Dyslipidaemia as a target for atherosclerotic cardiovascular disease prevention in children with type 1 diabetes: lessons learned from familial hypercholesterolaemia

The Effects of Exercise Training on Body Composition and Cardiometabolic Risk Factors in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis

INTRODUCTION AND AIM

We performed a systematic review and meta-analysis to investigate the effects of exercise training on body composition and cardiometabolic health in patients with Type 1 diabetes (T1D).

METHOD

A search in three main databases including PubMed, Web of Science, and Scopus was conducted from the inception of this review until June 2024 to identify randomized control trials investigating the effects of exercise training compared to a control on body composition and cardiometabolic risk factors in patients with T1D. The data were pooled using random effects models to calculate weighted mean differences (WMDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs).

RESULTS

Overall, 25 studies involving 1120 patients with T1D were included in the meta-analysis. Exercise training decreased body mass index (BMI) [WMD: -0.18 kg.m2, p = 0.02], fasting glucose [WMD: -14.97 mg/dl, p = 0.01], and HbA1c [WMD: -0.49%, p = 0.003], and increased VO2max/peak [WMD: 2.76 mL/kg/min, p = 0.001] as compared with controls. Exercise training had no effect on body fat percentage or lean body mass, lipid profiles, or blood pressure. Subgroup analysis indicated that age, exercise mode, and intervention duration were the main moderators for the beneficial effects of exercise training.

CONCLUSIONS

In patients with T1D, exercise training is effective for decreasing body weight and cardiometabolic risk factors.

Relationship among nursing support for parents of adolescents diagnosed with Type 1 Diabetes, parental monitoring of adolescents and the self-efficacy of adolescents with Type 1 Diabetes

BACKGROUND

This study aims to explore the connection between parental monitoring in the treatment of adolescents with type 1 diabetes mellitus (T1DM), the self-efficacy of adolescents with diabetes, and nurse assistance provided to parents of adolescents with T1DM.

METHODS

This cross-sectional descriptive study consisted of 115 adolescents aged 10-18 with T1DM and their parents. Study data were collected through the "Diabetes Management Self-Efficacy Scale in Adolescents with T1DM", "Introductory Information Form", "Nurse-Parent Support Tool (NPST)" and "Parental Monitoring of Diabetes Care Questionnaire in Adolescents with T1DM".

RESULTS

Only 31.3 % of the study adolescent participants reported monitoring their blood sugar less than four times per day, and the frequency of blood sugar monitoring increased with increasing parental supervision (p = 0.021). When diabetes was managed only by parents, adolescents' perceptions of their self-management were statistically significant and high (p = 0.015). Neither the level of nurse-parent support nor the connection between parental monitoring and adolescents' self-efficacy was statistically significant.

CONCLUSIONS

Adolescents with T1DM should receive support from both parents and medical professionals. In particular, nurses should closely inquire about the adolescent's and family's disease management strategies during hospital visits and health monitoring.

Insights in Nutrition to Optimize Type 1 Diabetes Therapy

Nutrition is an essential part of therapy for type 1 diabetes and is constantly evolving, offering growing opportunities to prevent this disease, slow down its evolution, and mitigate it. An attempt was made to bring together the current state of knowledge. In the path from the preclinical phase of the disease to its clinical onset, there is a phase known as the "honeymoon period" or partial remission, where different possible dietary options for combatting this disease have been presented. The most commonly used dietary models were compared, and the most frequent co-existing pathologies, such as overweight, non-alcoholic fatty liver disease, dyslipidemia, celiac disease, and metabolic instability, were addressed from their nutritional and dietary perspectives to provide clinicians with an updated framework of knowledge and support researchers in further investigations into the topic. Finally, a glimpse into the possible interplay between nutrition and the gut microbiome, food security, and ultra-processed food is provided. It is hoped that clinicians treating people with type 1 diabetes will be provided with further opportunities for the daily management of their patients through personalized nutrition.