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Pasqua MR, Odabassian M, Tsoukas MA, Haidar A. Participant Experiences of Low-Dose Empagliflozin Use as Adjunct Therapy to Hybrid Closed Loop: Findings From a Randomized Controlled Trial. J Diabetes Sci Technol 2023; 17:1448-1455. [PMID: 37226831 PMCID: PMC10658702 DOI: 10.1177/19322968231176302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Very few patient-reported outcomes have been published in regard to opinions of individuals with type 1 diabetes concerning adjunctive therapy. The aim of this subanalysis was to qualitatively and quantitatively assess the thoughts and experiences of participants with type 1 diabetes who have used low doses of empagliflozin as an adjunct to hybrid closed-loop therapy. METHODS Semi-structured interviews were performed with adult participants who completed a double-blinded, crossover, randomized controlled trial using low-dose empagliflozin as an adjunct to hybrid closed-loop therapy. Participant experiences were captured through qualitative and quantitative methods. A descriptive analysis was performed using a qualitative approach; attitudes toward relevant topics were extracted from interview transcripts. RESULTS Twenty-four participants were interviewed; 15 (63%) perceived differences between interventions despite blinding, due to glycemic control or side effects. Advantages that arose were better glycemic control, in particular postprandially, requiring less insulin, and ease of use. Disadvantages were thought to be adverse effects, increased incidence of hypoglycemia, and increased pill burden. Thirteen (54%) participants were interested in using low-dose empagliflozin beyond the study. CONCLUSIONS Many participants had positive experiences with low-dose empagliflozin as an adjunct to the hybrid closed-loop therapy. A dedicated study with unblinding would be beneficial to better characterize patient-reported outcomes.
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Affiliation(s)
- Melissa-Rosina Pasqua
- Division of Endocrinology, Department
of Medicine, McGill University, Montréal, QC, Canada
- The Research Institute of the McGill
University Health Centre, Montréal, QC, Canada
- Division of Experimental Medicine,
Department of Medicine, McGill University, Montréal, QC, Canada
| | - Madison Odabassian
- The Research Institute of the McGill
University Health Centre, Montréal, QC, Canada
| | - Michael A. Tsoukas
- Division of Endocrinology, Department
of Medicine, McGill University, Montréal, QC, Canada
- The Research Institute of the McGill
University Health Centre, Montréal, QC, Canada
- Division of Experimental Medicine,
Department of Medicine, McGill University, Montréal, QC, Canada
| | - Ahmad Haidar
- Division of Endocrinology, Department
of Medicine, McGill University, Montréal, QC, Canada
- The Research Institute of the McGill
University Health Centre, Montréal, QC, Canada
- Division of Experimental Medicine,
Department of Medicine, McGill University, Montréal, QC, Canada
- Department of Biomedical Engineering,
McGill University, Montréal, QC, Canada
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Grgic O, Prijatelj V, Dudakovic A, Vucic S, Dhamo B, Trajanoska K, Monnereau C, Zrimsek M, Gautvik K, Reppe S, Shimizu E, Haworth S, Timpson N, Jaddoe V, Jarvelin MR, Evans D, Uitterlinden A, Ongkosuwito E, van Wijnen A, Medina-Gomez C, Rivadeneira F, Wolvius E. Novel Genetic Determinants of Dental Maturation in Children. J Dent Res 2023; 102:349-356. [PMID: 36437532 PMCID: PMC10083589 DOI: 10.1177/00220345221132268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Dental occlusion requires harmonious development of teeth, jaws, and other elements of the craniofacial complex, which are regulated by environmental and genetic factors. We performed the first genome-wide association study (GWAS) on dental development (DD) using the Demirjian radiographic method. Radiographic assessments from participants of the Generation R Study (primary study population, N1 = 2,793; mean age of 9.8 y) were correlated with ~30 million genetic variants while adjusting for age, sex, and genomic principal components (proxy for population stratification). Variants associated with DD at genome-wide significant level (P < 5 × 10-8) mapped to 16q12.2 (IRX5) (lead variant rs3922616, B = 0.16; P = 2.2 × 10-8). We used Fisher's combined probability tests weighted by sample size to perform a meta-analysis (N = 14,805) combining radiographic DD at a mean age of 9.8 y from Generation R with data from a previous GWAS (N2 = 12,012) on number of teeth (NT) in infants used as proxy of DD at a mean age of 9.8 y (including the ALSPAC and NFBC1966). This GWAS meta-analysis revealed 3 novel loci mapping to 7p15.3 (IGF2BP3: P = 3.2 × 10-8), 14q13.3 (PAX9: P = 1.9 × 10-8), and 16q12.2 (IRX5: P = 1.2 × 10-9) and validated 8 previously reported NT loci. A polygenic allele score constructed from these 11 loci was associated with radiographic DD in an independent Generation R set of children (N = 703; B = 0.05, P = 0.004). Furthermore, profiling of the identified genes across an atlas of murine and human stem cells observed expression in the cells involved in the formation of bone and/or dental tissues (>0.3 frequency per kilobase of transcript per million mapped reads), likely reflecting functional specialization. Our findings provide biological insight into the polygenic architecture of the pediatric dental maturation process.
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Affiliation(s)
- O. Grgic
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - V. Prijatelj
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - A. Dudakovic
- Department of Orthopedic Surgery, Mayo
Clinic, Rochester, MN, USA
| | - S. Vucic
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - B. Dhamo
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - K. Trajanoska
- Department of Human Genetics McGill
University, Montréal, Québec, Canada
- Canada Excellence Research Chair in
Genomic Medicine, McGill University, Montréal, Québec, Canada
| | - C. Monnereau
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - M. Zrimsek
- Department of Pathology, Medical
University of Vienna, Vienna, Austria
| | - K.M. Gautvik
- Department of Medical Biochemistry,
Oslo University Hospital, Oslo, Norway
| | - S. Reppe
- Department of Medical Biochemistry,
Oslo University Hospital, Oslo, Norway
| | - E. Shimizu
- Department of Oral Biology, Rutgers
School of Dental Medicine, Newark, NJ, USA
| | - S. Haworth
- Department of Population Health
Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol Dental School, University of
Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit,
University of Bristol, Bristol, UK
| | - N.J. Timpson
- Department of Population Health
Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit,
University of Bristol, Bristol, UK
| | - V.W.V. Jaddoe
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - M.-R. Jarvelin
- Faculty of Medicine, Center for Life
Course Health Research, University of Oulu, Oulu, Finland
- Faculty of Medicine, School of Public
Health, Imperial College, London, UK
| | - D. Evans
- MRC Integrative Epidemiology Unit,
University of Bristol, Bristol, UK
- Diamantina Institute, The University
of Queensland, Brisbane, Australia
- Institute for Molecular Bioscience,
The University of Queensland, Brisbane, Australia
| | | | - E.M. Ongkosuwito
- Dentistry, Section Orthodontics and
Craniofacial Biology, Radboud University Medical Center, Nijmegen, The
Netherlands
| | - A.J. van Wijnen
- Department of Biochemistry,
University of Vermont, Burlington, VT, USA
| | - C. Medina-Gomez
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - F. Rivadeneira
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
| | - E.B. Wolvius
- Department of Oral and Maxillofacial
Surgery, ErasmusMC, Rotterdam, The Netherlands
- The Generation R Study, ErasmusMC,
Rotterdam, The Netherlands
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Tomaszewski EL, Orchard TJ, Hawkins MS, Conway RB, Buchanich JM, Maynard J, Songer T, Costacou T. Predictors of Change in Skin Intrinsic Fluorescence in Type 1 Diabetes: The Epidemiology of Diabetes Complications Study. J Diabetes Sci Technol 2021; 15:1368-1376. [PMID: 33993770 PMCID: PMC8655295 DOI: 10.1177/19322968211014337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Skin intrinsic fluorescent (SIF) scores are indirect measures of advanced glycation end-products (AGEs). SIF scores are cross-sectionally associated with type 1 diabetes (T1D) complications such as increased albumin excretion rate (AER), coronary artery calcification (CAC) and neuropathy. We assessed predictors of SIF score change in those with T1D. METHODS Data from the 30-year longitudinal Epidemiology of Diabetes Complications (EDC) study of childhood-onset T1D were used to assess AGEs measured with a SIF score produced by the SCOUT DS® device. SIF scores were assessed twice in 83 participants: between 2007-08 and again between 2010-14. Regression analyses were used to assess independent predictors of SIF score change. RESULTS At baseline, mean age was 47.9 ± 6.9 years, diabetes duration was 36.7 ± 6.4 years, and median glycosylated hemoglobin (HbA1c) was 7.1 (interquartile range: 6.5, 8.5). During a mean follow-up of 5.2 ± 0.9 years, mean change in SIF score was 2.9 ± 2.8 arbitrary units. In multivariable linear regression models, log HbA1c (P < 0.001), log estimated glomerular filtration rate (eGFR) (P < 0.001), overt nephropathy (defined as AER ≥ 200 µg/min, P = 0.06), and multiple daily insulin shots/pump use (MDI) exposure years (P = 0.02) were independent predictors of SIF score change. CONCLUSIONS Increases in SIF score over 5 years were related to increased glycemic levels and decreased kidney function (eGFR). MDI and glomerular damage were related to a decreased SIF score. This is one of the first studies with repeated SIF assessments in T1D and provides unique, albeit preliminary, insight about these associations.
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Affiliation(s)
- Erin L. Tomaszewski
- Graduate School of Public Health
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Trevor J. Orchard
- Graduate School of Public Health
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marquis S. Hawkins
- Graduate School of Public Health
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jeanine M. Buchanich
- Graduate School of Public Health
Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Maynard
- Medical Device and Diagnostics
Consultant, Atlanta, GA, USA
| | - Thomas Songer
- Graduate School of Public Health
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina Costacou
- Graduate School of Public Health
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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Zhang X, Li F, Wang H, Mao Z, Li H, Wang J, Jia L. Attentional Blink Effects on S-Cone Stimuli. Iperception 2019; 10:2041669519830103. [PMID: 30828417 PMCID: PMC6390211 DOI: 10.1177/2041669519830103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/17/2019] [Indexed: 11/25/2022] Open
Abstract
This study aimed to compare attentional blink (AB) effects on S-cone and on luminance stimuli. Recent research had revealed considerable AB effects not only on high-order visual areas but also on low-order visual areas. Therefore, whether AB formation occurred or not at primary visual cortex must be examined. Previous studies had reported the absence of attention modulation in an early koniocellular pathway driven by S-cone stimuli; therefore, the AB effects on S-cone stimuli would be a strong piece of evidence for late-stage hypothesis at least in the koniocellular pathway. For this study, 12 participants were instructed to identify a centrally presented target (T1) only or to identify either T1 or a peripheral target (T2). The targets were either luminance or S-cone stimuli. As expected, comparable AB effects on S-cone and luminance stimuli were observed. Findings suggested that AB formation through a koniocellular pathway must occur at a later cortical processing stage.
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Affiliation(s)
- Xin Zhang
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
| | - Feiming Li
- Department of Psychology, Zhejiang Normal University, Jinhua, PR China
| | - Hui Wang
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
| | - Zhenghuan Mao
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
| | - HaiFeng Li
- The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, PR China
| | - Jun Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, PR China
| | - Lei Jia
- Department of Psychology, Zhejiang Normal University, Jinhua, PR China
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