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Yilmaz YC, Hayat SC, Ipek SC. Analysis of Corneal and Lens Densitometry Changes in Patients With Type 1 Diabetes Mellitus. Am J Ophthalmol 2023; 254:23-30. [PMID: 37269970 DOI: 10.1016/j.ajo.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE By comparing the densitometry findings of patients with type 1 diabetes mellitus (T1DM) and the healthy group, we aimed to understand the possible changes that may occur in the cornea and lens in those with diabetes mellitus (DM). DESIGN Prospective, cross-sectional study. METHODS A total of 60 eyes of 60 patients with T1DM and 101 eyes of 101 healthy subjects were included in this study. A complete ophthalmologic evaluation was performed in all participants. Scheimpflug tomography was performed to record the corneal and lens densitometry and other tomographic data. Mean glycosylated hemoglobin (HbA1c) and mean DM duration were recorded. RESULTS The mean age of the patients with T1DM and patients in the control group was 29.93 ± 8.56 years and 27.27 ± 1 4.96 years, respectively. The mean HbA1c was 8.43 ± 1.92, and the mean DM duration was 14.10 ± 7.77 years. Corneal densitometry (CD) values were significantly higher in the 0- to 2-mm zone in all layers and in the anterior and central 6- to 10-mm zone in the diabetic group (P = .03, P = .018, P = .001, P = .000, P = .004). The mean crystalline lens densitometry was higher in the T1DM group (P = .129). There were positive correlations between DM duration and CD in the anterior 0- to 2-mm (P = .043), central 6- to 10-mm (P = .016), posterior 6- to 10-mm (P = .022), and posterior 10- to 12-mm zone (P = .043). CONCLUSIONS CD values were significantly higher in the diabetic group. Diabetes duration and HbA1c values showed correlations with densitometry especially in the 6- to 10-mm corneal zone. Evaluation of the cornea with optical densitometry will be useful in the early diagnosis and follow-up of clinical structural and functional changes in the cornea.
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Affiliation(s)
- Yusuf Cem Yilmaz
- From the The Agri İbrahim Cecen University Faculty of Medicine, Department of Ophthalmology, Agri, Turkey (Y.C.Y., S.C.I.).
| | - Serife Ciloglu Hayat
- Başakşehir Çam Sakura State Hospital, Department of Ophthalmology, Istanbul, Turkey (S.C.H.)
| | - Sefik Can Ipek
- From the The Agri İbrahim Cecen University Faculty of Medicine, Department of Ophthalmology, Agri, Turkey (Y.C.Y., S.C.I.)
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Ji B, Suresh S, Bally K, Naher K, Banerji MA. Ketosis-Prone Type 2 Diabetes (Flatbush Diabetes) in Remission: A Report of Two Cases. Cureus 2022; 14:e28514. [PMID: 36185931 PMCID: PMC9514152 DOI: 10.7759/cureus.28514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 11/21/2022] Open
Abstract
Diabetic ketoacidosis (DKA) is a triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration. It is a well-known manifestation of type 1 diabetes mellitus (T1DM). However, it can also be the first presentation of type 2 diabetes mellitus (T2DM). This subtype of diabetes shares the characteristics of both T1DM and T2DM and is called 'Flatbush diabetes,' also known as 'ketosis-prone T2DM.' This article highlights the importance of early identification of ketosis-prone T2DM (KPD). We describe two cases of African American men with no past medical histories who presented with unproved DKA as the first presentation of T2DM requiring initial intensive insulin therapy, which was gradually withdrawn with the addition of metformin. Both patients are currently insulin independent for more than 15 months. It is an essential clinical entity to recognize as insulin independence positively impacts the quality of life and decreases the economic burden on the health care system.
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The relationship between GAD65 autoantibody and the risk of T1DM onset. J Diabetes Metab Disord 2022. [PMID: 36404832 PMCID: PMC9672278 DOI: 10.1007/s40200-022-01098-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Type 1 diabetes mellitus (T1DM) is a well-known autoimmune disease, characterized by β-cell destruction in pancreas islet cells, which results insulin deficiency and subsequent hyperglycemic sequelae. While there is screening for type 2 DM that leads to better glycemic control and outcome, the majority of T1DM patients are diagnosed when much of the pancreatic cells and their function are disturbed. The aim of this article is to present an overview of the effective factors in the positivity of Glutamic acid decarboxylase antibody )GADA( and identifying the high-risk individuals for T1DM. Methods We searched English literature available at National Library of Medicine via PubMed, and Google Scholar through December 2020. Finally, 79 papers have been included in the study. Studies were summarized based on the number of positive autoantibodies and onset of T1DM over time and GADA correlation with different variables. Conclusions GADA is an easy marker to measure that can be detected many months prior to the clinical presentation and remains positive even after early childhood.
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Marrero YG, Kobayashi Y, Ihsan MS, Pilch LA, Chen L, Jiang S, Ye Y, Fine DH, Falcon CY, Falcon PA, Hirschberg CS, Shimizu E. Altered Prevalence of Pulp Diagnoses in Diabetes Mellitus Patients: A Retrospective Study. J Endod 2022; 48:208-212.e3. [PMID: 34780805 PMCID: PMC8810723 DOI: 10.1016/j.joen.2021.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/08/2021] [Accepted: 11/02/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) is a complex multisystemic disorder that affects an estimated 21 million Americans. No studies have evaluated the association of DM with the prevalence of each pulpal diagnosis. The objective of this study was to compare the prevalence of each pulp diagnosis including symptomatic irreversible pulpitis (SIP), asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and pulp necrosis (PN) in DM patients against a nondiabetic control group. METHODS A retrospective chart review was approved by Rutgers University Institutional Review Board. The prevalence of the diagnoses SIP, asymptomatic irreversible pulpitis, reversible pulpitis, normal pulp, and PN was calculated from AxiUm (Exan software, Las Vegas, NV) electronic health records at Rutgers School of Dental Medicine. The chi-square test was used to see the relationship between the 2 categoric variables. Second, binary logistic regression analyses were performed for each group. RESULTS A total of 2979 teeth were diagnosed with a pulp condition between April 2013 and November 2018. The total tooth number of DM patients was 682, whereas the tooth number of nondiabetic patients was 2297. In the subgroup of patients younger than 40 years old, SIP was notably more prevalent in DM patients. In addition, the prevalence of PN in elderly DM patients (60-69 years old) was significantly higher than in the control group. CONCLUSIONS The prevalence of SIP in DM patients was significantly higher compared with the control group (<40 years old), suggesting the possibility that DM could hypersensitize the subgroup of patients younger than 40 years old to pulpitis pain.
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Affiliation(s)
| | | | | | - Lisa A. Pilch
- Office of Information Technology, Rutgers University
| | - Liyaa Chen
- Office of Information Technology, Rutgers University
| | | | - Yi Ye
- Bluestone Center for Clinical Research, New York University College of Dentistry, Department of Oral & Maxillofacial Surgery, New York University College of Dentistry, Department of Molecular Pathobiology, New York University College of Dentistry
| | - Daniel H. Fine
- Department of Oral Biology, Rutgers School of Dental Medicine
| | - Carla Y. Falcon
- Department of Endodontics, Rutgers School of Dental Medicine
| | - Paul A. Falcon
- Department of Endodontics, Rutgers School of Dental Medicine
| | | | - Emi Shimizu
- Department of Endodontics, Rutgers School of Dental Medicine, Department of Oral Biology, Rutgers School of Dental Medicine,Corresponding author Emi Shimizu, Department of Oral Biology, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, , 973-972-8892
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Lin J, Lu Y, Wang B, Jiao P, Ma J. Analysis of immune cell components and immune-related gene expression profiles in peripheral blood of patients with type 1 diabetes mellitus. J Transl Med 2021; 19:319. [PMID: 34311758 PMCID: PMC8314644 DOI: 10.1186/s12967-021-02991-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/14/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease caused by severe loss of pancreatic β cells. Immune cells are key mediators of β cell destruction. This study attempted to investigate the role of immune cells and immune-related genes in the occurrence and development of T1DM. METHODS The raw gene expression profile of the samples from 12 T1DM patients and 10 normal controls was obtained from Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified by Limma package in R. The least absolute shrinkage and selection operator (LASSO)-support vector machines (SVM) were used to screen the hub genes. CIBERSORT algorithm was used to identify the different immune cells in distribution between T1DM and normal samples. Correlation of the hub genes and immune cells was analyzed by Spearman, and gene-GO-BP and gene-pathway interaction networks were constructed by Cytoscape plug-in ClueGO. Receiver operating characteristic (ROC) curves were used to assess diagnostic value of genes in T1DM. RESULTS The 50 immune-related DEGs were obtained between the T1DM and normal samples. Then, the 50 immune-related DEGs were further screened to obtain the 5 hub genes. CIBERSORT analysis revealed that the distribution of plasma cells, resting mast cells, resting NK cells and neutrophils had significant difference between T1DM and normal samples. Natural cytotoxicity triggering receptor 3 (NCR3) was significantly related to the activated NK cells, M0 macrophages, monocytes, resting NK cells, and resting memory CD4+ T cells. Moreover, tumor necrosis factor (TNF) was significantly associated with naive B cell and naive CD4+ T cell. NCR3 [Area under curve (AUC) = 0.918] possessed a higher accuracy than TNF (AUC = 0.763) in diagnosis of T1DM. CONCLUSIONS The immune-related genes (NCR3 and TNF) and immune cells (NK cells) may play a vital regulatory role in the occurrence and development of T1DM, which possibly provide new ideas and potential targets for the immunotherapy of diabetes mellitus (DM).
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Affiliation(s)
- Jian Lin
- Department of Regenerative Medicine, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun, Jilin, 130021, P.R. China
| | - Yuanhua Lu
- Department of Regenerative Medicine, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun, Jilin, 130021, P.R. China
| | - Bizhou Wang
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Ping Jiao
- Department of Regenerative Medicine, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun, Jilin, 130021, P.R. China.
| | - Jie Ma
- Department of Regenerative Medicine, School of Pharmaceutical Sciences, Jilin University, 1266 Fujin Road, Changchun, Jilin, 130021, P.R. China.
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Padoa CJ, Rheeder P, Pirie FJ, Motala AA, van Dyk JC, Crowther NJ. Identification of a subgroup of black South Africans with type 1 diabetes who are older at diagnosis but have lower levels of glutamic acid decarboxylase and islet antigen 2 autoantibodies. Diabet Med 2020; 37:2067-2074. [PMID: 31811665 DOI: 10.1111/dme.14204] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 12/21/2022]
Abstract
AIMS To compare the age at diagnosis and prevalence of islet autoantibody [glutamic acid decarboxylase (65 kDa) 65 and islet antigen 2] positivity in black and white participants with type 1 diabetes in South Africa, and to analyse the relationship between age at diagnosis and the presence of autoantibodies. METHODS Participants were recruited from diabetes outpatient departments and autoantibodies to glutamic acid decarboxylase (65 kDa) and islet antigen 2 were measured by enzyme-linked immunosorbent assay. RESULTS We recruited 472 (353 black and 119 white) participants with type 1 diabetes. Age at diagnosis of diabetes was later in black (19.7 ± 10.5) than in white participants (12.7 ± 10.8 years; P < 0.001) with a median (interquartile range) disease duration of 5.0 (2.0-10.0) and 8.5 (4.0-20.0) years (P < 0.001), respectively. An older age at diagnosis (≥ 21 years) was more frequent in black (152 of 340, 45%) than in white participants (24 of 116, 21%; P < 0.001). The prevalence of islet antigen 2 autoantibodies was 19% (66/352) in black and 41% in white participants (48/118; P < 0.001). There was no significant difference in glutamic acid decarboxylase (65 kDa) autoantibody positivity between black (212/353, 60%) and white participants (77/117, 66%; P = 0.269). In black, but not white, participants the prevalence of both glutamic acid decarboxylase (65 kDa) and islet antigen 2 autoantibody positivity was significantly lower in participants diagnosed at age ≥ 21 years (P < 0.001 for both comparisons). CONCLUSIONS The older age at diagnosis, lower prevalence of islet antigen 2 autoantibodies and a distinct subgroup of participants with type 1 diabetes with age at diagnosis of > 20 years in the black compared to white population suggest a difference in the immunological aetiology of type 1 diabetes in these two population groups.
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Affiliation(s)
- C J Padoa
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - P Rheeder
- Department of Internal Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - F J Pirie
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - A A Motala
- Department of Diabetes and Endocrinology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - J C van Dyk
- Private Practice, Life Hospital, Groenkloof, Pretoria, South Africa
| | - N J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
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Demir ST, Ucar A, Elitok GK, Karatas ME, Karapapak M, Kutucu OK, Uzun SU, Guven D. Evaluation of retinal neurovascular structures by optical coherence tomography and optical coherence tomography angiography in children and adolescents with type 1 diabetes mellitus without clinical sign of diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2020; 258:2363-2372. [PMID: 32700056 DOI: 10.1007/s00417-020-04842-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/05/2020] [Accepted: 07/10/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The aim of the study was to investigate whether retinal neurovascular structural impairment in children and adolescents with type 1 diabetes mellitus (T1D) without clinical signs of diabetic retinopathy (DR) could be detected early via optical coherence tomography (OCT) and OCT angiography (OCTA). METHODS In the current prospective, cross-sectional, observational clinical study children and adolescents with T1D without DR were evaluated between December 2018 and May 2019. Retinal neurovascular structures in the macular and optic disc regions were examined in detail and quantitatively assessed using OCT and OCTA. Data from subjects with T1D were compared with data from healthy controls. Whether retinal neurovascular structural changes were significantly associated with puberty stage, diabetes duration, and HbA1c level was also investigated. RESULTS The T1D group included 110 eyes and the control group included 84 eyes. In the T1D group the mean inside disc vessel density (VD) was significantly lower than that of the control group (p < 0.001), as was the mean superior temporal disc VD (p < 0.043). Puberty stage was significantly associated with retinal thickness, parafoveal superficial capillary plexus VD, and peripapillary retinal nerve fiber layer thickness (p < 0.05). Diabetes duration and HbA1c level was significantly correlated with retinal layer thickness, foveal avascular zone diameter, and superficial and deep capillary plexus VDs. CONCLUSION In children and adolescents with T1D without clinical signs of DR, the VD of the disc region is affected earlier than the macular region. In these patients, early neurovascular impairment can be detected non-invasively via OCT and OCTA.
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Affiliation(s)
- Semra Tiryaki Demir
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey.
| | - Ahmet Ucar
- Department of Pediatric Endocrinology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gizem Kara Elitok
- Department of Pediatric, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Egemen Karatas
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey
| | - Murat Karapapak
- Department of Ophthalmology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Oguz Kaan Kutucu
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey
| | - Saniye Uke Uzun
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey
| | - Dilek Guven
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Cad. Etfal St., 34371, Sisli/Istanbul, Turkey
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Liu Y, Du X, Cui J, Li C, Guo M, Lv J, Liu X, Dou J, Du X, Fang H, Chen Z. A Genome-Wide Analysis of Long Noncoding RNAs in Circulating Leukocytes and Their Differential Expression in Type 1 Diabetes Patients. J Diabetes Res 2020; 2020:9010314. [PMID: 33299893 PMCID: PMC7710437 DOI: 10.1155/2020/9010314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/27/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022] Open
Abstract
Long noncoding RNAs (lncRNAs) regulate gene expression at different levels in various diseases, including type 1 diabetes (T1D). However, the expression of circulating lncRNAs in leukocytes in T1D has not been well documented. To identify differentially expressed lncRNAs between T1D patients and healthy controls, RNA sequencing was performed on samples of leukocytes collected from both healthy persons and T1D patients. The categories, enriched pathways, coexpression networks, and the characteristics of novel lncRNAs were analyzed to provide an extensive profile. qPCR was adopted to validate the differential expression of lncRNAs in the validation cohort. A total of 14,930 lncRNAs and 16,063 mRNAs were identified in the peripheral blood leukocyte of T1D patients. After optimization using an adjusted p value (threshold of <0.05), 393 circulating lncRNAs were identified, of which 69 were downregulated and 324 were upregulated in T1D patients. Gene Ontology analysis indicated that these lncRNAs and mRNAs were enriched in the immune system category. Further analysis showed that 61.28% of the novel lncRNAs were conserved in humans. A set of 12 lncRNAs were selected for qPCR validation, and 9 of 12 lncRNAs were confirmed to show significant differential expression between the T1D and control validation cohorts. Among the 9 confirmed lncRNAs, lncRNA MSTRG.128697 and lncRNA MSTRG.128958 were novel and human-specific; however, further validation is required. lncRNA MSTRG.63013 has orthologous sequences in the mouse genome and was identified as a key node for etiology and pathophysiology in animal studies, which will help understand the epigenetic mechanisms of T1D complications.
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Affiliation(s)
- Yihan Liu
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiaoming Du
- Tianjin Stomatological Hospital, Tianjin Key Laboratory of Oral Function Reconstruction, Hospital of Stomatology, Nankai University, Tianjin 300041, China
| | - Jia Cui
- Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
| | - Changlong Li
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Meng Guo
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Jianyi Lv
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Xin Liu
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Jingtao Dou
- Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaoyan Du
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Hongjuan Fang
- Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Zhenwen Chen
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
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Shidler KL, Letourneau LR, Novak LM. Uncommon Presentations of Diabetes: Zebras in the Herd. Clin Diabetes 2020; 38:78-92. [PMID: 31975755 PMCID: PMC6969666 DOI: 10.2337/cd19-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The majority of patients with diabetes are diagnosed as having either type 1 or type 2 diabetes. However, when encountered in clinical practice, some patients may not match the classic diagnostic criteria or expected clinical presentation for either type of the disease. Latent autoimmune, ketosis-prone, and monogenic diabetes are nonclassical forms of diabetes that are often misdiagnosed as either type 1 or type 2 diabetes. Recognizing the distinguishing clinical characteristics and understanding the diagnostic criteria for each will lead to appropriate treatment, facilitate personalized medicine, and improve patient outcomes.
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Affiliation(s)
- Karen L. Shidler
- North Central Indiana Area Health Education Center, Rochester, IN
| | | | - Lucia M. Novak
- Riverside Diabetes Center, Riverside Medical Associates, Riverdale, MD
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Human Leukocyte Antigen (HLA) and Islet Autoantibodies Are Tools to Characterize Type 1 Diabetes in Arab Countries: Emphasis on Kuwait. DISEASE MARKERS 2019; 2019:9786078. [PMID: 31827651 PMCID: PMC6886320 DOI: 10.1155/2019/9786078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/15/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022]
Abstract
The incidence rate of type 1 diabetes in Kuwait had been increasing exponentially and has doubled in children ≤ 14 years old within almost two decades. Therefore, there is a dire need for a careful systematic familial cohort study. Several immunogenetic factors affect the pathogenesis of the disease. The human leukocyte antigen (HLA) accounts for the major genetic susceptibility to the disease. The triggering agents initiate disease onset by type 1 destruction of pancreatic β-cells. Both HLA and anti-islet antibodies can be used to characterize, predict susceptibility to the disease, innovate, or delay the β-cell destruction. Evidence from prospective longitudinal studies suggested that the underlying disease process represents a continuum that begins before the symptoms are clinically evident. Autoimmunity of the functional pancreatic β-cells results in symptomatic type 1 diabetes and lifelong insulin dependence. The autoantibodies against glutamic acid decarboxylase (GADA), insulinoma antigen-2 (IA-2A), insulin (IAA), and zinc transporter-8 (ZnT-8A) comprise the most reliable biomarkers for type 1 diabetes in both children and adults. Although Kuwait is the second among the top 10 countries with a high incidence rate of type 1 diabetes, there have been no proper diagnostic and prediction tools as per the World Health Organization. The Kuwaiti Type 1 Diabetes Study (KADS) was initiated to understand the disease pathogenesis as well as the HLA and anti-islet autoantibody profile of type 1 diabetes in Kuwait. Understanding the disease sequela in a homogenous gene pool and highly consanguineous population of Kuwaitis could help solve the challenges and pathogenesis, as well as hasten the prevention, of type 1 diabetes.
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Inanc M, Tekin K, Kiziltoprak H, Ozalkak S, Doguizi S, Aycan Z. Changes in Retinal Microcirculation Precede the Clinical Onset of Diabetic Retinopathy in Children With Type 1 Diabetes Mellitus. Am J Ophthalmol 2019; 207:37-44. [PMID: 31009594 DOI: 10.1016/j.ajo.2019.04.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/30/2019] [Accepted: 04/13/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate whether abnormal glucose metabolism in diabetes mellitus (DM) affects the retinal microcirculation of children with well-controlled type 1 DM and to compare these results with those obtained from healthy children. DESIGN Cross-sectional prospective study. METHODS This study enrolled 60 patients with DM without clinically detectable diabetic retinopathy (DR) and 57 age-matched control subjects. Optical coherence tomography angiography (OCT-A) was performed using AngioVue (Avanti, Optivue). Foveal avascular zone (FAZ) area, nonflow area, superficial and deep vessel densities, FAZ perimeter, acircularity index of FAZ (AI; the ratio of the perimeter of FAZ and the perimeter of a circle with equal area), and foveal density (FD-300; vessel density in 300 μm around FAZ) were analyzed. Correlations between the investigated OCT-A parameters with DM duration and glycated hemoglobin (HbA1c) levels were evaluated among patients with type 1 DM. RESULTS Differences in the mean values for FAZ perimeter, AI, and FD-300 were statistically significant between DM group and control group (P < .001, P = .001, and P = .009, respectively). There were also statistically significant differences between the groups for vessel densities of deep superior hemi-parafovea, deep temporal parafovea, and deep superior parafoveal zones (P = .008, P = .015, and P = .005, respectively). There were no significant correlations between DM duration and HbA1c levels with the investigated OCT-A parameters. CONCLUSION Diabetic eyes without clinically detectable DR exhibited alterations in FD-300, AI, perimeter, and vessel density of parafoveal capillaries in deep capillary plexus preceding the enlargement of FAZ; therefore, these new parameters might be sensitive imaging biomarkers to define early DR.
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Jahromi M, Al-Mulla F, Al-Ozairi E. Autoimmune signatures for prediction and diagnosis of autoimmune diabetes in Kuwait. Autoimmun Rev 2019; 18:642-644. [PMID: 30959212 DOI: 10.1016/j.autrev.2019.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Mohamed Jahromi
- Clinical Care Research, Medical Division, Dasman Diabetes Institute, Kuwait.
| | - Fahd Al-Mulla
- Research Division, Dasman Diabetes Institute, Kuwait
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Uno S, Imagawa A, Kozawa J, Fukui K, Iwahashi H, Shimomura I. Complete loss of insulin secretion capacity in type 1A diabetes patients during long-term follow up. J Diabetes Investig 2018; 9:806-812. [PMID: 29034607 PMCID: PMC6031490 DOI: 10.1111/jdi.12763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 10/04/2017] [Accepted: 10/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM/INTRODUCTION Patients with type 1 diabetes are classified into three subtypes in Japan: acute onset, fulminant and slowly progressive. Acute-onset type 1 diabetes would be equivalent to type 1A diabetes, the typical type 1 diabetes in Western countries. The insulin secretion capacity in Japanese patients with long-standing type 1A diabetes is unclear. The aim of the present study was to clarify the course of endogenous insulin secretion during long-term follow up and the factors associated with residual insulin secretion in patients with acute-onset type 1 diabetes (autoimmune). MATERIALS AND METHODS We retrospectively investigated endogenous insulin secretion capacity in 71 patients who fulfilled the diagnostic criteria for acute-onset type 1 diabetes (autoimmune) in Japan. To assess the residual insulin secretion capacity, we evaluated randomly measured C-peptide levels and the results of glucagon stimulation test in 71 patients. RESULTS In the first year of disease, the child- and adolescent-onset patients had significantly more in residual insulin secretion than the adult-onset patients (34 patients in total). C-peptide levels declined more rapidly in patients whose age of onset was ≤18 years than in patients whose age of onset was ≥19 years. Endogenous insulin secretion capacity stimulated by glucagon was completely lost in almost all patients at >15 years after onset (61 patients in total). CONCLUSIONS Most patients with acute-onset type 1 diabetes (autoimmune) completely lose their endogenous insulin secretion capacity during the disease duration in Japan. Age of onset might affect the course of insulin secretion.
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Affiliation(s)
- Sae Uno
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Akihisa Imagawa
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
- Present address:
Department of Internal Medicine (I)Osaka Medical CollegeTakatsukiOsakaJapan
| | - Junji Kozawa
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Kenji Fukui
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Hiromi Iwahashi
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
| | - Iichiro Shimomura
- The Department of Metabolic MedicineGraduate School of MedicineOsaka UniversitySuitaJapan
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Shaltout AA, Wake D, Thanaraj TA, Omar DM, Al-AbdulRazzaq D, Channanath A, AlKandari H, Abdulrasoul M, Miller S, Conway N, Tuomilehto J, Davidsson L. Incidence of type 1 diabetes has doubled in Kuwaiti children 0-14 years over the last 20 years. Pediatr Diabetes 2017; 18:761-766. [PMID: 27981709 DOI: 10.1111/pedi.12480] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/24/2016] [Accepted: 11/03/2016] [Indexed: 12/22/2022] Open
Abstract
AIMS This study had 2 aims: to report data on the incidence of childhood-onset type 1 diabetes in Kuwaiti children aged 0-14 years during 2011 to 2013 and to compare the recent data with those collected during 1992 to 1997. METHODS All newly diagnosed patients were registered through the Childhood-Onset Diabetes eRegistry (CODeR) in 2011-2013, based on the DiaMond protocol used in 1992-1997. RESULTS A total of 515 Kuwaiti children (247 boys and 268 girls) aged 0-14 years newly diagnosed with type 1 diabetes were registered from 1 January 2011 to 31 December 2013. Data ascertainment were 96.7%. The mean age ± SD at diagnosis was 8.7 ± 3.4 years in boys and 7.9 ± 3.1 years in girls. The crude incidence rate (95% CI) was 40.9 (37.4-44.6) and the age standardized rate 41.7 (95% 38.1-45.4) per 100,000 per year, 39.3 (34.6-44.4) among boys and 44.1 (39.0-49.7) among girls. A statistically significant increasing trend in incidence was observed as the overall crude incidence rose from 17.7 in 1992-1994 to 40.9 per 100,000 per year in 2011-2013. The Poisson regression model depicting the trend in incidence revealed that, the incidence rates adjusted for age and sex in 2011 to 2013 was 2.3 (95% CI 1.9-2.7) times higher than 1992-1997. CONCLUSIONS The incidence of type 1 diabetes in Kuwaiti children 0-14 years has doubled in the last 2 decades. The reasons for this increase requires further investigation.
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Affiliation(s)
- Azza A Shaltout
- Research Division, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Deborah Wake
- Medical Research Unit, University of Dundee, Ninewells Hospital, Dundee, United Kingdom of Great Britain and Northern Ireland
| | | | - Dina M Omar
- Research Division, Dasman Diabetes Institute, Kuwait, Kuwait
| | | | | | | | - Majedah Abdulrasoul
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | | | - Nicholas Conway
- Medical Research Unit, University of Dundee, Ninewells Hospital, Dundee, United Kingdom of Great Britain and Northern Ireland
| | | | - Lena Davidsson
- Research Division, Dasman Diabetes Institute, Kuwait, Kuwait
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Tekin K, Inanc M, Kurnaz E, Bayramoglu E, Aydemir E, Koc M, Aycan Z. Objective Evaluation of Corneal and Lens Clarity in Children With Type 1 Diabetes Mellitus. Am J Ophthalmol 2017; 179:190-197. [PMID: 28528120 DOI: 10.1016/j.ajo.2017.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 05/07/2017] [Accepted: 05/10/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate whether abnormal glucose metabolism and duration of diabetes mellitus (DM) affected the corneal and lens clarity in children with well-controlled type 1 DM and to compare the results obtained with those in healthy children. DESIGN Cross-sectional prospective study. METHODS This multicenter study enrolled 56 patients with DM and 51 control subjects. The duration of DM and the glycosylated hemoglobin (HbA1c) levels of the patients in the DM group were recorded. The Pentacam HR imaging system was used for corneal densitometry (12-mm corneal diameter) measurements. Furthermore, the lens densitometry and lens thickness (LT) measurements were performed after dilation of the pupils, using the same Pentacam HR device. RESULTS The corneal densitometry values were similar in all concentric zones and layers in both groups (P > .05, for all). The mean values of the average and maximum lens densitometry measurements of the 2 groups, as well as the mean LT values, were statistically significantly different (P = .021, P = .011, and P < .001, respectively). There were statistically significant correlations between the lens densitometry values and the duration of DM (P < .05, for all). Conversely, no statistically significant relationship was found between the lens densitometry values and HbA1c levels (r = 0.743; P = .084). CONCLUSIONS The children with type 1 DM had decreased lens clarity and increased LT, even in cases of well-controlled DM, without DR. It is reasonable to think that these changes might have been caused by the type 1 DM.
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Affiliation(s)
- Kemal Tekin
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
| | - Merve Inanc
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Erdal Kurnaz
- Department of Pediatric Endocrinology and Metabolism, Dr Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Elvan Bayramoglu
- Department of Pediatric Endocrinology and Metabolism, Dr Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Emre Aydemir
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Koc
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology and Metabolism, Dr Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey
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Lee EY, Lee YH, Jin SM, Yang HK, Jung CH, Park CY, Cho JH, Lee WJ, Lee BW, Kim JH. Differential association of body mass index on glycemic control in type 1 diabetes. Diabetes Metab Res Rev 2017; 33. [PMID: 27155402 DOI: 10.1002/dmrr.2815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 03/07/2016] [Accepted: 04/22/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND In contrast to type 2 diabetes, the association of body mass index (BMI) with glycemic control in type 1 diabetes (T1D) remains unclear. We investigated the relationship between BMI and average HbA1c levels in subjects with T1D. METHOD In this multi-centre observational study, we analysed 719 subjects with T1D aged ≥18 years. Average HbA1c levels over 18 months and other clinical and laboratory parameters were evaluated. RESULTS The mean age and duration of diabetes at baseline were 41.5 ± 13.9 and 11.3 ± 8.7 years, respectively. A U-shaped correlation between BMI and 18-month average HbA1c levels was documented by a spline curve. Based on this finding, subjects were divided into three groups according to BMI (group I, <21; group II, 21-23; and group III, ≥23 kg/m2 ). In group I, the BMI negatively correlated with average HbA1c (r = -0.172, p = 0.011), while a positive relationship was observed (r = 0.162, p = 0.012) in group III. Average HbA1c levels were lower and the proportion of individuals with well-controlled glycemia (HbA1c <7%) were increased in the higher BMI tertile group among subjects with group I as well as in the lower BMI tertile group among subjects with group III BMI. After adjustment with additional covariates in the multiple regression model, these associations between BMI and HbA1c levels according to the different BMI ranges remained significant. CONCLUSIONS In Korean subjects with T1D, an inverse relationship of BMI with HbA1c levels was observed in the low BMI group, while a positive correlation was shown in the high BMI group. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital,College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hae Kyung Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital,College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheol-Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital,College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Woo Je Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Seoul, Korea
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Song S, Roy S. Progress and challenges in macroencapsulation approaches for type 1 diabetes (T1D) treatment: Cells, biomaterials, and devices. Biotechnol Bioeng 2016; 113:1381-402. [PMID: 26615050 DOI: 10.1002/bit.25895] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/30/2015] [Accepted: 11/24/2015] [Indexed: 12/15/2022]
Abstract
Macroencapsulation technology has been an attractive topic in the field of treatment for Type 1 diabetes due to mechanical stability, versatility, and retrievability of the macro-capsule design. Macro-capsules can be categorized into extravascular and intravascular devices, in which solute transport relies either on diffusion or convection, respectively. Failure of macroencapsulation strategies can be due to limited regenerative capacity of the encased insulin-producing cells, sub-optimal performance of encapsulation biomaterials, insufficient immunoisolation, excessive blood thrombosis for vascular perfusion devices, and inadequate modes of mass transfer to support cell viability and function. However, significant technical advancements have been achieved in macroencapsulation technology, namely reducing diffusion distance for oxygen and nutrients, using pro-angiogenic factors to increase vascularization for islet engraftment, and optimizing membrane permeability and selectivity to prevent immune attacks from host's body. This review presents an overview of existing macroencapsulation devices and discusses the advances based on tissue-engineering approaches that will stimulate future research and development of macroencapsulation technology. Biotechnol. Bioeng. 2016;113: 1381-1402. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Shang Song
- Department of Bioengineering and Therapeutic Sciences, University of California-San Francisco, San Francisco, California 94158
| | - Shuvo Roy
- Department of Bioengineering and Therapeutic Sciences, University of California-San Francisco, San Francisco, California 94158.
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Yoon HJ, Lee YH, Kim SR, Rim TH, Lee EY, Kang ES, Cha BS, Lee HC, Lee BW. Glycated albumin and the risk of micro- and macrovascular complications in subjects with type 1 diabetes. Cardiovasc Diabetol 2015; 14:53. [PMID: 25975731 PMCID: PMC4438622 DOI: 10.1186/s12933-015-0219-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/22/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND We investigated the relationship between the glycemic indices glycated albumin (GA) and glycated hemoglobin (HbA1c) and the progression of diabetic vascular complications [diabetic nephropathy (DN) and carotid artery atherosclerosis (CAA)] in subjects with type 1 diabetes (T1D). METHODS A total of 154 participants with a median follow-up of 2.8 years were enrolled in this retrospective longitudinal study. We recruited T1D subjects who had regularly measured urine albumin-creatinine ratios and estimated glomerular filtration rates, as well as tested HbA1c and GA levels consecutively every 3 or 6 months. A subgroup of 54 subjects was measured repeated carotid intima-media thickness (IMT). RESULTS We classified subjects into the DN progression (Group I; n = 30) with either deteriorated stages of chronic kidney disease (n = 18) or albuminuria progression (n = 17), and the non-progression (Group II; n = 124). In multiple logistic regression analyses, baseline albuminuria (odds ratio [OR] = 2.64, 95 % confidence interval [CI] = 1.03-6.74), mean GA levels (OR = 2.03, 95 % CI = 1.27-3.26) were significantly associated with progression of DN. However, there was no association with mean HbA1c (OR = 0.98, 95 % CI = 0.62-1.54). In a subgroup analysis for follow-up measurements of carotid IMT, age was independently associated with the presence of plaque and the mean IMT. However glycemic indices were not significantly associated with CAA. CONCLUSIONS Mean GA levels were more closely associated with DN progression than mean HbA1c in subjects with T1D. However, they were not associated with the CAA.
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Affiliation(s)
- Hye-jin Yoon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Yong-ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - So Ra Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Tyler Hyungtaek Rim
- Severance Hospital, Seoul, Korea, , 120-752. .,Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea, , 120-752.
| | - Eun Young Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Bong-soo Cha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Hyun Chul Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
| | - Byung-wan Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. .,Severance Hospital, Seoul, Korea, , 120-752.
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Kolesnikova LI, Darenskaya MA, Semenova NV, Grebenkina LA, Suturina LV, Dolgikh MI, Gnusina SV. Lipid peroxidation and antioxidant protection in girls with type 1 diabetes mellitus during reproductive system development. MEDICINA-LITHUANIA 2015; 51:107-11. [PMID: 25975879 DOI: 10.1016/j.medici.2015.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 01/16/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Type 1 diabetes mellitus (T1D) is found worldwide and is regarded as one of the main risks to human health. The objective of this study was to determine the state of lipid peroxidation (LPO) and antioxidant protection in girls with T1D type considering the stages of reproductive system development. MATERIALS AND METHODS This study enrolled 56 young girls with T1D and 60 healthy girls (control) matched by age. The study population was divided into 3 age groups: prepubertal, adolescent, and juvenile. The state of LPO and antioxidant system was assessed using the coefficient of oxidative stress that represented the ratio of LPO products to general antioxidative blood activity. Spectrophotometric and fluorometric methods were applied. RESULTS The results of our study showed increased conjugated diene (CD) and thiobarbituric acid reactant (TBAR) concentrations as well as a decreased reduced glutathione level in prepubertal girls with T1D. Adolescent girls with T1D had a significantly greater CD level and juvenile girls with T1D had a significantly greater TBAR level and lower α-tocopherol concentration than girls in the control group. The greatest coefficient of oxidative stress (1.16) was observed in the prepubertal period. CONCLUSIONS The prepubertal period is characterized by the most severe state of lipid peroxidation process-antioxidant protection.
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Affiliation(s)
- Lubov I Kolesnikova
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
| | - Marina A Darenskaya
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
| | - Natalia V Semenova
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation.
| | - Lyudmila A Grebenkina
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
| | - Larisa V Suturina
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
| | - Marya I Dolgikh
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
| | - Svetlana V Gnusina
- Department of Reproductive Pathophysiology, Scientific Centre of Family Health and Human Reproduction Problems, Siberian Branch, Russian Academy of Medical Sciences, Irkutsk, Russian Federation
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Diaz-Valencia PA, Bougnères P, Valleron AJ. Covariation of the incidence of type 1 diabetes with country characteristics available in public databases. PLoS One 2015; 10:e0118298. [PMID: 25706995 PMCID: PMC4338253 DOI: 10.1371/journal.pone.0118298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/24/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The incidence of Type 1 Diabetes (T1D) in children varies dramatically between countries. Part of the explanation must be sought in environmental factors. Increasingly, public databases provide information on country-to-country environmental differences. METHODS Information on the incidence of T1D and country characteristics were searched for in the 194 World Health Organization (WHO) member countries. T1D incidence was extracted from a systematic literature review of all papers published between 1975 and 2014, including the 2013 update from the International Diabetes Federation. The information on country characteristics was searched in public databases. We considered all indicators with a plausible relation with T1D and those previously reported as correlated with T1D, and for which there was less than 5% missing values. This yielded 77 indicators. Four domains were explored: Climate and environment, Demography, Economy, and Health Conditions. Bonferroni correction to correct false discovery rate (FDR) was used in bivariate analyses. Stepwise multiple regressions, served to identify independent predictors of the geographical variation of T1D. FINDINGS T1D incidence was estimated for 80 WHO countries. Forty-one significant correlations between T1D and the selected indicators were found. Stepwise Multiple Linear Regressions performed in the four explored domains indicated that the percentages of variance explained by the indicators were respectively 35% for Climate and environment, 33% for Demography, 45% for Economy, and 46% for Health conditions, and 51% in the Final model, where all variables selected by domain were considered. Significant environmental predictors of the country-to-country variation of T1D incidence included UV radiation, number of mobile cellular subscriptions in the country, health expenditure per capita, hepatitis B immunization and mean body mass index (BMI). CONCLUSIONS The increasing availability of public databases providing information in all global environmental domains should allow new analyses to identify further geographical, behavioral, social and economic factors, or indicators that point to latent causal factors of T1D.
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Affiliation(s)
- Paula Andrea Diaz-Valencia
- Institut National de la Santé et de la Recherche Médicale, Inserm Unité-1169, F-94276, Le Kremlin Bicêtre, France
- Université Pierre et Marie Curie-Paris 6, Ecole Doctorale 393, F-75012, Paris, France
| | - Pierre Bougnères
- Institut National de la Santé et de la Recherche Médicale, Inserm Unité-1169, F-94276, Le Kremlin Bicêtre, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Kremlin Bicêtre, Service Endocrinologie, F-94276, Le Kremlin Bicêtre, France
| | - Alain-Jacques Valleron
- Institut National de la Santé et de la Recherche Médicale, Inserm Unité-1169, F-94276, Le Kremlin Bicêtre, France
- Université Pierre et Marie Curie-Paris 6, Ecole Doctorale 393, F-75012, Paris, France
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Kim W, Kim KJ, Lee BW, Kang ES, Cha BS, Lee HC. The glycated albumin to glycated hemoglobin ratio might not be associated with carotid atherosclerosis in patients with type 1 diabetes. Diabetes Metab J 2014; 38:456-63. [PMID: 25541609 PMCID: PMC4273032 DOI: 10.4093/dmj.2014.38.6.456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/31/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The ratio of glycated albumin to glycated hemoglobin (GA/A1c) is known to be elevated in subjects with type 2 diabetes mellitus (T2DM) who had decreased insulin secretion. Additionally, the carotid intima media thickness (IMT) is greater in T2DM patients with higher GA/A1c ratios. We investigated whether increased GA/A1c ratio and IMT are also associated in type 1 diabetes mellitus (T1DM), which is characterized by lack of insulin secretory capacity. METHODS In this cross-sectional study, we recruited 81 T1DM patients (33 men, 48 women; mean age 44.1±13.0 years) who underwent carotid IMT, GA, and HbA1c measurements. RESULTS The mean GA/A1c ratio was 2.90. Based on these results, we classified the subjects into two groups: group I (GA/A1c ratio <2.90, n=36) and group II (GA/A1c ratio ≥2.90, n=45). Compared with group I, the body mass indexes (BMIs), waist circumferences, and IMTs were lower in group II. GA/A1c ratio was negatively correlated with BMI, urine albumin to creatinine ratio (P<0.001 for both), and both the mean and maximal IMT (P=0.001, both). However, after adjusting the confounding factors, we observed that IMT was no longer associated with GA/A1c ratio. CONCLUSION In contrast to T2DM, IMT was not significantly related to GA/A1c ratio in the subjects with T1DM. This suggests that the correlations between GA/A1c ratio and the parameters known to be associated with atherosclerosis in T2DM could be manifested differently in T1DM. Further studies are needed to investigate these relationships in T1DM.
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Affiliation(s)
- Wonjin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Joon Kim
- Severance Executive Healthcare Clinic, Yonsei University Health System, Seoul, Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bong Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Chul Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Abstract
Type 1 diabetes mellitus (T1D) can occur at any age, with a peak in incidence around puberty. Classification between T1D and type 2 diabetes becomes more challenging with increasing age of onset of T1D over time develops in genetically predisposed individuals. The main susceptibility is conferred with human leukocyte antigen (HLA) genes. Some of the geographic variation in incidence and familial aggregation is explained by differences in HLA haplotypes. In many populations, the incidence is somewhat higher in males than in females, and a 1.3- to 2.0-fold male excess in incidence after about 15 years of age exists in most populations. The incidence of childhood-onset T1D varies markedly among countries. East Asian and native American populations have low incidences (approximately 0.1-8 per 100 000/year), while the highest rates are found in Finland (>60 per 100 000/year), Sardinia (40 per 100 000/year), and Sweden (47 per 100 000/year). The risk is highest in European-derived populations. About 10 %-20 % of newly diagnosed childhood cases of T1D have an affected first-degree relative. Those with an affected sibling or parent have a cumulative risk of 3 %-7 % up to about 20 years of age, as compared with <1 % in the general population. The cumulative incidence among the monozygotic co-twins of persons with T1D is less than 50 %. Thus, the majority of genetically predisposed people do not develop T1D. Studies assessing temporal trends have shown that the incidence of childhood-onset T1D has increased in all parts of the world. The average relative increase is 3 %-4 % per calendar year. For instance, in Finland, the incidence today is 5 times higher than 60 years ago. At the same time, the age at onset of T1D in children has become younger. It is strongly believed that nongenetic factors are important for the development of T1D and its increase, but the causative evidence is missing. The causes for this increasing trend and current epidemic still remain unknown.
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Affiliation(s)
- Jaakko Tuomilehto
- Centre for Vascular Prevention, Danube-University Krems, Dr-Karl-Dorrek-Strasse 30, 3500, Krems, Austria,
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Seok H, Jung CH, Kim SW, Lee MJ, Lee WJ, Kim JH, Lee BW. Clinical characteristics and insulin independence of Koreans with new-onset type 2 diabetes presenting with diabetic ketoacidosis. Diabetes Metab Res Rev 2013; 29:507-13. [PMID: 23653323 DOI: 10.1002/dmrr.2421] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 12/29/2012] [Accepted: 04/07/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND We evaluated the incidence, characteristics and insulin independence of Koreans with new-onset type 2 diabetes (T2D) initially presenting with diabetic ketoacidosis (DKA). METHODS We analysed clinical and biochemical data from diabetic patients presenting with DKA. They were classified into ketosis-prone diabetes (KPD) type 1A (KPD-T1A) (A+β-), type 1B (KPD-T1B) (A-β-), type 2A (KPD-T2A) (A+β+) or type 2B (KPD-T2B) (A-β+) according to the presence or absence of an autoantibody and β-cell reserve. Changes in therapy after insulin discontinuation were evaluated for up to 4 years. We also compared clinical and biochemical characteristics between newly diagnosed T2D patients presenting with DKA and previously diagnosed T2D patients presenting with DKA. RESULTS Among 60 newly diagnosed KPD patients, 18, 21 and 21 patients were classified as KPD-T1A, KPD-T1B and KPD-T2B, respectively. In the KPD-T2B group, both fasting and stimulated C-peptide were recovered over 6 months. After 4 years of DKA development, 75% of KPD-T2B subjects no longer required insulin. Compared with previously diagnosed T2D patients presenting with DKA, newly diagnosed KPD-T2B patients tended to be younger, more obese and showed better insulin secretory function after recovery from DKA. CONCLUSIONS New-onset T2D patients presenting with DKA was not uncommon among the Korean population. In contrast to previously diagnosed T2D patients presenting with DKA, who showed a progressive decrease in insulin secretory function, new-onset KPD-T2B patients recovered insulin secretory function over time, and insulin independence could be expected.
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Affiliation(s)
- H Seok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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25
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Kawasaki E, Maruyama T, Imagawa A, Awata T, Ikegami H, Uchigata Y, Osawa H, Kawabata Y, Kobayashi T, Shimada A, Shimizu I, Takahashi K, Nagata M, Makino H, Hanafusa T. Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012): Report of the Committee of Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus. J Diabetes Investig 2013; 5:115-8. [PMID: 24843746 PMCID: PMC4025242 DOI: 10.1111/jdi.12119] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 05/22/2013] [Indexed: 12/17/2022] Open
Abstract
Type 1 diabetes is a disease characterized by destruction of pancreatic β‐cells, which leads to absolute deficiency of insulin secretion. Depending on the manner of onset and progression, it is classified as fulminant, acute‐onset or slowly progressive type 1 diabetes. Here, we propose the diagnostic criteria for acute‐onset type 1 diabetes mellitus. Among the patients who develop ketosis or diabetic ketoacidosis within 3 months after the onset of hyperglycemic symptoms and require insulin treatment continuously after the diagnosis of diabetes, those with anti‐islet autoantibodies are diagnosed with ‘acute‐onset type 1 diabetes mellitus (autoimmune)’. In contrast, those whose endogenous insulin secretion is exhausted (fasting serum C‐peptide immunoreactivity <0.6 ng/mL) without verifiable anti‐islet autoantibodies are diagnosed simply with ‘acute‐onset type 1 diabetes mellitus’. Patients should be reevaluated after certain periods in case their statuses of anti‐islet autoantibodies and/or endogenous insulin secretory capacity are unknown.
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Affiliation(s)
- Eiji Kawasaki
- Department of Metabolism/Diabetes and Clinical Nutrition Nagasaki University Hospital Nagasaki Japan
| | - Taro Maruyama
- Department of Internal Medicine Saitama Social Insurance Hospital Saitama Japan
| | - Akihisa Imagawa
- Department of Metabolic Medicine Graduate School of Medicine Osaka University Osaka Japan
| | - Takuya Awata
- Department of Endocrinology and Diabetes Saitama Medical University Saitama Japan
| | - Hiroshi Ikegami
- Department of Endocrinology Metabolism and Diabetes Kinki University School of Medicine Osaka Japan
| | - Yasuko Uchigata
- Diabetes Center Tokyo Women's Medical University School of Medicine Tokyo Japan
| | - Haruhiko Osawa
- Department of Laboratory Medicine Ehime University School of Medicine Ehime Japan
| | - Yumiko Kawabata
- Department of Endocrinology Metabolism and Diabetes Kinki University School of Medicine Osaka Japan
| | - Tetsuro Kobayashi
- Third Department of Internal Medicine University of Yamanashi Yamanashi Japan
| | - Akira Shimada
- Department of Internal Medicine Saiseikai Central Hospital Tokyo Japan
| | - Ikki Shimizu
- Department of Internal Medicine The Sakakibara Heart Institute of Okayama Okayama Japan
| | - Kazuma Takahashi
- Department of Diabetes and Metabolism Iwate Medical University Iwate Japan
| | - Masao Nagata
- Department of Internal Medicine Kakogawa West City Hospital Hyogo Japan
| | | | - Toshiaki Hanafusa
- Department of Internal Medicine (I) Osaka Medical College Osaka Japan
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26
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Isabel Padrão A, Ferreira R, Vitorino R, Amado F. Proteome-base biomarkers in diabetes mellitus: progress on biofluids' protein profiling using mass spectrometry. Proteomics Clin Appl 2013; 6:447-66. [PMID: 22997208 DOI: 10.1002/prca.201200044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The worldwide number of individuals suffering from diabetes mellitus (DM) has been projected to rise from 171 million in 2000 to 366 million in 2030. Identification of specific biomarkers for prediction and monitoring of DM is needed not only for the adequate screening diagnosis but also to assist the design of interventions to prevent or delay progression of this pathology and its attendant complications. Proteomic methods based on MS hold special promise for the identification of novel biomarkers that might form the foundation for new clinical tests, but to date, their contribution has been somehow unfruitful. Indeed, from more than 300 proteins found differently modulated in body fluids from diabetic patients, approximately 50 were validated with other approaches like ELISA or Western blotting and the clinical trials are being initiated to employ biofluids' proteomics (specifically urinary proteomics) in clinical decision. This review provides an overview of MS-based applications in the identification of potential biomarkers for DM, emphasizing the methodological challenges involved.
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Affiliation(s)
- Ana Isabel Padrão
- QOPNA, Department of Chemistry, University of Aveiro, Aveiro, Portugal
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27
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McCall KD, Schmerr MJ, Thuma JR, James CBL, Courreges MC, Benencia F, Malgor R, Schwartz FL. Phenylmethimazole suppresses dsRNA-induced cytotoxicity and inflammatory cytokines in murine pancreatic beta cells and blocks viral acceleration of type 1 diabetes in NOD mice. Molecules 2013; 18:3841-58. [PMID: 23535518 PMCID: PMC6269916 DOI: 10.3390/molecules18043841] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 02/28/2013] [Accepted: 03/22/2013] [Indexed: 12/13/2022] Open
Abstract
Accumulating evidence supports a role for viruses in the pathogenesis of type 1 diabetes mellitus (T1DM). Activation of dsRNA-sensing pathways by viral dsRNA induces the production of inflammatory cytokines and chemokines that trigger beta cell apoptosis, insulitis, and autoimmune-mediated beta cell destruction. This study was designed to evaluate and describe potential protective effects of phenylmethimazole (C10), a small molecule which blocks dsRNA-mediated signaling, on preventing dsRNA activation of beta cell apoptosis and the inflammatory pathways important in the pathogenesis of T1DM. We first investigated the biological effects of C10, on dsRNA-treated pancreatic beta cells in culture. Cell viability assays, quantitative real-time PCR, and ELISAs were utilized to evaluate the effects of C10 on dsRNA-induced beta cell cytotoxicity and cytokine/chemokine production in murine pancreatic beta cells in culture. We found that C10 significantly impairs dsRNA-induced beta cell cytotoxicity and up-regulation of cytokines and chemokines involved in the pathogenesis of T1DM, which prompted us to evaluate C10 effects on viral acceleration of T1DM in NOD mice. C10 significantly inhibited viral acceleration of T1DM in NOD mice. These findings demonstrate that C10 (1) possesses novel beta cell protective activity which may have potential clinical relevance in T1DM and (2) may be a useful tool in achieving a better understanding of the role that dsRNA-mediated responses play in the pathogenesis of T1DM.
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Affiliation(s)
- Kelly D McCall
- Department of Specialty Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH 45701, USA.
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28
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Li X, Huang G, Lin J, Yang L, Zhou Z. Variation of C peptide decay rate in diabetic patients with positive glutamic acid decarboxylase antibody: better discrimination with initial fasting C peptide. BMC Endocr Disord 2013; 13:10. [PMID: 23452723 PMCID: PMC3598544 DOI: 10.1186/1472-6823-13-10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 02/19/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Diabetic patients with positive glutamic acid decarboxylase antibody (GAD-Ab) could be classified as autoimmune diabetes, which is discriminated into acute-onset classical type 1 diabetes (T1DM) and latent autoimmune diabetes in adults (LADA). However, whether the decay rate of beta cell function is relevant with the mode of onset (acute or latent-onset) is unclear. We aimed to investigate whether initial C peptide levels could help differentiate variation of C peptide decay rate. METHODS Five hundred and twenty-seven newly diagnosed GAD-Ab positive diabetic patients were followed up to assess the natural course of beta cell function. Beta cell function failure was defined as fasting C peptide and postprandial C peptide levels less than 100 pmol/L and 150 pmol/L respectively. RESULTS All these diabetic patients were discriminated according to initial fasting C peptide of 300 pmol/L, that is B+ (larger than 300 pmol/L) and B- (less than 300 pmol/L) group. The proportion of developing beta cell function failure was 13.1% in B+ group and 90.5% in B- group, which suggested that fasting C peptide levels made a good distinction of the heterogeneity in autoimmune diabetes. Receiver operator characteristic (ROC) analysis suggested that the fasting C peptide level of 300 pmol/L was optimal for determining beta cell function failure with sensitivity of 90.5% and specificity of 86.9%. CONCLUSIONS Initial level of fasting C peptide is a good indicator for predicting beta cell function failure in GAD-Ab positive diabetic patients.
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Affiliation(s)
- Xia Li
- Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No.139 Middle Renmin Road, 410011, Changsha, Hunan, P.R. China
| | - Gan Huang
- Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No.139 Middle Renmin Road, 410011, Changsha, Hunan, P.R. China
| | - Jian Lin
- Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No.139 Middle Renmin Road, 410011, Changsha, Hunan, P.R. China
| | - Lin Yang
- Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No.139 Middle Renmin Road, 410011, Changsha, Hunan, P.R. China
| | - Zhiguang Zhou
- Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No.139 Middle Renmin Road, 410011, Changsha, Hunan, P.R. China
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29
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Lima SMF, Grisi DC, Kogawa EM, Franco OL, Peixoto VC, Gonçalves-Júnior JF, Arruda MP, Rezende TMB. Diabetes mellitus and inflammatory pulpal and periapical disease: a review. Int Endod J 2013; 46:700-9. [PMID: 23442003 DOI: 10.1111/iej.12072] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 01/12/2013] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus (DM) is one of the most common metabolic disorders. DM is characterized by hyperglycaemia, resulting in wound healing difficulties and systemic and oral manifestations, which have a direct effect on dental pulp integrity. Experimental and clinical studies have demonstrated a higher prevalence of periapical lesions in patients with uncontrolled diabetes. The influence of DM on periapical bone resorption and its impact on dental intervention of such patients are reviewed, and its aetiology and pathogenesis are analysed at molecular level. Pulps from patients with diabetes have the tendency to present limited dental collateral circulation, impaired immune response, increased risk of acquiring pulp infection (especially anaerobic ones) or necrosis, besides toothache and occasional tendency towards pulp necrosis caused by ischaemia. In regard to molecular pathology, hyperglycaemia is a stimulus for bone resorption, inhibiting osteoblastic differentiation and reducing bone recovery. The relationship between poorly controlled diabetes and bone metabolism is not clearly understood. Molecular knowledge about pulp alterations in patients with diabetes could offer new therapeutic directions. Knowledge about how diabetes affects systemic and oral health has an enduring importance, because it may imply not only systemic complications but also a higher risk of oral diseases with a significant effect on pulp and periapical tissue.
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Affiliation(s)
- S M F Lima
- Center of Proteomic and Biochemical Analyzes, Post graduation in Genomic Sciences and Biotechnology, Catholic University of Brasília, Brasília, DF, Brazil
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30
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Rubio Cabezas O, Argente J. [Diabetes mellitus: clinical presentation and differential diagnosis of hyperglycemia in childhood and adolescence]. An Pediatr (Barc) 2012; 77:344.e1-344.e16. [PMID: 22857943 DOI: 10.1016/j.anpedi.2012.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 06/18/2012] [Indexed: 10/28/2022] Open
Abstract
Diabetes mellitus is one of the most common chronic diseases in childhood. Despite being a clinical and etiopathogenically heterogeneous disorder, type 1 autoimmune diabetes accounts for more than 95% of cases in children. Recent advances have meant that a growing number of patients have been assigned to other subtypes of diabetes. In such cases, the correct diagnosis is facilitated by the fact that many of these rare causes of diabetes are associated with specific clinical syndromes or may present at a certain age. Many of them are also subsidiaries of molecular diagnosis. The aim of this review is to update the current knowledge in this field of pediatric diabetes, in an attempt to determine the most accurate diagnosis and its implications on appropriate treatment and prognosis.
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Affiliation(s)
- O Rubio Cabezas
- Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, España
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