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Alam A, Dhoundiyal S, Ahmad N, Rao GSNK. Unveiling Diabetes: Categories, Genetics, Diagnostics, Treatments, and Future Horizons. Curr Diabetes Rev 2024; 20:e180823219972. [PMID: 37594107 DOI: 10.2174/1573399820666230818092958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023]
Abstract
Diabetes mellitus is a global epidemic affecting millions of individuals worldwide. This comprehensive review aims to provide a thorough understanding of the categorization, disease identity, genetic architecture, diagnosis, and treatment of diabetes. The categorization of diabetes is discussed, with a focus on type 1 and type 2 diabetes, as well as the lesser-known types, type 3 and type 4 diabetes. The geographical variation, age, gender, and ethnic differences in the prevalence of type 1 and type 2 diabetes are explored. The impact of disease identity on disease management and the role of autoimmunity in diabetes are examined. The genetic architecture of diabetes, including the interplay between genotype and phenotype, is discussed to enhance our understanding of the underlying mechanisms. The importance of insulin injection sites and the insulin signalling pathway in diabetes management are highlighted. The diagnostic techniques for diabetes are reviewed, along with advancements for improved differentiation between types. Treatment and management approaches, including medications used in diabetes management are presented. Finally, future perspectives are discussed, emphasizing the need for further research and interventions to address the global burden of diabetes. This review serves as a valuable resource for healthcare professionals, researchers, and policymakers, providing insights to develop targeted strategies for the prevention, diagnosis, and management of this complex disease.
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Affiliation(s)
- Aftab Alam
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shivang Dhoundiyal
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Niyaz Ahmad
- Department of Pharmaceutical Analysis, Green Research Lab, Green Industrial Company, Second Industrial Area, Riyadh 14334, Saudi Arabia
| | - G S N Koteswara Rao
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM's NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai 400056, India
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Li Y, Qian K, Wu D, Wang X, Cui H, Yuan G, Yuan J, Yang L, Wei L, Cao B, Su C, Liang X, Liu M, Li W, Qin M, Chen J, Meng X, Wang R, Su S, Chen X, Chen H, Gong C. Incidence of Childhood Type 1 Diabetes in Beijing During 2011-2020 and Predicted Incidence for 2025-2035: A Multicenter, Hospitalization-Based Study. Diabetes Ther 2023; 14:519-529. [PMID: 36701106 PMCID: PMC9879256 DOI: 10.1007/s13300-023-01367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION China has a low incidence of type 1 diabetes mellitus (T1DM); however, based on the large population, the absolute numbers are high. Our aim was to assess the incidence of childhood T1DM in Beijing during 2011-2020, predicted incidence for 2025-2035, and to determine the incidence of diabetic ketosis or diabetic ketoacidosis (DK/DKA) in this population. METHODS Data on patients aged less than 15 years of age with newly diagnosed T1DM between January 1, 2011 and December 31, 2020 was obtained from five tertiary hospitals in Beijing and retrospectively analyzed. RESULTS In all, 636 children aged less than 15 years were diagnosed with T1DM during 2011-2020. The incidence of T1DM was 3.11-5.46 per 100,000 per year, with an average increase of 5.10% per year. The age-specific incidence for ages 0-4 years, 5-9 years, and 10-14 years was 2.97, 4.69, and 4.68 per 100,000 per year, respectively. The highest average annual increase (7.07%) in incidence was for the youngest age group. DK or DKA was present at the time of diagnosis of T1DM in 84.6% of patients. The age-specific incidence of T1DM among children aged less than 15 years was predicted to be 7.32, 11.4, and 11.52 per 100,000 in 2035 for ages 0-4 years, 5-9 years, and 10-14 years, respectively. CONCLUSIONS The was a gentle increase in the incidence of childhood T1DM during 2011-2020 in Beijing. This increase is expected to continue for the next 15 years.
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Affiliation(s)
- Yuchuan Li
- Outpatient Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Kun Qian
- Department of Endocrinology, Capital Institute of Pediatrics, No. 2 Yaobao Road Chaoyang District, Beijing, 100020, China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Xinli Wang
- Department of Pediatrics, Third Hospital Peking University, Beijing, 100191, China
| | - Hong Cui
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Geheng Yuan
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Jinfang Yuan
- Department of Pediatrics, Third Hospital Peking University, Beijing, 100191, China
| | - Lijun Yang
- Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Liya Wei
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Bingyan Cao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Chang Su
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Xuejun Liang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Min Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Wenjing Li
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Miao Qin
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Jiajia Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Xi Meng
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Rui Wang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Shan Su
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China
| | - Xiaobo Chen
- Department of Endocrinology, Capital Institute of Pediatrics, No. 2 Yaobao Road Chaoyang District, Beijing, 100020, China.
| | - Hui Chen
- School of Biomedical Engineering, Capital Medical University, No. 10 Youanmenwai Xitoutiao, Fengtai District, Beijing, 100069, China.
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing, 100045, China.
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Hashemipour M, Maracy M, Javanmard SH, Zamaneh F, Mostofizadeh N, Hovsepian S. Trends in incidence rates of childhood type 1 diabetes mellitus: A retrospective study in Isfahan province, Iran. J Diabetes Investig 2023; 14:376-386. [PMID: 36695001 PMCID: PMC9951581 DOI: 10.1111/jdi.13975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023] Open
Abstract
AIMS/INTRODUCTION We aimed to determine the incidence trend of childhood type 1 diabetes mellitus in Isfahan province over a period of 12 years. MATERIALS AND METHODS In this retrospective study, children aged <20 years at the time of type 1 diabetes mellitus diagnosis, from March 2007 to March 2019, were included. The crude and adjusted incidence rate of type 1 diabetes mellitus is calculated as the number of cases per 100,000 person-years by the period. The cumulative, age- and sex-specific incidence rates were also calculated. Age-specific incidence rates were calculated for age and sex groups. RESULTS A total of 1,954 (983 boys and 971 girls) cases of type 1 diabetes mellitus were identified. The mean age at diagnosis in all studied populations was 9.89 (standard deviation 4.76). There were no significant differences between the proportion of boys and girls in different years (P = 0.12) and different age groups (P = 0.19). The average annual percent change of incidence rate for the total population, for girls and boys, was 6.9%, 6.7% and 6.3% respectively. The type 1 diabetes mellitus incidence rate had a significant trend to be increased from 2007 to 2019 (P < 0.001, t = 3.6). CONCLUSION Our findings showed that currently our region is considered a region with a high incidence rate of type 1 diabetes mellitus. Although we have had fluctuations in the incidence rate over the 12 years, the overall trend is increasing.
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Affiliation(s)
- Mahin Hashemipour
- Metabolic Liver Diseases Research Center, Isfahan Endocrine and Metabolism Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mohammadreza Maracy
- Department of Epidemiology and Biostatistics, School of HealthIsfahan University of Medical SciencesIsfahanIran
| | | | - Farzane Zamaneh
- Metabolic Liver Diseases Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Neda Mostofizadeh
- Department of Pediatric Endocrinology, Isfahan Endocrine and Metabolism Research Center, Imam Hossein Children's HospitalIsfahan University of Medical SciencesIsfahanIran
| | - Silva Hovsepian
- Metabolic Liver Diseases Research Center, Imam Hossein Children's HospitalIsfahan University of Medical SciencesIsfahanIran
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Khallaf NMR, Manzour AF, Mostafa A, Salam Meky FA. Maternal knowledge, coping strategies, and metabolic control of children with type 1 diabetes. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00259-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background
Trends of type 1 diabetes have increased among Egyptian children in the past two decades. Managing a child with type 1 diabetes is a great challenge for parents especially when the child is not developmentally able to manage the disease independently. This study aimed to determine level of diabetes-specific knowledge among diabetic children’s mothers, measure maternal diabetes-related stress, identify diabetes-related maternal coping strategies, and to examine the effect of maternal diabetes-specific knowledge, maternal diabetes-related stress, and their adopted coping strategy on glycemic control of their children. A cross-sectional study was conducted in outpatient clinic for diabetic children at a university hospital in Cairo, Egypt. One hundred and four mothers of diabetic children were recruited. Diabetes-specific knowledge was measured by Modified Diabetes Knowledge Questionnaire. Diabetes-related stress and coping strategies were measured by the Ways of Coping Questionnaire. Glycosylated hemoglobin level was obtained from medical records.
Results
61.5% of mothers had good diabetes-specific knowledge; however, 45.2% had high levels of diabetes-related stress. The most common adopted maternal coping strategy was acceptance of child’s illness (71.6%). Glycosylated hemoglobin level in diabetic children was negatively correlated with positive and wishful thinking (p = 0.042 and p = 0.010 respectively) and acceptance of illness (p = 0.002), while positively correlated with cognitive restructuring (p = 0.007).
Conclusions
Health education to train mothers to adopt positive coping strategies might maintain a better glycemic control in diabetic children in similar settings.
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Alazwari A, Abdollahian M, Tafakori L, Johnstone A, Alshumrani RA, Alhelal MT, Alsaheel AY, Almoosa ES, Alkhaldi AR. Predicting age at onset of type 1 diabetes in children using regression, artificial neural network and Random Forest: A case study in Saudi Arabia. PLoS One 2022; 17:e0264118. [PMID: 35226685 PMCID: PMC8884498 DOI: 10.1371/journal.pone.0264118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/03/2022] [Indexed: 11/18/2022] Open
Abstract
The rising incidence of type 1 diabetes (T1D) among children is an increasing concern globally. A reliable estimate of the age at onset of T1D in children would facilitate intervention plans for medical practitioners to reduce the problems with delayed diagnosis of T1D. This paper has utilised Multiple Linear Regression (MLR), Artificial Neural Network (ANN) and Random Forest (RF) to model and predict the age at onset of T1D in children in Saudi Arabia (S.A.) which is ranked as the 7th for the highest number of T1D and 5th in the world for the incidence rate of T1D. De-identified data between (2010-2020) from three cities in S.A. were used to model and predict the age at onset of T1D. The best subset model selection criteria, coefficient of determination, and diagnostic tests were deployed to select the most significant variables. The efficacy of models for predicting the age at onset was assessed using multi-prediction accuracy measures. The average age at onset of T1D is 6.2 years and the most common age group for onset is (5-9) years. Most of the children in the sample (68%) are from urban areas of S.A., 75% were delivered after a full term pregnancy length and 31% were delivered through a cesarean section. The models of best fit were the MLR and RF models with R2 = (0.85 and 0.95), the root mean square error = (0.25 and 0.15) and mean absolute error = (0.19 and 0.11) respectively for logarithm of age at onset. This study for the first time has utilised MLR, ANN and RF models to predict the age at onset of T1D in children in S.A. These models can effectively aid health care providers to monitor and create intervention strategies to reduce the impact of T1D in children in S.A.
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Affiliation(s)
- Ahood Alazwari
- School of Science, RMIT University, Melbourne, Victoria, Australia
- School of Science, Al-Baha University, Moundq, Saudi Arabia
- * E-mail:
| | - Mali Abdollahian
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Laleh Tafakori
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Alice Johnstone
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - Rahma A. Alshumrani
- Pediatric Endocrine Department, Al Aziziyah Maternal and Children Hospital, Jeddah, Saudi Arabia
| | - Manal T. Alhelal
- Pediatric Endocrine Department, Maternal and Children Hospital, Al-Ahsa, Saudi Arabia
| | | | - Eman S. Almoosa
- Pediatric Endocrine Department, Maternal and Children Hospital, Al-Ahsa, Saudi Arabia
| | - Aseel R. Alkhaldi
- Pediatric Endocrine Department, King Fahad Medical City (KFMC), Riyadh, Saudi Arabia
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Hamed SA, Metwalley KA, Farghaly HS, Oseily AM. Vestibular function for children with insulin dependent diabetes using cervical vestibular evoked myogenic potentials testing. World J Clin Pediatr 2022; 11:61-70. [PMID: 35096547 PMCID: PMC8771316 DOI: 10.5409/wjcp.v11.i1.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/17/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Healthy vestibular system adjusts balance during static and dynamic conditions. This is important for normal development (standing up and walking). Vestipulopathies (central and peripheral) are common complications of diabetes in adult population. Related studies are scare in children with type 1 diabetes (T1D).
AIM To assess saccular function of otolith organ in children with T1D and predictors for its dysfunction.
METHODS Cervical vestibular evoked myogenic potential (cVEMP) was used for objective evaluation.
RESULTS The study included 40 patients (boys = 15; girls = 25). Patients had mean age of 13.63 ± 1.50 years, duration of diabetes of 5.62 ± 2.80 years, frequent attacks of diabetic ketoacidosis (55%) and hypoglycemia (30%), hyperlipidemia (20%), hypertension (12.5%) and peripheral neuropathy (40%). Dizziness was found in 10%. Compared to healthy children (n = 25), patients had prolonged cVEMP P1 and N1 latencies and reduced P1-N1 amplitude. Bilateral cVEMP abnormalities were found in 60% (vs 25% for unilateral abnormalities). Higher frequencies and severe vestibulopathies were found with chronic diabetes of > 5 years, hemoglobin A1c values > 7%, frequent diabetic ketoacidosis and hypoglycemic attacks and presence of dizziness. Regression analyses showed that predictors for prolonged P1 latencies and reduced P1-N1 amplitudes were only chronic diabetes (> 5 years) {odds ratio (OR) = 2.80 [95% confidence interval (CI): 1.80–5.33], P = 0.01; OR = 3.42 (95%CI: 2.82–6.81)} and its severity (hemoglobin A1c > 7%) [OR = 3.05 (95%CI: 2.55–6.82), P = 0.01; OR = 4.20 (95%CI: 3.55–8.50), P = 0.001].
CONCLUSION Dysfunction or injury of the saccular macula and its pathways is prevalent in children with T1D. Optimum glycemic control is important to prevent diabetes related vestipulopathies.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospitals, Assiut 71516, Egypt
| | | | | | - Amira Mohamed Oseily
- Department of ENT (Auditory Unit), Assiut University Hospitals, Assiut 71516, Egypt
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Low-dose interleukin-2-loaded nanoparticle effect on NK and T-reg cell expression in experimentally induced type 1 diabetes mellitus. GASTROENTEROLOGY REVIEW 2021; 16:67-82. [PMID: 33986891 PMCID: PMC8112267 DOI: 10.5114/pg.2021.104737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
Introduction Type 1 diabetes mellitus is an autoimmune disorder characterized by inflammatory damage to pancreatic β cells resulting in loss of insulin secretion. In autoimmune type 1 diabetes mellitus (T1D) natural killer cells (NK) initiate pancreatic islets cell lyses in autoimmune T1D. Loss of T regulatory cells (Treg) at disease onset facilitates the activation and accumulation of NKs in the pancreatic microenvironment. A proper low-dose interleukin 2 (IL-2) could enhance Tregs and enforce control and regulation of pro-inflammatory NKs. Aim This relation needs to be studied to improve therapeutic strategies aimed at resetting the balance between Tregs and proinflammatory cells. Material and methods We used novel formulations of low-dose IL-2 loaded on chitosan nanoparticles. The study included 116 T1D BALB/c mice experimentally induced by streptozotocin, divided into groups. Their splenocytes were maintained in a short-term culture for assessment of expression of CD4+FOXP3+ Treg and NKp46+NK by both flow cytometry and enzyme-linked immunoassay (ELISA). Morphological, immunohistochemical, and morphometrical analyses were done.In vitro suppressor assay was used to assess the suppressor effect of Treg cells after exogenous IL-2 treatment. Results NK cell expression, NKp46 level, and NK cell functions were modulated more in mice injected with IL-2-loaded chitosan nanoparticles than in other groups. A statistical inverse correlation was found between Treg and NK cell expression in IL-2-loaded chitosan with 0.3 µIU (p = 0.047), and this correlation was related to FOXP3 expression on Treg cells. The modified expression of NK and NKp46 was noticed in mice injected with 0.3 µIU for longer duration (3 weeks) (p < 0.001), but the NK functions did not show any significant changes with prolonged treatment. Conclusions Prolonged administration of low-dose IL-2 results in the vigorous expression of NKp46, indicating a significant role of Tregs in NK stimulation and motivation. Low-dose IL-2 selectively modulates NKp46 NK and FOXP3+ Tregs and increases their expression.
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Khater S, Aouar A, Bensmain N, Bendedouche S, Chabni N, Hamdaoui H, Moussouni A, Moqaddem Z. Very High Incidence of Type 1 Diabetes Among Children Aged Under 15 Years in Tlemcen, Northwest Algeria (2015-2018). J Clin Res Pediatr Endocrinol 2021; 13:44-51. [PMID: 32938578 PMCID: PMC7947720 DOI: 10.4274/jcrpe.galenos.2020.2020.0073] [Citation(s) in RCA: 3] [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] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE In Algeria, there is a lack of epidemiological data concerning childhood type 1 diabetes (T1D). The International Diabetes Federation estimated in 2019 that Algeria ranked 7th among countries with the highest prevalence of T1D. This study aimed to determine the incidence of T1D in children <15 years, living in Tlemcen in Northwest Algeria. METHODS A retrospective study using data from children (<15 years) who have been diagnosed with T1D in Tlemcen between 2015 and 2018, using the two-source capture–recapture method to estimate the completeness of ascertainment (%). Total average incidences, by sex, by onset age group, and by season of onset were calculated per 100,000 and per year. RESULTS During the study period, 437 new cases of T1D were registered, among them, 233 boys and 204 girls, with a sex ratio of 1.14. The average annual incidence rate of childhood T1D was 38.5/100,000 with a 95% confidence interval (CI): 35.20-41.79; boys: 40.51, 95% CI: 38.16-42.85; girls: 36.49, 95% CI: 34.17-38.80. Overall incidence rates in 2015, 2016, 2017 and 2018 were respectively 36.6 (95% CI: 33.72-39.48), 38.7 (95% CI: 35.43-41.97), 39.3 (95% CI: 35.97-42.62) and 39.5 (95% CI: 36.12-42.87)/100,000. Newly diagnosed children were more likely to present in winter and autumn. Ketoacidosis at diagnosis was diagnosed in 29.2%. CONCLUSION The mean incidence of childhood T1D in Tlemcen was 38.5/100,000, this incidence is in the “extremely high” category of the World Health Organization DiaMond project classification of diabetes giving this region a very high risk.
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Affiliation(s)
- Sarra Khater
- Abou Beker Belkaid University, Valorisation of Human Actions for the Protection of the Environment and Application in Public Health Laboratory, Tlemcen, Algeria
| | - Ammaria Aouar
- Abou Beker Belkaid University, Valorisation of Human Actions for the Protection of the Environment and Application in Public Health Laboratory, Tlemcen, Algeria
| | - Nawel Bensmain
- Abou Beker Belkaid University, Statistics and Random Models Laboratory, Tlemcen, Algeria
| | - Salih Bendedouche
- Abou Beker Belkaid University, Tlemcen University Hospital, Department of Pediatrics, Tlemcen, Algeria
| | - Nafissa Chabni
- Abou Beker Belkaid University, Tlemcen University Hospital, Department of Epidemiology, Tlemcen, Algeria
| | - Houari Hamdaoui
- Abou Beker Belkaid University, Valorisation of Human Actions for the Protection of the Environment and Application in Public Health Laboratory, Tlemcen, Algeria,* Address for Correspondence: Abou Beker Belkaid University, Valorisation of Human Actions for the Protection of the Environment and Application in Public Health Laboratory, Tlemcen, Algeria E-mail:
| | | | - Zakarya Moqaddem
- Abou Beker Belkaid University, Valorisation of Human Actions for the Protection of the Environment and Application in Public Health Laboratory, Tlemcen, Algeria
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Effect of low dose IL-2 loaded chitosan nanoparticles on natural killer and regulatory T cell expression in experimentally induced autoimmune type 1 diabetes mellitus. Cent Eur J Immunol 2021; 45:382-392. [PMID: 33658887 PMCID: PMC7882410 DOI: 10.5114/ceji.2020.103412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 12/13/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Natural killer cells (NK) initiate pancreatic islets cell lyses in autoimmune type 1 diabetes mellitus (T1D). Loss of T regulatory cells (Treg) at disease onset facilitates activation and accumulation of NKs in the pancreatic microenvironment. A proper low dose interleukin 2 (IL-2) could enhance Tregs and enforce control and regulation of pro-inflammatory NKs. This relation needs to be studied to improve therapeutic strategies aimed at resetting the balance between Tregs and proinflammatory cells. Material and methods We used novel formulations of low dose IL-2 loaded on chitosan nanoparticles. The study included 116 T1D BALB/c mice experimentally induced by streptozotocin, divided into groups. Their splenocytes were maintained in a short-term culture for assessment of expression of CD4+Foxp3+ Treg and NKp46+NK by both flow cytometry and enzyme linked immunoassay (ELISA). In vitro suppressor-assay was used in order to assess the suppressor effect of Treg cells after exogenous IL-2 treatment. Results NK cell expression, NKp46 level and NK cell functions were modulated in mice injected with IL-2 loaded chitosan nanoparticles than other groups. A statistical inverse correlation was found between Treg and NK cell expression in IL-2 loaded chitosan with (0.3 µIU) (p = 0.047) and this correlation was related to Foxp3 expression on Treg cells. The modified expression of NK and NKp46 was noticed in mice injected with (0.3 µIU) for longer duration (three weeks) (p < 0.001) but the NK functions did not show any significant changes with prolonged treatment. Conclusions Low dose (0.3) µIU IL-2 nanoparticles effectively modulated NK and NKp46 expression. It selectively modulates the suppressive activity of Tregs indicating a significant role of Tregs in NK activation and function by controlling the availability of IL-2 in the microenvironment.
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Adar A, Shalitin S, Eyal O, Loewenthal N, Pinhas-Hamiel O, Zuckerman Levin N, Dally-Gottfried O, Landau Z, Zung A, Levy-Khademi F, Zangen D, Tenenbaum-Rakover Y, Rachmiel M. Birth during the moderate weather seasons is associated with early onset of type 1 diabetes in the Mediterranean area. Diabetes Metab Res Rev 2020; 36:e3318. [PMID: 32270907 DOI: 10.1002/dmrr.3318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/13/2020] [Accepted: 03/18/2020] [Indexed: 02/05/2023]
Abstract
AIM To assess the association of seasonal and perinatal parameters with early age of type 1 diabetes (T1D) onset. METHODS A cross-sectional review of all medical records of T1D patients born between the years 1990 and 2005, and diagnosed before/by the age of 10 years, from 13 university-affiliated paediatric medical centres in Israel, was performed. Data included: gender, ethnicity, seasons of birth and disease onset, birth gestational age and weight, and autoimmune diseases of the probands and their first-degree family members. Statistical analysis included the Chi-square test or Mann-Whitney test, as appropriate and multivariate regression analysis. RESULTS Enrolled were 1571 T1D patients at a median age of T1D onset 6.9 years (IQR 4.4,8.4); 336 of them presented before 4 years of age. The median age of this group was 2.5 years (IQR 1.7,3.2), and of the 1235 patients who presented after 4 years of age, median presentation age was 7.5 years (IQR 6.1,8.8). Multivariate regression analysis demonstrated that a more recent birth year; OR = 1.06, 95% CI 1.02-1.1, P = 0.003, and birth during the moderate weather months (September, October, March, and April) were significantly associated with younger age at T1D onset; OR = 1.68, 95% CI 1.17-2.4, P = 0.005. CONCLUSIONS Our novel finding demonstrates the association between younger than 4 years old age at presentation and birth during moderate weather months. The results also support previous reports, that there is a slight increase in the annual incidence of T1D in the youngest age groups.
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Affiliation(s)
- Adi Adar
- Pediatric Endocrinology Unit, Division of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Shlomit Shalitin
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center of Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Eyal
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Neta Loewenthal
- Pediatric Endocrinology and Metabolic Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Orit Pinhas-Hamiel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Juvenile Diabetes Center, Maccabi Health Care Services, Ra'anana, Israel
| | - Nehama Zuckerman Levin
- Pediatric Diabetes Clinic, Institute of Diabetes, Endocrinology and Metabolism, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Orna Dally-Gottfried
- The Center for Juvenile Diabetes and Pediatric Endocrinology and Pediatric Outpatient Clinics, Rebecca Ziv Hospital, Safed, affiliated to the School of Medicine, Bar Ilan University, Safed, Israel
| | - Zohar Landau
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, E. Wolfson Medical Center, Holon, Israel
| | - Amnon Zung
- Pediatric Endocrinology Unit, Kaplan Medical Center, Rehovot, Israel
- The School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Floris Levy-Khademi
- The School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Division of Pediatric Endocrinology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - David Zangen
- The School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Division of Pediatric Endocrinology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yardena Tenenbaum-Rakover
- Pediatric Endocrine Unit, Ha'Emek Medical Center and the Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Marianna Rachmiel
- Pediatric Endocrinology Unit, Division of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Alhazmi A, Sane F, Lazrek M, Nekoua MP, Badia-Boungou F, Engelmann I, Alidjinou EK, Hober D. Enteroviruses and Type 1 Diabetes Mellitus: An Overlooked Relationship in Some Regions. Microorganisms 2020; 8:microorganisms8101458. [PMID: 32977495 PMCID: PMC7598226 DOI: 10.3390/microorganisms8101458] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023] Open
Abstract
Enteroviruses (EVs) infect millions of people annually. EV infections can be asymptomatic or symptomatic with conditions ranging from mild illnesses to serious diseases such as dilated cardiomyopathy. A causal relationship between EV infections and type 1 diabetes mellitus (T1DM) has been heavily debated, with some studies suggesting that this relationship is not yet conclusive and requires additional evidence, whereas others strongly argue for this correlation. While this relationship is well investigated in some developed countries like the USA and Finland, it is understudied or neglected in other countries like Russia for many reasons such as the low incidence of T1DM. Although the Middle East and North Africa (MENA) are highly affected by T1DM, the role of EVs in the disease in MENA has not been investigated extensively. Therefore, we aimed to address the relationship between T1DM and EVs in MENA and other regions globally.
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Affiliation(s)
- Abdulaziz Alhazmi
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Microbiology and Parasitology Department, College of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Famara Sane
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Mouna Lazrek
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Magloire Pandoua Nekoua
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Laboratoire de Biologie et Physiologie Cellulaires, Institut des Sciences Biomédicales Appliquées (ISBA), Faculté des Sciences et Techniques (FAST), Université d’Abomey-Calavi, 01 BP 526 Cotonou, Benin
| | - Francis Badia-Boungou
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Ilka Engelmann
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Enagnon Kazali Alidjinou
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
| | - Didier Hober
- Laboratoire de Virologie ULR3610, Univ Lille, CHU Lille, F-59000 Lille, France; (A.A.); (F.S.); (M.L.); (M.P.N.); (F.B.-B.); (I.E.); (E.K.A.)
- Correspondence: ; Tel.: +33-3-20-44-66-88
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12
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Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study. Clin Oral Investig 2020; 24:4033-4042. [PMID: 32468484 DOI: 10.1007/s00784-020-03273-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 04/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The purpose of the present study is to (1) evaluate the oral health-related quality of life (OHRQoL) among a group of Egyptian children and early adolescents with type-1 diabetes mellitus (T1DM) aged from 8 to 14 years and the impact of individual, environmental, oral health care and biological independent predictors (2) assess oral health status (OHS) in terms of oral hygiene, caries experience, untreated carious cavities and gingival condition. MATERIALS AND METHODS A case-control investigation conducted on eligible 444 participants who have been assigned into four groups (two case groups included 125 children and 97 early adolescents with T1DM and two matched control groups). The OHRQoL was measured using a validated structured CPQ8-10 for children and CPQ11-14 short-form questionnaires for early adolescents. The questionnaire comprised of four parts that represented the study independent variables. Descriptive data were analysed using Mann-Whitney U test for the non-parametric data. Pearson's correlations have been calculated to inspect the interrelation between metabolic disease control and study of different OHS representatives. Log-linear Poisson model regression analyses performed to determine associations between the OHRQoL and independent predictors. RESULTS The prevalence of dental caries (DT ≥ 1) in children with diabetes was 49.6% (75.3%). The worse GI mean and median scores were recorded among early adolescents with T1DM [mean (SD) = 2.24 ± 0.61; median (IQR) = 2.3(1)]. The social well-being of CPQ domains was a prominent concern that negatively affected children and early adolescents' life aspects. A strong correlation between OHRQoL and the level of HbA1c in the two diabetic groups (r = 0.69 for children's group and 0.74 for the early adolescent group) was observed. The final model of log-linear Poisson regression analysis demonstrated that the odds ratio (OR) of poor OHRQoL among children and early adolescents with poor metabolic control was 1.30 [95% CI 1.18-1.47] and 1.22 [95% CI 1.11-1.38] times more than those with good metabolic control do. CONCLUSIONS The overall self-reported OHRQL appears to be adversely affected by T1DM especially among children and early adolescents with poor metabolic control. Socioeconomic status and oral health care demonstrate a significant impact on the OHRQoL; however, the effect was obvious in the diabetic and non-diabetic groups. CLINICAL RELEVANCE 1. In Egypt, the number of new cases rises progressively in a retrospective survey to figure out the prevalence of T1DM among children and adolescents. The available data is limited regarding the incidence and prevalence of dental caries and gingival condition among Egyptian children and early adolescents. 2. The present study is a premier study that assesses the OHRQoL and studies the impact of the individual, environmental, biological and oral health care variables. 3. This study highlights the urgent need for improving the oral health status of diabetic children and adolescents and the necessity for qualified oral health education programs for children and parents. There is an intense need to reinforce the role of preventive oral hygiene measures.
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Zahran AM, Nafady-Hego H, Askar E, Elmasry HM, Mohamad IL, El-Asheer OM, Esmail AM, Elsayh KI. Analysis of Toll-Like Receptor-2 and 4 Expressions in Peripheral Monocyte Subsets in Patients with Type 1 Diabetes Mellitus. Immunol Invest 2020; 50:113-124. [PMID: 32281447 DOI: 10.1080/08820139.2020.1714649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Dysfunction of the peripheral blood monocytes in the form of changes in their proportion, cytokines or pattern-recognition receptors (PRR) expressions may be involved in the pathogenesis of type 1 diabetes mellitus (T1DM). Our aim is to analyze the three monocyte subsets; classical, non-classical and intermediate monocytes and their expression of Toll-like receptors 2 (TLR-2) and 4 (TLR-4) in T1DM patients. Methods: The peripheral blood monocytes of 20 T1DM patients were analyzed by Flow cytometry to measure their count and TLR-2 and TLR-4 expression. Results: T1DM patients had more non-classical and intermediate monocytes, whereas classical monocytes were comparable between patients and control (20 healthy volunteers). Classical, non-classical and intermediate monocytes had no significant correlations with hemoglobin (Hb) A1C in controls, while all subsets showed positive correlations with HbA1C in T1DM. TLR-2 and TLR-4 expression were significantly increased in classical monocytes in patients, especially those with diabetic ketoacidosis (DKA), and both of them showed positive correlations with the duration of T1DM. The expression of TLR-2 inside non-classical monocytes showed a negative correlation with LDL cholesterol and TLR-4/TLR-2 ratio showed positive correlations with the duration of T1DM and negative correlations with total cholesterol. The expression of TLR-2 inside intermediate monocytes showed positive correlations with the duration of T1DM and TLR-4/TLR-2 ratio showed negative correlations with the duration of T1DM Conclusions: The observed changes in both proportions and TLR-2 and TLR-4 expression of monocyte subsets can raise the possible role in the pathogenesis of early stages of T1DM and DKA. Abbreviations APC: allophycocyanin; CBC: complete blood picture; DKA: diabetic acidosis; DM: diabetes mellitus; FITC: fluorescein isothiocyanate; FSC: forward scatter; Hb: haemoglobin; MFI: mean channel fluorescence intensity; PE: phycoerythrin; PRR: pattern-recognition receptors; SPSS: statistical package for the social sciences; SSC: side scatter; T1DM: Type1DM; TLRs: toll-like receptors.
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Affiliation(s)
- Asmaa M Zahran
- Department of Clinical Pathology, South Egypt Cancer Institute , Assiut, Egypt
| | - Hanaa Nafady-Hego
- Microbiology and Immunology Department, Faculty of Medicine, Assiut University , Assiut, Egypt.,Division of Translational Medicine, Sidra Medical and Research Center , Doha, Qatar
| | - Eman Askar
- Paediatric Department, Faculty of Medicine, Assiut University , Assiut, Egypt
| | - Heba M Elmasry
- Department of Clinical Pathology, South Egypt Cancer Institute , Assiut, Egypt
| | - Ismail L Mohamad
- Paediatric Department, Faculty of Medicine, Assiut University , Assiut, Egypt
| | - Osama M El-Asheer
- Paediatric Department, Faculty of Medicine, Assiut University , Assiut, Egypt
| | - Asmaa M Esmail
- Paediatric Department, Faculty of Medicine, Aswan University , Aswan, Egypt
| | - Khalid I Elsayh
- Paediatric Department, Faculty of Medicine, Assiut University , Assiut, Egypt
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Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10:98-115. [PMID: 32296622 PMCID: PMC7146037 DOI: 10.34172/hpp.2020.18] [Citation(s) in RCA: 295] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Diabetes is referred to a group of diseases characterized by high glucose levels in blood. It is caused by a deficiency in the production or function of insulin or both, which can occur because of different reasons, resulting in protein and lipid metabolic disorders. The aim of this study was to systematically review the prevalence and incidence of type 1 diabetes in the world. Methods: A systematic search of resources was conducted to investigate the prevalence and incidence of type 1 diabetes in the world. The databases of Medline (via PubMed and Ovid),ProQuest, Scopus, and Web of Science from January 1980 to September 2019 were searched to locate English articles. The located articles were screened in multiple levels of title, abstract,and full-text and final studies that met the inclusion criteria were retrieved and included in the study. Results: From 1202 located articles, 193 studies were included in this systematic review. The results of meta-analysis showed that the incidence of type 1 diabetes was 15 per 100,000 people and the prevalence was 9.5% (95% CI: 0.07 to 0.12) in the world, which was statistically significant. Conclusion: According to the results, the incidence and prevalence of type 1 diabetes are increasing in the world. As a result, insulin will be difficult to access and afford, especially in underdeveloped and developing countries.
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Affiliation(s)
- Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Shirmohammadi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tarlan Amiri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafiseh Vahed
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Hosseini Fard
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz University of Medical Sciences, Tabriz, Iran
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Gomez-Lopera N, Pineda-Trujillo N, Diaz-Valencia PA. Correlating the global increase in type 1 diabetes incidence across age groups with national economic prosperity: A systematic review. World J Diabetes 2019; 10:560-580. [PMID: 31915518 PMCID: PMC6944530 DOI: 10.4239/wjd.v10.i12.560] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 10/17/2019] [Accepted: 10/29/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The global epidemiology of type 1 diabetes (T1D) is not yet well known, as no precise data are available from many countries. T1D is, however, characterized by an important variation in incidences among countries and a dramatic increase of these incidences during the last decades, predominantly in younger children. In the United States and Europe, the increase has been associated with the gross domestic product (GDP) per capita. In our previous systematic review, geographical variation of incidence was correlated with socio-economic factors.
AIM To investigate variation in the incidence of T1D in age categories and search to what extent these variations correlated with the GDP per capita.
METHODS A systematic review was performed to retrieve information about the global incidence of T1D among those younger than 14 years of age. The study was carried out according to the PRISMA recommendations. For the analysis, the incidence was organized in the periods: 1975-1999 and 2000-2017. We searched the incidence of T1D in the age-groups 0-4, 5-9 and 10-14. We compared the incidences in countries for which information was available for the two periods. We obtained the GDP from the World Bank. We analysed the relationship between the incidence of T1D with the GDP in countries reporting data at the national level.
RESULTS We retrieved information for 84 out of 194 countries around the world. We found a wide geographic variation in the incidence of T1D and a worldwide increase during the two periods. The largest contribution to this increase was observed in the youngest group of children with T1D, with a relative increase of almost double when comparing the two periods (P value = 2.5 × e-5). Twenty-six countries had information on the incidence of T1D at the national level for the two periods. There was a positive correlation between GDP and the incidence of T1D in both periods (Spearman correlation = 0.52 from 1975-1999 and Spearman correlation = 0.53 from 2000-2017).
CONCLUSION The incidence increase was higher in the youngest group (0-4 years of age), and the highest incidences of T1D were found in wealthier countries.
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Affiliation(s)
- Natalia Gomez-Lopera
- Grupo Mapeo Genetico, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010470, Colombia
| | - Nicolas Pineda-Trujillo
- Grupo Mapeo Genetico, Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, Medellín 050010470, Colombia
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Ahmad AK, Hussein OA, Saedii AA. Vitamin D level in patients with type 1 diabetes and its relation to tissue transglutaminase immunoglobulin A antibodies. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_31_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hamed MS, Samy M, Mahmoud H, Yehia N. Study of the difficult glycemic control in relation to the presence of diabetes-autoantibodies in a sample of Egyptians with type 1 diabetes. Diabetes Res Clin Pract 2019; 152:53-57. [PMID: 31063857 DOI: 10.1016/j.diabres.2019.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/27/2019] [Accepted: 04/18/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND T1DM is divided into 1A (immune-mediated), 1B (virus-triggered, genetic and idiopathic). Presence of auto-antibodies may be correlated to glycemic control. AIM Assessment relation between the autoantibodies and the poor glycemic control in T1DM. METHODS 60 patients T1DM 30 males, 30 females, subjected to full history, clinical, anthropometric assessment and laboratory assessment of fasting C-peptide, FBS, 2 h PP glucose, HbA1c, GADA, ICA and IAA level. Classified into two groups; Group I: negative auto-antibodies, Group II: positive auto-antibodies, Group II was further classified into 3 sub-groups, Group II a:1 positive autoantibody, Group II b: 2 positive autoantibodies and Group II c: 3 positive autoantibodies. RESULTS HbA1c was significantly higher in group II than group I (11.85 ± 1.61% vs. 8.52 ± 0.41%, p = 0.000). HbA1c was highest in group IIc followed by IIb then IIa (12.25 ± 1.48% vs. 11.57 ± 1.59% vs. 10.78 ± 1.73%, p = 0.038). Total insulin units per day was significantly higher in group II than group I (109.83 ± 7.77 U/day vs. 100.83 ± 1.83 U/day, p = 0.007). Duration of diabetes was significantly higher in group I than group II (10.17 ± 1.94 years vs. 8.11 ± 2.20 years, p = 0.033). HbA1c, total insulin units per day and duration of diabetes were independent predictive factors for presence of autoantibodies (p = 0.007, p = 0.033 and p = 0.043 respectively). CONCLUSION Autoantibodies affect the glycemic control presented by high HbA1c; also it causes increase in total insulin units needed by patients; the more autoantibodies, the higher HbA1c, the more insulin units required to control glycemic state.
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Affiliation(s)
- Mohammed Saad Hamed
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Merhan Samy
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanan Mahmoud
- Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Noha Yehia
- Endocrinology Department, Ain Shams University, Cairo, Egypt
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Ahmed AEA, Sakhr HM, Hassan MH, El-Amir MI, Ameen HH. Vitamin D receptor rs7975232, rs731236 and rs1544410 single nucleotide polymorphisms, and 25-hydroxyvitamin D levels in Egyptian children with type 1 diabetes mellitus: effect of vitamin D co-therapy. Diabetes Metab Syndr Obes 2019; 12:703-716. [PMID: 31190930 PMCID: PMC6526182 DOI: 10.2147/dmso.s201525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/04/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: We aimed to examine the possible association role of vitamin D and vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) in type 1 diabetes mellitus (T1DM) development, glycemic control and complications among a cohort of Egyptian children. Subjects and methods: A prospective case-control study has been conducted on 50 Egyptian children with T1DM who were comparable with 50 controls. Vitamin D and HbA1c were measured. VDR-SNPs [ApaI (rs7975232), TaqI (rs731236) and BsmI (rs1544410)] detection was done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) technique. Vitamin D supplements were given to the included T1DM children with low vitamin D and reassessments of both HbA1c% and 25(OH)D serum levels were performed in those children three months later. Results: Eighty percent of the included diabetic patients have poor glycemic control. Vitamin D was deficient in 68% and insufficient in 16% of diabetic patients. Significant improvements in both vitamin D and glycemic status among T1DM children, who have low vitamin D and received vitamin D supplementations. There were significantly negative correlations between serum levels of vitamin D with both HbA1c % (r= -0.358, P˂0.05) and daily insulin dose (r=-0.473, P˂0.05). Compared with controls, T1DM children presented more commonly with ApaI a allele (OR: 2.87; 95%CI: 1.39-5.91, P˂0.05) and BsmI b allele (OR: 4.38; 95%CI: 2.30-8.33, P˂0.05). TaqI t allele wasn't significantly differing among patients and controls (P˃0.05). Aa+aa and Bb+bb genotypes were significantly higher among T1DM vs the controls (OR: 3.08;, 95%CI: 1.33-7.15, P˂0.05 and OR: 9.33; 95%CI: 3.61-24.17, P˂0.05respectively). Conclusion: ApaI and BsmI were associated with risk of T1DM development among Egyptian children. Low vitamin D status was frequently occurring among T1DM with significant improvement in the glycemic control of such children when adding vitamin D supplements to the standard insulin therapy.
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Affiliation(s)
- Ahmed El-Abd Ahmed
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hala M Sakhr
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mostafa I El-Amir
- Department of Medical Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hesham H Ameen
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
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Xia Y, Xie Z, Huang G, Zhou Z. Incidence and trend of type 1 diabetes and the underlying environmental determinants. Diabetes Metab Res Rev 2019; 35:e3075. [PMID: 30207035 DOI: 10.1002/dmrr.3075] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/27/2018] [Accepted: 09/09/2018] [Indexed: 12/15/2022]
Abstract
A wealth of epidemiological studies concerning the distribution of type 1 diabetes (T1D) around the world have pointed to the appreciable variation in the incidence of T1D among disparate age groups, ethnicities, and geographical locations. On the whole, the incidence of childhood T1D has been on the rise, and a plausible inverse relationship between the initial incidence rate and the following annual increase in incidence has been raised. Countries that used to exhibit lower incidences tend to have steep annual increase whereas those with already-established high incidences are more likely to show a modest increase or even stabilization in T1D incidence. Environmental agents considered responsible for the current evolving pattern of T1D incidence will be detailed, mainly including the increasing prevalence of childhood obesity, viral infections in a chronic manner, maternal-child interaction such as breastfeeding, and latitude-ultraviolet B-vitamin D pathway. Certain rationale has been put forward in an attempt to explain the potential association between environmental agents and development of T1D. For instance, accelerator hypothesis regards insulin resistance as the promoter of earlier disease onset in obese children whereas the negative correlation of microbial infections in background populations with incidence of T1D represents the basic component of the hygiene hypothesis. Further investigations are still warranted to verify these theories across multiple ethnic groups and to identify additional contributors to the variation in T1D incidence.
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Affiliation(s)
- Ying Xia
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China
| | - Zhiguo Xie
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China
| | - Gan Huang
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China
| | - Zhiguang Zhou
- Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China
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20
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Abdel-Motal UM, G A, Abdelalim EM, Ponnuraja C, Iken K, Jahromi M, Doss GP, El Bekay R, Zayed H. Prevalence of nephropathy in type 1 diabetes in the Arab world: A systematic review and meta-analysis. Diabetes Metab Res Rev 2018; 34:e3026. [PMID: 29774648 DOI: 10.1002/dmrr.3026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/13/2018] [Accepted: 05/07/2018] [Indexed: 11/08/2022]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis and determine the prevalence of diabetic nephropathy (DN) among Arab patients with T1D. A systematic literature search was conducted using 4 different literature databases (PubMed, ScienceDirect, Web of Science, and Embase) to capture all relevant data about Arab patients with T1D that had DN. Meta-analysis and systematic review were performed using the random effect model, and the heterogeneity of the studies was assessed using the Q-test, I2, and Tau-squared statistics. Publication bias was assessed using the funnel-plot test. Our search strategy captured 372 studies in only 10 out of the 22 Arab countries in a period of 48 years (1969-2017); of which, 41 met our inclusion criteria for full article analysis, of those, 15 were eligible for meta-analysis. We estimated the prevalence of DN among Arab people with T1D to be 18.2% (95% confidence interval 13.1%-24.8%). In conclusion, DN prevalence is underexplored among Arab patients with T1D and represents a significant risk for the well-being of Arab patients with T1D. Therefore, there is an urgent need for comprehensive epidemiological studies for DN among Arab patients with T1D.
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Affiliation(s)
- Ussama M Abdel-Motal
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Akila G
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Essam M Abdelalim
- Diabetes Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Chinnaiyan Ponnuraja
- Department of Statistics, National Institute for Research in Tuberculosis, Chennai, India
| | - Khadija Iken
- Department of Medicine/Paediatrics', Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - George Priya Doss
- Department of Integrative Biology, School of Biosciences and Technology, VIT University, Vellore, India
| | - Rajaa El Bekay
- CIBER Pathophysiology of obesity and nutrition CB06/03, Carlos III Health Institute. Unidad de Gestion Clínica Intercentros de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
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Mahfouz EM, Kamal NN, Mohammed ES, Refaei SA. Effects of Mothers' Knowledge and Coping Strategies on the Glycemic Control of Their Diabetic Children in Egypt. Int J Prev Med 2018; 9:26. [PMID: 29619150 PMCID: PMC5869960 DOI: 10.4103/ijpvm.ijpvm_336_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/02/2017] [Indexed: 11/12/2022] Open
Abstract
Background: This study aimed to examine the relationship between mothers’ knowledge related to treatment management of type 1 diabetes (T1D), with perceptions of coping with diabetes-related stress and to examine the relationship between children's metabolic control and maternal coping. A cross-sectional study was done among ninety-two mothers of T1D children. Methods: Data were collected using a structured questionnaire, Ways of coping questionnaire (WCQ), and Diabetes Knowledge questionnaire-24 (DKQ-24). Results: The most important predictors of the total knowledge scores among mothers were father education (P < 0.0001), followed by child age and sex (P < 0.0001), while the most important coping scales affected by total knowledge scores was accepting responsibility (P = 0.01). There were positive correlation between HBA1C and escape-avoidance and positive reappraisal coping scales (r = 0.24, P = 0.02 and r = 0.23, P = 0.02, respectively). Blood glucose level was the most important clinical characteristics affecting the use of seeking social support coping scale among mothers. Conclusions: Parents with more knowledge of diabetes and with better education were able to cope more effective and maintain a better glycemic control of their diabetic children.
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Affiliation(s)
- Eman Mohamed Mahfouz
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nashwa Nabil Kamal
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Eman Sameh Mohammed
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Sara Ahmed Refaei
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
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Almahfoodh D, Alabbood M, Alali A, Mansour A. Epidemiology of type 1 diabetes mellitus in Basrah, Southern Iraq: A retrospective study. Diabetes Res Clin Pract 2017; 133:104-108. [PMID: 28926733 DOI: 10.1016/j.diabres.2017.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/01/2017] [Indexed: 12/31/2022]
Abstract
AIMS To investigate the epidemiology of type 1 diabetes mellitus (T1DM) in Basrah city, Southern Iraq, between 2012 and 2016 among people 0-40year old. METHODS This was a retrospective data analysis of electronic archives for patients with T1DM registered in Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), which is a tertiary referring Center in Basrah. The data include electronic database from August 2008 to February 2016. Incidence and prevalence rates are expressed per 100,000. Population of Basrah estimates were derived from official data of The Ministry of Planning of Iraq. RESULTS There were 2536 people registered at FDEMC. Of them 53.5% were males. The overall mean age at first diagnosis was 15.3±9years and it was significantly higher in males; p value 0.0005. The prevalence rate of T1DM in people 40years old and younger in 2016 was 87 per 100,000. Between 1 January 2012 and 31 December 2016, there were 818 identified new cases of T1DM. Of these, 417 (50%) were males. The average annual incidence rate of T1DM was 7.4 per 100,000 (95% CI, 7.1-8.1). CONCLUSIONS The incidence of T1DM in Basrah lies in the "intermediate group" according to DIAMOND project group classification. The incidence was increasing over the last three years. The data produced by this study provide a baseline for assessing future changes in the epidemiology of T1DM in Iraq.
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Affiliation(s)
| | - Majid Alabbood
- Faculty of Medicine and Health Sciences, Macquarie University, 2 Technology Place, 2113 New South Wales, Australia.
| | - Ahmed Alali
- Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah, Iraq.
| | - Abbas Mansour
- Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah, Iraq; Department of Medicine, College of Medicine, University of Basrah, Basrah, Iraq.
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Hassan NE, El-Masry SA, Khalil A. Standard body mass index reference data of prepubescent diabetic Egyptian children. J Pediatr Endocrinol Metab 2017; 30:909-915. [PMID: 28792911 DOI: 10.1515/jpem-2017-0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/03/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Data on the growth of diabetic children is conflicting. The aim of this study was to create and validate acceptable body mass index (BMI)-standardized percentiles and curves applied to Egyptian prepubescent diabetic children. METHODS The cross-sectional study comprised 822 prepubescent children with type 1 diabetes mellitus (T1DM), whose ages ranged from 3 years to 10 years±6 months. An anthropometric assessment for each child was performed: body weight, height and BMI were calculated (weight [kg]/height [m2]), and glycated hemoglobin levels were determined. Means±standard deviations (SDs) and the smoothed percentiles of the BMI from age 3-10 years, by sex, for total, controlled and uncontrolled diabetic children were calculated. Comparisons of the 50th percentiles for the controlled and uncontrolled diabetic children, by sex, with those of the Egyptian and World Health Organization (WHO) growth curves were made. RESULTS For controlled diabetic males and females, the 50th percentile BMI was higher than those of the Egyptian and WHO growth curves, while differences in BMI were recorded for uncontrolled diabetic males and females. For uncontrolled diabetic males, the BMI was lower than the standard Egyptian and WHO growth curves up to 5 years of age, after which it became higher than the standard WHO and lower than the standard Egyptian growth curves from 5 years up to 10 years of age. Contrary to that, the BMI of uncontrolled diabetic females was higher than the standard Egyptian and WHO growth curves up to 6.5 years, between the curves from 6.5 years up to 7.5 years and then became lower than both curves up to 10 years of age. CONCLUSIONS Children with T1DM should use their own BMI percentiles and never be compared with normal healthy children.
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Hamed S, Metwalley KA, Farghaly HS, Sherief T. Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis. J Child Neurol 2017; 32:475-481. [PMID: 28056586 DOI: 10.1177/0883073816686718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90 children (age 9.2 ± 3.4 years) with diabetic ketoacidosis. Neuron-specific enolase was measured at 3 time points (baseline and after 12 and 24 hours of starting treatment). Among patients, 74.4% had diagnosis of new diabetes, 60% had Glasgow Coma Scale score <15, and 75.6% had moderate/severe diabetic ketoacidosis. Compared with controls (n = 30), children with diabetic ketoacidosis had higher neuron-specific enolase levels at the 3 time points ( P = .0001). In multiple regression analysis, the factors associated with higher neuron-specific enolase levels were younger age, higher glucose, lower pH, and bicarbonate values. This study indicates that serum neuron-specific enolase is elevated in diabetic ketoacidosis and correlated with the severity of hyperglycemia, ketosis, and acidosis. This study indicates that diabetic ketoacidosis may cause neuronal injury from which the patients recovered partially but not completely.
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Affiliation(s)
- Sherifa Hamed
- 1 Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | | | - Hekma Saad Farghaly
- 2 Department of Pediatrics, Assiut University Children's Hospital, Assiut, Egypt
| | - Tahra Sherief
- 3 Department of Clinical Pathology, Assiut University Hospital, Assiut, Egypt
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Kim JH, Lee CG, Lee YA, Yang SW, Shin CH. Increasing incidence of type 1 diabetes among Korean children and adolescents: analysis of data from a nationwide registry in Korea. Pediatr Diabetes 2016; 17:519-524. [PMID: 26420382 DOI: 10.1111/pedi.12324] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/30/2015] [Accepted: 09/01/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The incidence of type 1 diabetes mellitus (T1DM) in children and adolescents has increased worldwide. However, the epidemiology of T1DM among Korean youth has not been reported since 2001. We investigated the incidence of T1DM in Korean children and adolescents from 2012 to 2014 and compared it with data from 1995 to 2000. PATIENTS AND METHODS Data were obtained from the National Health Insurance Service (NHIS) registry, and age- and sex-specific incidence rates were calculated per 100 000 population. RESULTS In total, 706 patients (326 boys and 380 girls, aged <15 yr) with T1DM were registered in the NHIS during 2012-2014. The incidence rate per 100 000 population was 3.19 (95% confidence interval [CI] 2.96-3.43). We found incidence rates of 1.68, 3.16, and 4.46 in children 0-4, 5-9, and 10-14 yr, respectively. The T1DM incidence was 2.84 in boys and 3.56 in girls. A higher T1DM incidence was seen during 2012-2014 than from 1995-2000 (incidence rate ratio 2.33; p < 0.001). The incidence rate ratios between 1995-2000 and 2012-2014 were 2.31, 2.20, and 2.27 in children 0-4, 5-9, and 10-14 yr, respectively. The annual increase in T1DM incidence was 5.6% (95% CI 5.0-6.3%) between 1995 and 2014. CONCLUSIONS We observed a significant increase in the T1DM incidence. This increase was higher in boys than in girls, and was highest in children aged 0-4 yr. Studies are needed to evaluate the long-term epidemiological trend of T1DM incidence.
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Affiliation(s)
- Jae Hyun Kim
- Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Chong Guk Lee
- Department of Pediatrics, Asan Chungmu Hospital, Asan-si, Korea
| | - Young Ah Lee
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Sei Won Yang
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Ho Shin
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
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Bahadoran Z, Ghasemi A, Mirmiran P, Azizi F, Hadaegh F. Nitrate-nitrite-nitrosamines exposure and the risk of type 1 diabetes: A review of current data. World J Diabetes 2016; 7:433-440. [PMID: 27795817 PMCID: PMC5065663 DOI: 10.4239/wjd.v7.i18.433] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/30/2016] [Accepted: 08/16/2016] [Indexed: 02/05/2023] Open
Abstract
The potential toxic effects of nitrate-nitrite-nitrosamine on pancreatic β cell have remained a controversial issue over the past two decades. In this study, we reviewed epidemiological studies investigated the associations between nitrate-nitrite-nitrosamines exposure, from both diet and drinking water to ascertain whether these compounds may contribute to development of type 1 diabetes. To identify relevant studies, a systematic search strategy of PubMed, Scopus, and Science Direct was conducted using queries including the key words “nitrate”, “nitrite”, “nitrosamine” with “type 1 diabetes” or “insulin dependent diabetes mellitus”. All searches were limited to studies published in English. Ecologic surveys, case-control and cohort studies have indicated conflicting results in relation to nitrate-nitrite exposure from drinking water and the risk of type 1 diabetes. A null, sometimes even negative association has been mainly reported in regions with a mean nitrate levels < 25 mg/L in drinking water, while increased risk of type 1 diabetes was observed in those with a maximum nitrate levels > 40-80 mg/L. Limited data are available regarding the potential diabetogenic effect of nitrite from drinking water, although there is evidence indicating dietary nitrite could be a risk factor for development of type 1 diabetes, an effect however that seems to be significant in a higher range of acceptable limit for nitrate/nitrite. Current data regarding dietary exposure of nitrosamine and development of type 1 diabetes is also inconsistent. Considering to an increasing trend of type 1 diabetes mellitus (T1DM) along with an elevated nitrate-nitrite exposure, additional research is critical to clarify potential harmful effects of nitrate-nitrite-nitrosamine exposure on β-cell autoimmunity and the risk of T1DM.
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Abo-el-Asrar M, Andrawes NG, Rabie MA, El-Gabry DA, Khalifa AG, El-Sherif M, Abdel Aziz K. Cognitive functions in children and adolescents with early-onset diabetes mellitus in Egypt. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 7:21-30. [DOI: 10.1080/21622965.2016.1224186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | - Nevine G. Andrawes
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Menan A. Rabie
- Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina Aly El-Gabry
- Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Abdel-Gawad Khalifa
- Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mariam El-Sherif
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Karim Abdel Aziz
- Psychiatry Department, College of Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates
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Abstract
Type 1 diabetes (T1D) is a complex autoimmune disorder that results from the T cell-mediated destruction of the pancreatic β cells and is due to interactions between environmental and genetic factors. Although Arabs have one of the highest global incidence and prevalence rates of T1D, unfortunately, there is a dearth of information regarding the genetic epidemiology of T1D in the Arab world. Arabs share several HLA haplotypes with other ethnic groups, which confer either susceptibility or protection to T1D, but they have specific haplotypes that are distinctive from other ethnicities. Among different Arab countries, several non-HLA genes were reported to be associated with susceptibility to T1D, including CTLA4, CD28, PTPN22, TCRβ, CD3z, IL15, BANK1, and ZAP70. In Arab countries, consanguinity, endogamy, and first-cousin marriage rates are some of the highest reported worldwide and are responsible for the creation of several inbreeding communities within the Arab world that have led to an increase in homozygosity of both the HLA haplotypes and non-HLA genes associated with either protection or susceptibility to T1D among Arabs. Homozygosity reduces the HLA complexity and is expected to facilitate our understanding of the mode of inheritance of HLA haplotypes and provide valuable insight into the intricate genotype-phenotype correlations in T1D patients. In this review, based on literature studies, I will discuss the current epidemiological profile and molecular genetic risks of Arabs with T1D.
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Affiliation(s)
- Hatem Zayed
- College of Health Sciences, Biomedical Program, Qatar University, Doha, Qatar.
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Zayed H. Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review. Int J Clin Pract 2016; 70:186-95. [PMID: 26842462 DOI: 10.1111/ijcp.12777] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS Diabetic ketoacidosis (DKA) is an acute and risky complication of type 1 diabetes. The aim of this study is to build the overall rate of DKA in Arab patients with type 1 diabetes in the 22 Arab nations. This is expected to tailor the healthcare approaches in Arab countries where attention is needed to save lives from the devastating consequences of DKA. METHODS The study here is a quantitative analysis of the articles indexed in four different scientific literature databases: Web of Science, PubMed, Science Direct and Scopus, from inception to June 2015. Arab patients with type 1 diabetes who presented with DKA have been captured. Key information was possible to extract for patients belong to only 12 Arab countries out of the 22 Arab patients. RESULTS Twenty-nine studies in 12 different Arab countries captured 4,688 type 1 diabetes patients with overall rates of 46.7% patients presented with DKA, ranging from a low of 17% in Egypt to a high of 100% in Morocco, Algeria and Tunisia. CONCLUSION This is the first descriptive quantitative study to determine the overall DKA rate in 46 years of studies in the Arab world of patients with type 1 diabetes; DKA rates were found to range from 17% to 100% with overall rate of 46.7%.
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Affiliation(s)
- H Zayed
- Department of Health Sciences, Biomedical Program, Qatar University, Doha, Qatar
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30
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Anbar M, Ammar H, Mahmoud RA. Corneal Endothelial Morphology in Children with Type 1 Diabetes. J Diabetes Res 2016; 2016:7319047. [PMID: 27429990 PMCID: PMC4939174 DOI: 10.1155/2016/7319047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 05/29/2016] [Indexed: 12/23/2022] Open
Abstract
Aim. To investigate corneal endothelial cell morphological in children with type 1 diabetes and to determine the systemic and local factors that contribute to these changes. Methods. One hundred sixty eyes of 80 children with type 1 diabetes and 80 eyes of 40 normal children as a control during the period from July 2015 to February 2016 underwent full clinical and ophthalmologic examination. We measured the central corneal thickness (CCT), endothelial cell density (ECD), ploymegathism, and pleomorphism using a noncontact specular microscope. Results. The mean age of the diabetic children was 8.22 ± 3.11 years. The mean duration of type 1 diabetes was 3.51 ± 2.23 years. The mean CCT was significantly higher: 537 ± 33.41 microns (right eye), in the diabetic group compared to the control group. The mean ECD in patients with type 1 diabetes was 3149.84 ± 343.75 cells/mm(2) (right eye), and it was significantly lower than in the control group. Furthermore, pleomorphism was significantly lower 48.73 ± 5.43% (right eye), in the diabetic group compared to the control group. The mean polymegathism was significantly higher 37.96 ± 5.61% (right eye), in the diabetic group compared to the control group. All of these changes are significantly correlated only with the duration of diabetes. Conclusions. Diabetic children have thicker corneas, lower ECD, an increased polymegathism, and a decreased pleomorphism. The duration of diabetes is the factor that affects all of these changes. To what extent these changes affect visional function on long term needs to be investigated in further studies.
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Affiliation(s)
- Mohamed Anbar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
| | - Hatem Ammar
- Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
| | - Ramadan A. Mahmoud
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag 82524, Egypt
- *Ramadan A. Mahmoud:
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Wojcik M, Sudacka M, Wasyl B, Ciechanowska M, Nazim J, Stelmach M, Starzyk JB. Incidence of type 1 diabetes mellitus during 26 years of observation and prevalence of diabetic ketoacidosis in the later years. Eur J Pediatr 2015; 174:1319-24. [PMID: 25894913 DOI: 10.1007/s00431-015-2537-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/31/2015] [Accepted: 04/02/2015] [Indexed: 02/07/2023]
Abstract
UNLABELLED The prevalence of type 1 diabetes (T1D) varies greatly between countries. However, over the past several decades, a global rise in the incidence of T1D in the pediatric population has been noted. The aim of our study was to investigate the incidence of T1D in children living in the Lesser Poland during the period of time from January 1, 1987, to December 31, 2012, and to analyze the demographic characteristics and occurrence of diabetic ketoacidosis (DKA) in patients with newly diagnosed T1D in the second part of the study (2006-2012). During 26 years, 636 children (331 boys, 305 girls) aged 0-14 years were newly diagnosed with T1D (0-4 years old, n = 131; 5-9 years old, n = 253, 10-14 years old, n = 252). The standardized incidence ratio (SIR) ranged significantly (p < 0.001) from 5.2/100,000/year in 1987 to 21.9/100,000/year in 2012. The highest SIR was observed in age group 5-9 years old (21.2) and the lowest in 0-4 years old (8.8). There was no association with sex or living in urban or rural area. On admission, DKA was diagnosed in 22.4 % of patients. There were no significant differences relating to the presence of DKA (p = 0.912) in subsequent years. CONCLUSIONS The incidence of T1D among children is increasing rapidly with the highest SIR in the 5-9 years old age group. DKA is still an important problem in the pediatric population. WHAT IS KNOWN • The incidence of pediatric type 1 diabetes mellitus in Europe is increasing. The initial manifestation of the type 1 diabetes mellitus is diabetic ketoacidosis. What is New: • This is the longest (26 years) continuous analysis of the incidence of type 1 diabetes in Poland and the first analysis focused on the incidence rate and also on presence of diabetic ketoacidosis.
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Affiliation(s)
- Malgorzata Wojcik
- Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. .,Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland.
| | - Malgorzata Sudacka
- Student's Scientific Group, Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland.
| | - Barbara Wasyl
- Student's Scientific Group, Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland.
| | - Marta Ciechanowska
- Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland.
| | - Joanna Nazim
- Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. .,Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland.
| | - Malgorzata Stelmach
- Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland.
| | - Jerzy B Starzyk
- Department of Pediatric and Adolecent Endocrinology, Chair of Pediatrics, Institute of Pediatrics, Jagiellonian University, Medical College, Krakow, Poland. .,Department of Pediatric and Adolecent Endocrinology, Children's University Hospital of Krakow, Krakow, Poland.
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Hassan NE, El-Kahky A, Hana MA, Abu Shady MM, Galal EM, Khalil A. Physical Growth and Body Composition of Controlled Versus Uncontrolled Type 1 Egyptian Diabetic Children. Open Access Maced J Med Sci 2014. [DOI: 10.3889/oamjms.2014.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Type 1 Diabetes Mellitus (T1DM) is one of the most common chronic endocrine disorders of childhood. Data on growth parameters of diabetic children is scarce.AIM: To assess growth and body composition in a group of diabetic children.SUBJECTS AND METHODS: 427 T1DM children (age 2-10 years) were recruited from Diabetic Paediatric Unit, outpatients' clinic of Abou El-Rish Hospital. Anthropometric and body composition parameters were taken and HbA1c was measured for all subjects.RESULTS:Â Highly significant difference was detected between controlled and uncontrolled groups as regard to weight/age z-score, height/age z-score, BMI z-score, triceps skin fold thickness, subscapular skin fold thickness, midupper arm circumference, fat mass, fat %, lean mass, and body water (p < 0.001). All values are higher in the controlled group than in the uncontrolled group. Uncontrolled subjects were significantly more at risk of being underweight and short, with odds ratio of 15.131 and 16.877 and 95% confidence interval 1.972-116.130 and 3.973-71.694 respectively. However, controlled subjects were significantly more at risk of being obese than the uncontrolled with an odds ratio 0.116 and 95% confidence interval 0.045-0.302.CONCLUSION: Growth was compromised in uncontrolled T1DM children. This is of utmost importance since most of the clinical features are reversible with better glycemic control and appropriate insulin management.
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