Journal of diabetes and its complications最新文献

{"title":"Disease-modifying therapies for diabetic peripheral neuropathy: A systematic review and meta-analysis of randomized controlled trials","authors":"Gui-Lin Ran ,&nbsp;Yan-Ping Li ,&nbsp;Li-Chin Lu ,&nbsp;Shao-Huan Lan","doi":"10.1016/j.jdiacomp.2024.108691","DOIUrl":"10.1016/j.jdiacomp.2024.108691","url":null,"abstract":"<div><h3>Background</h3><p>Alpha-lipoic acid, epalrestat, and mecobalamin are widely used as monotherapies for diabetic peripheral neuropathy. However, whether a triple-combination therapy with these three drugs is superior to monotherapy or dual therapy remains debatable.</p></div><div><h3>Methods</h3><p>Nine randomized controlled trials were identified through a search on electronic databases such as PubMed, Web of Science, and Cochrane Library. The trial participants (<em>N</em> = 1153) were divided into the experimental group who received the triple-combination therapy and the control group who received conventional or dual therapy with the aforementioned drugs.</p></div><div><h3>Results</h3><p>Therapeutic outcomes were better in the experimental group than in the control group (odds ratio: 3.74; 95 % confidence interval: 2.57–5.45; <em>I</em>² = 0 %; <em>p</em> &lt; 0.00001). No statistic difference was noted in adverse effects. Compared with the control group, the experimental group exhibited significant improvements in median motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV), peroneal MNCV, peroneal SNCV, and vibration perception thresholds (VPT) in the left and right lower limbs. In the control group, a subgroup analysis by treatment strategy revealed similar improvements in total efficacy, MNCV, and SNCV.</p></div><div><h3>Conclusions</h3><p>For diabetic peripheral neuropathy, the triple-combination therapy may be more effective than monotherapy or dual therapy.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139662358","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}

{"title":"Autologous platelet-rich plasma (APRP) in diabetes foot disease: a meta-analysis","authors":"Maria Ruiz-Muñoz,&nbsp;Francisco-Javier Martinez-Barrios,&nbsp;Raul Fernandez-Torres,&nbsp;Eva Lopezosa-Reca,&nbsp;Ana Marchena-Rodriguez","doi":"10.1016/j.jdiacomp.2024.108690","DOIUrl":"10.1016/j.jdiacomp.2024.108690","url":null,"abstract":"<div><h3>Introduction</h3><p>This study will explore the effectiveness of autologous platelet-rich plasma in the treatment of diabetic foot disease compared to conventional treatments, based on the ulcer healing rate.</p></div><div><h3>Methods</h3><p>The electronic databases of PubMed, EMBASE, and WOS internet were searched. Evaluated outcome rate of complete ulcer healing. Statistical analysis was performed with RevMan 5.0 software and SPSS 25.0.</p></div><div><h3>Results</h3><p>Eleven RCTs with 828 patients were included in this study. The meta-analysis showed a higher complete ulcer healing rate (OR = 3.69, 95 % CI 2.62 to 5.20, <em>P</em> &lt; 0.01, I² = 0 %) in growth factors based in autologous platelech-rich plasma (aPRP) group compared with control. Mixed evidence was seen for publication bias, but analyses by using the trim-and-fill method did not appreciably alter results.</p></div><div><h3>Conclusion</h3><p>Autologous platelet-rich plasma can improve the complete healing rate of the ulcer compared to current conventional treatments in diabetic foot ulcer patients.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000163/pdfft?md5=a20a19ed83472873364011949f2d7a37&pid=1-s2.0-S1056872724000163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139509943","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}

{"title":"Delayed prandial insulin boluses are an important determinant of blood glucose control and relate to fear of hypoglycemia in people with type 1 diabetes on advanced technologies","authors":"Giovanni Annuzzi,&nbsp;Raffaella Triggiani,&nbsp;Raffaele De Angelis,&nbsp;Carmen Rainone,&nbsp;Alessandra Corrado,&nbsp;Giuseppe Scidà,&nbsp;Roberta Lupoli,&nbsp;Lutgarda Bozzetto","doi":"10.1016/j.jdiacomp.2024.108689","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2024.108689","url":null,"abstract":"<div><h3>Aims</h3><p>Automated insulin delivery systems improve blood glucose control in patients with type 1 diabetes (T1D). However, optimizing their performance requires patient's proper compliance to meal insulin bolus administration. We explored real-life prevalence of delayed prandial boluses (DBs) in adults with T1D on advanced technologies, and their association with glycemic control and fear of hypoglycemia (FH).</p></div><div><h3>Methods</h3><p>In the last two-week web-based reports of 152 adults with T1D on Hybrid Closed Loop Systems (HCLS) or Sensor Augmented Pump (SAP), DBs were identified when a steep increase in blood glucose occurred at CGM before the prandial bolus, and CGM metrics were evaluated. All participants completed an online questionnaire on FH.</p></div><div><h3>Results</h3><p>Mean DBs over two weeks were 10.2 ± 4.7 (M ± SD, range 1–23) and more frequent in women than men (11.0 ± 4.6 vs. 9.4 ± 4.7, p = 0.036). Participants with more DBs (&gt;12) showed significantly lower Time-In-Range (62.4 ± 13.8 vs. 76.6 ± 9.0 %) than those with less DBs (&lt;7.7), along with higher Time-Above-Range, GMI, and Coefficient-of-Variation (ANOVA, p &lt; 0.001 for all). Participants with higher FH score showed more DBs (11.6 ± 5.0) than those in lower tertiles (9.57 ± 4.59 and 9.47 ± 4.45, ANOVA p = 0.045).</p></div><div><h3>Conclusions</h3><p>In patients on advanced technologies, delayed boluses are extremely common, and associate with significantly worse glycemic control. Utmost attention is needed to bolus timing, mainly tackling fear of hypoglycemia.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000151/pdfft?md5=f4239e391d4ca12a269bf1b5889aa83e&pid=1-s2.0-S1056872724000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139494165","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}

{"title":"Dapagliflozin attenuates renal fibrosis by suppressing angiotensin II/TGFβ signaling in diabetic mice","authors":"Mingwang Jiang ,&nbsp;Zhichen Yang ,&nbsp;Lu Lyu ,&nbsp;Meng Shi","doi":"10.1016/j.jdiacomp.2024.108687","DOIUrl":"10.1016/j.jdiacomp.2024.108687","url":null,"abstract":"<div><h3>Aims</h3><p>Diabetic nephropathy<span><span> (DN) complicates diabetes Mellitus and intimately relates to intrarenal renin–angiotensin system (RAS) activity. Dapagliflozin<span>, a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), has been validated to improve renal outcomes in diabetic patients from </span></span>clinical research<span> by elusive mechanisms. This study explored the presumption that the eagerness activity of intrarenal RAS in DN generated oxidative stress<span> to promote renal fibrosis, and the process can be interrupted by dapagliflozin.</span></span></span></p></div><div><h3>Methods</h3><p>A streptozotocin-induced DN model was established in male C57BL/6J mice. Mice were treated with dapagliflozin or losartan for 14 weeks. Biochemical data, renal fibrosis, oxidative stress, and RAS were measured.</p></div><div><h3>Results</h3><p>DN mice were characterized by overtly low body weight, high levels of blood glucose<span>, and renal injury. Interrupting SGLT2 and RAS significantly improved renal dysfunction and pathological lesions in DN mice. Consistent with these favorable effects, dapagliflozin revoked the local RAS/oxidative stress and the succeeding transforming growth factor beta (TGFβ) signaling.</span></p></div><div><h3>Conclusions</h3><p>This research clarifies that intrarenal RAS activity triggers renal injury in DN, and dapagliflozin attenuates renal fibrosis by suppressing Angiotensin II/TGFβ signaling. It unravels a novel insight into the role of prevention and treatment of SGLT2 inhibitors to DN.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139475048","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}

{"title":"Corrigendum to “Cumulative incidence of and risk factors for herpes zoster among patients with diabetes mellitus: Results from a 10-year nested case-control study” [J Diabetes Complicat., Volume 36, Issue 5, May 2022, 108168]","authors":"Nalinee Chuanchaiyakul ,&nbsp;Nuntakorn Thongtang ,&nbsp;Pinyo Rattanaumpawan","doi":"10.1016/j.jdiacomp.2023.108674","DOIUrl":"https://doi.org/10.1016/j.jdiacomp.2023.108674","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872723002726/pdfft?md5=bf886b1aff00d259ad740dbd864b16bd&pid=1-s2.0-S1056872723002726-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139108415","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}

{"title":"The effects of semaglutide, empagliflozin and their combination on the kidney sodium signal from magnetic resonance imaging: A prespecified, secondary analysis from a randomized, clinical trial","authors":"Søren Gullaksen ,&nbsp;Liv Vernstrøm ,&nbsp;Steffen S. Sørensen ,&nbsp;Steffen Ringgaard ,&nbsp;Christoffer Laustsen ,&nbsp;Henrik Birn ,&nbsp;Kristian L. Funck ,&nbsp;Per L. Poulsen ,&nbsp;Esben Laugesen","doi":"10.1016/j.jdiacomp.2023.108673","DOIUrl":"10.1016/j.jdiacomp.2023.108673","url":null,"abstract":"<div><h3>Aims</h3><p>To evaluate the effect of treatment with semaglutide and empagliflozin on the cortico-medullary sodium gradient (MCR; medulla/cortex ratio), urine sodium/creatinine ratio (UNACR), and estimated plasma volume (ePV) and to compare the MCR between persons with and without type 2 diabetes.</p></div><div><h3>Methods</h3><p>Using the ²³Na magnetic resonance imaging (²³Na-MRI) technique, we investigated the effects of 32 weeks of treatment with semaglutide, empagliflozin or their combination on MCR in 65 participants with type 2 diabetes and high risk of cardiovascular disease. The participants were recruited from a randomized, controlled interventional trial and further characterized by UNACR and ePV. In addition, in a cross-sectional design, we compared MCR by ²³Na-MRI in 12 persons with type 2 diabetes and 17 matched controls. Data from the interventional trial were analyzed using a single, multivariate linear mixed model strategy for repeated measurements. Data from the cross-sectional study were analyzed by fitting a linear regression model adjusted for age and sex.</p></div><div><h3>Results</h3><p>Compared to placebo, semaglutide, but not empagliflozin, significantly decreased the MCR (−9 %, 95%CI (−18, −0.06)%, <em>p</em> = 0.035 and −0.05 %, 95%CI(−0.15, 0.05)%, <em>p</em> = 0.319, respectively). The UNACR decreased in the semaglutide group(−35 %, 95 % CI(−52, −14) %, <em>p</em> = 0.003) but not in the empagliflozin group (7 %, 95 % CI(−21, 44)%, <em>p</em> = 0.657), whereas the ePV decreased in the combination group. The MCR was not different between persons with and without type 2 diabetes.</p></div><div><h3>Conclusion</h3><p>²³Na magnetic resonance imaging can identify drug induced changes in the MCR in persons with type 2 diabetes, and 32 weeks of semaglutide decreases the MCR in such persons. There is no difference in the MCR between persons with and without type 2 diabetes.</p></div><div><h3>Trial number and registry</h3><p>EUDRACT 2019-000781-38, clinicaltrialsregister.eu.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872723002714/pdfft?md5=fe0591cfa5db3f32af88b9801ab4473a&pid=1-s2.0-S1056872723002714-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139102281","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}

{"title":"Reduced skeletal muscle mass to visceral fat area ratio is independently associated with reduced cognitive function in type 2 diabetes mellitus","authors":"Serena Low ,&nbsp;Tze Pin Ng ,&nbsp;Kiat Sern Goh ,&nbsp;Angela Moh ,&nbsp;Jonathon Khoo ,&nbsp;Keven Ang ,&nbsp;Philip Yap ,&nbsp;Chin Yee Cheong ,&nbsp;Wern Ee Tang ,&nbsp;Ziliang Lim ,&nbsp;Tavintharan Subramaniam ,&nbsp;Chee Fang Sum ,&nbsp;Su Chi Lim","doi":"10.1016/j.jdiacomp.2023.108672","DOIUrl":"10.1016/j.jdiacomp.2023.108672","url":null,"abstract":"<div><h3>Aim</h3><p>Skeletal muscle<span><span><span> mass to visceral fat area ratio (SVR) has been recognised as an index of </span>sarcopenic obesity<span><span>. SVR is associated with type 2 diabetes mellitus (T2DM), metabolic syndrome<span> and arterial stiffness which are known risk factors for </span></span>cognitive dysfunction. We aimed to investigate association between SVR and cognitive function </span></span>in patients with T2DM.</span></p></div><div><h3>Methods</h3><p>This was a cross-sectional study of 1326 patients with T2DM and mean age 61.3 ± 8.0 years. SVR was assessed based on bioelectrical impedance measurements of muscle mass and visceral fat area (VFA). Cognitive function was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Linear regression was used to examine the association between SVR in quartiles and RBANS score, adjusting for demographics, education, presence of depressive symptoms, clinical covariates and medications.</p></div><div><h3>Results</h3><p>The lower SVR quartiles were negatively associated with RBANS total score in the unadjusted analysis. The corresponding coefficients for Quartiles 1 and 2 SVR were −3.79 (95 % CI −5.39 to −2.19; p &lt; 0.001) and −1.47 (95 % CI −2.86 to −0.07; p = 0.039) in fully adjusted analysis. The negative association between Quartile 1 SVR and RBANS score was evident in immediate memory, delayed memory, visuo-spatial construction, language and attention domains. Muscle mass and VFA alone had weaker associations with RBANS scores.</p></div><div><h3>Conclusion</h3><p>Our study demonstrated, for the first time, an independent association between reduced SVR and lower cognitive function. This is evident in global and multiple cognitive domains. The synergistic effects of reduced muscle mass and visceral obesity may be more pronounced than their independent effects on cognitive function.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139093461","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}

{"title":"Roles and mechanisms of umbilical cord mesenchymal stem cells in the treatment of diabetic foot: A review of preclinical and clinical studies","authors":"Haorui Zhang,&nbsp;Yuanrui Gu,&nbsp;Ke Zhang,&nbsp;Yanxia Tu,&nbsp;Chenxi Ouyang","doi":"10.1016/j.jdiacomp.2023.108671","DOIUrl":"10.1016/j.jdiacomp.2023.108671","url":null,"abstract":"<div><h3>Aims</h3><p>Growing preclinical and clinical evidence has suggested the potential method of umbilical cord<span><span> mesenchymal stem cell (UCMSC) therapy for diabetic foot. Thus, the authors provided an outline of the application of UCMSCs in the </span>treatment of diabetic foot and further summarized the roles and mechanisms of this therapy.</span></p></div><div><h3>Data synthesis</h3><p><span>With no time limitations, the authors searched the Web of Science, Cochrane Central Register of Controlled Trials, and PubMed (MEDLINE) databases. 14 studies were included, including 9 preclinical experiments and 5 </span>clinical trials<span> (3 RCTs and 2 single-arm trials).</span></p></div><div><h3>Conclusions</h3><p><span><span>The UCMSCs are of great efficacy and safety, and function mainly by reducing inflammation, regulating immunity, promoting growth factors, and enhancing the functions of </span>vascular endothelial cells<span>, fibroblasts, and keratinocytes<span><span>. As a result, ulcer healing-related biological processes ensue, which finally lead to </span>diabetic foot ulcer healing and clinical symptom improvement. </span></span></span>UCMSC<span> treatment enhances diabetic foot ulcer healing and has a safety profile. They function mainly by modulating immunity, promoting growth factor secretion, and enhancing cellular functions. More well-designed preclinical and clinical studies are needed to provide the most optimal protocol, the comprehensive molecular mechanisms, as well as to further evaluate the efficiency and safety profile of UCMSC treatment in diabetic foot patients.</span></p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021747","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}

{"title":"Contents/Barcode","authors":"","doi":"10.1016/S1056-8727(24)00003-5","DOIUrl":"https://doi.org/10.1016/S1056-8727(24)00003-5","url":null,"abstract":"","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1056872724000035/pdfft?md5=72a437e67ce6045e5d87e6616e7cbb1d&pid=1-s2.0-S1056872724000035-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433730","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}

{"title":"Diabetic ketosis vs ketoacidosis as initial presentation of pediatric type 1 diabetes mellitus. Associated features and rate of progression during the first two years after diagnosis","authors":"Aristeidis Giannakopoulos,&nbsp;Natasa Chrysanthakopoulou,&nbsp;Alexandra Efthymiadou,&nbsp;Dionisios Chrysis","doi":"10.1016/j.jdiacomp.2023.108667","DOIUrl":"10.1016/j.jdiacomp.2023.108667","url":null,"abstract":"<div><h3>Aims</h3><p><span>In this study we described the clinical and laboratory features of children presented with diabetic ketosis or diabetic ketoacidosis at diagnosis of </span>type 1 diabetes (T1DM) and evaluated its course up to 2 years after initial diagnosis to investigate the progression rate of T1DM in both groups.</p></div><div><h3>Methods</h3><p><span>This was a prospective longitudinal cohort study that included 59 children and adolescents presented with either diabetic ketosis (DK) (</span><em>n</em> = 27) or diabetic ketoacidosis (DKA) (<em>n</em> = 32) at their first diagnosis with T1DM.</p></div><div><h3>Results</h3><p><span>Apart from the metabolic state of presentation at diagnosis, differences in the other basic clinical and laboratory features of both DK and DKA were not statistically significant (age, BMI, pre- diagnosis symptomatic period, HbA1c, multiplicity of autoantibodies positivity, fasting insulin, and total IgG levels), except from the C-peptide and IgA levels which were lower in DKA (</span><em>p</em> &lt; 0.05). Regarding family history, only the DK group had individuals with a parent diagnosed with T1DM (<em>p</em> = 0.001). During follow-up there was no difference in the levels of HbA1c, basal insulin dose, and insulin/carbohydrate ratio between the DK and DKA group at 3,6,12 and 24 months' time points.</p></div><div><h3>Conclusions</h3><p>The severity of presentation of T1DM (DK or DKA) is not associated to the rate of progression of the disease course after diagnosis.</p></div>","PeriodicalId":15659,"journal":{"name":"Journal of diabetes and its complications","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139029039","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}