), coronary artery stenosis (CAS), and FFR<sub>CT</sub> analysis. Hazard ratio (HR) and 95 % confidence interval (CI) for incidence MACE were calculated by Cox Proportional Hazards model for adjustment of Framingham risk score.</div></div><div><h3>Results</h3><div>During a median follow-up of 4.0 years, MACE frequently occurred in DM patients than non-DM (15.9 % vs. 5.7 %). A lower CAC threshold with >0 or > 50 Agatston score was significantly associated with increased MACE in DM (HR [95 % CI], 3.62 [1.12–11.67] or 4.72 [2.11–10.55], respectively), but not in non-DM. DM patients with >50 CAC, CAS, and ≤ 0.71 FFR<sub>CT</sub> value showed the HR (95 % CI) for MACE was 9.84 (4.26–22.69) as compared with those with ≤50 CAC, whereas non-DM patients showed that it was 2.56 (1.02–6.43).</div></div><div><h3>Conclusion</h3><div>Step-by-step assessment using CAC, CAS, and FFR<sub>CT</sub> on top of clinical risk factors was useful for more accurate cardiovascular risk stratification in patients with DM.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"39 1","pages":"Article 108908"},"PeriodicalIF":2.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with diabetes commonly experience an aberrant production of free radicals and weakened antioxidative defenses, making them highly susceptible to oxidative stress development. This, in turn, can induce and promote diabetic complications. Therefore, utilizing antidiabetic agents with antioxidative properties can offer dual benefits by addressing hyperglycemia and reducing oxidative damage. Semaglutide, a recently approved oral form of glucagon-like peptide-1 (GLP-1) analogues, has shown potent antidiabetic effects. Additionally, recent studies have suggested that it possesses antioxidative properties. However, the exact effects and the molecular pathways involved are not well understood. In this review, we present the latest findings on the antioxidative impacts of semaglutide and draw conclusions about the mechanisms involved.
{"title":"Exploring the antioxidant properties of semaglutide: A comprehensive review","authors":"Habib Yaribeygi , Mina Maleki , Behina Forouzanmehr , Prashant Kesharwani , Tannaz Jamialahmadi , Sercan Karav , Amirhossein Sahebkar","doi":"10.1016/j.jdiacomp.2024.108906","DOIUrl":"10.1016/j.jdiacomp.2024.108906","url":null,"abstract":"<div><div>Patients with diabetes commonly experience an aberrant production of free radicals and weakened antioxidative defenses, making them highly susceptible to oxidative stress development. This, in turn, can induce and promote diabetic complications. Therefore, utilizing antidiabetic agents with antioxidative properties can offer dual benefits by addressing hyperglycemia and reducing oxidative damage. Semaglutide, a recently approved oral form of glucagon-like peptide-1 (GLP-1) analogues, has shown potent antidiabetic effects. Additionally, recent studies have suggested that it possesses antioxidative properties. However, the exact effects and the molecular pathways involved are not well understood. In this review, we present the latest findings on the antioxidative impacts of semaglutide and draw conclusions about the mechanisms involved.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108906"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetic Neuropathy (DN) is one of the most frequent chronic complications of diabetes mellitus. Its commonest form, distal symmetrical polyneuropathy (DSPN), is characterised by slowly progressing length-dependent nerve damage in the lower limbs, increasing the risk of foot ulcerations and leading to symptoms like tingling, pain, or numbness.
Aim
The aim of this review was to discuss the utility of cilostazol, a phosphodiesterase inhibitor with known antiplatelet, vasodilatory, anti-inflammation properties, in the treatment of DSPN.
Results
Preclinical studies in animals have demonstrated the ability of cilostazol to improve nerve function and to protect from peripheral nerve disruption and central sensitisation. However, clinical trials in humans are very sparse and have so far not been encouraging.
Conclusions
Further research is needed to fully understand the mechanisms and potential efficacy of cilostazol in treating DSPN.
{"title":"Cilostazol for the treatment of distal symmetrical polyneuropathy in diabetes mellitus: Where do we stand?","authors":"Dimitrios Pantazopoulos , Evanthia Gouveri , Manfredi Rizzo , Nikolaos Papanas","doi":"10.1016/j.jdiacomp.2024.108905","DOIUrl":"10.1016/j.jdiacomp.2024.108905","url":null,"abstract":"<div><h3>Introduction</h3><div>Diabetic Neuropathy (DN) is one of the most frequent chronic complications of diabetes mellitus. Its commonest form, distal symmetrical polyneuropathy (DSPN), is characterised by slowly progressing length-dependent nerve damage in the lower limbs, increasing the risk of foot ulcerations and leading to symptoms like tingling, pain, or numbness.</div></div><div><h3>Aim</h3><div>The aim of this review was to discuss the utility of cilostazol, a phosphodiesterase inhibitor with known antiplatelet, vasodilatory, anti-inflammation properties, in the treatment of DSPN.</div></div><div><h3>Results</h3><div>Preclinical studies in animals have demonstrated the ability of cilostazol to improve nerve function and to protect from peripheral nerve disruption and central sensitisation. However, clinical trials in humans are very sparse and have so far not been encouraging.</div></div><div><h3>Conclusions</h3><div>Further research is needed to fully understand the mechanisms and potential efficacy of cilostazol in treating DSPN.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108905"},"PeriodicalIF":2.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.jdiacomp.2024.108904
Christopher M Lawrence , Carmel E Smart , Aleeza Fatima , Bruce R King , Prudence Lopez
Aims
To determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB.
Methods
50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed.
Results
Twenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, p = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, p < 0.002) and BMI Z-score (+1.28 SD vs +0.76 SD, p = 0.040). They had lower time in range, 3.9–10 mmol/L (50.3 % vs. 63.8 %, p = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, p = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, p = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, p < 0.002).
Conclusions
DEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.
{"title":"Increased bolus overrides and lower time in range: Insights into disordered eating revealed by insulin pump metrics and continuous glucose monitor data in Australian adolescents with type 1 diabetes","authors":"Christopher M Lawrence , Carmel E Smart , Aleeza Fatima , Bruce R King , Prudence Lopez","doi":"10.1016/j.jdiacomp.2024.108904","DOIUrl":"10.1016/j.jdiacomp.2024.108904","url":null,"abstract":"<div><h3>Aims</h3><div>To determine the prevalence of disordered eating behaviors (DEB) in a population of Australian adolescents with T1D and to investigate clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) data trends, and psychological attributes associated with DEB.</div></div><div><h3>Methods</h3><div>50 participants (27 female, 23 male, average age 15.2 years, average duration of diabetes 6.2 years) were recruited. Diabetes Eating Problem Survey-Revised (DEPS-R) and Strengths and Difficulties Questionnaires were completed. Prevalence of disordered eating was reported, and associations with clinical parameters, insulin pump therapy (IPT) and continuous glucose monitor (CGM) metrics were assessed.</div></div><div><h3>Results</h3><div>Twenty-four participants (48 %) had an elevated DEPS-R score. Participants with elevated DEPS-R were more likely to be female (75 % vs 31.6 %, <em>p</em> = 0.004), have a higher HbA1c (8.2 %/67 mmol/mol vs. 6.9 %/51 mmol/mol, <em>p</em> < 0.002) and BMI <em>Z</em>-score (+1.28 SD vs +0.76 SD, <em>p</em> = 0.040). They had lower time in range, 3.9–10 mmol/L (50.3 % vs. 63.8 %, <em>p</em> = 0.01) and higher mean glucose (10.0 mmol/L vs. 8.3 mmol/L, <em>p</em> = 0.005). Of the 60 % using IPT, participants with elevated DEPS-R had increased meal bolus overrides (7.9 % vs 3.8 %, <em>p</em> = 0.047). Reported difficulties on SDQ were higher in the elevated DEPS-R group (18.3 vs 10.5, <em>p</em> < 0.002).</div></div><div><h3>Conclusions</h3><div>DEB are common in Australian adolescents with T1D and associated with increased dysglycemia. Diabetes technology cannot be solely relied upon for detection of DEB and there remains a need for routine screening.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108904"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.jdiacomp.2024.108903
Mary R. Rooney , Faye L. Norby , Elsayed Z. Soliman , Lin Yee Chen , Elizabeth Selvin , Justin B. Echouffo-Tcheugui
Persons with long-standing, poorly controlled diabetes or recent hyperglycemia had the highest burden of cardiac autonomic neuropathy. Cardiac autonomic neuropathy contributed to elevated long-term incidence of cardiovascular disease and mortality even in persons with well-controlled diabetes.
{"title":"Duration of diabetes, glycemic control, and low heart rate variability: The Atherosclerosis Risk in Communities (ARIC) study","authors":"Mary R. Rooney , Faye L. Norby , Elsayed Z. Soliman , Lin Yee Chen , Elizabeth Selvin , Justin B. Echouffo-Tcheugui","doi":"10.1016/j.jdiacomp.2024.108903","DOIUrl":"10.1016/j.jdiacomp.2024.108903","url":null,"abstract":"<div><div>Persons with long-standing, poorly controlled diabetes or recent hyperglycemia had the highest burden of cardiac autonomic neuropathy. Cardiac autonomic neuropathy contributed to elevated long-term incidence of cardiovascular disease and mortality even in persons with well-controlled diabetes.</div></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":"38 12","pages":"Article 108903"},"PeriodicalIF":2.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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