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Edwards K, Uruska A, Duda-Sobczak A, Zozulinska-Ziolkiewicz D, Lingvay I. Patient-perceived benefits and risks of off-label use of SGLT2 inhibitors and GLP-1 receptor agonists in type 1 diabetes: a structured qualitative assessment. Ther Adv Endocrinol Metab 2023; 14:20420188231180987. [PMID: 37440840 PMCID: PMC10334016 DOI: 10.1177/20420188231180987] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/19/2023] [Indexed: 07/15/2023] Open
Abstract
Background Patients with type 1 diabetes mellitus (T1DM) may have suboptimal glucose control and are interested in the use of adjuvant therapies. Objectives To determine, from the patients' perspective, the reasons for initiation of glucagon-like peptide 1 receptor agonist (GLP-1RA) and/or sodium glucose cotransporter 2 inhibitor (SGLT2i) in treating T1DM; perceived benefits/side effects, reasons for discontinuation, and willingness to reinitiate therapy. Design Retrospective chart review with structured telephone interviews. Methods We identified patients with T1DM treated with a GLP-1RA and/or SGLT2i for >3 months at University of Texas Southwestern Medical Center (Dallas, TX, USA) and Poznan University (Poznan, Poland). We conducted structured telephone interviews regarding their experiences. Results We interviewed 68 participants treated with GLP-1RA and 82 with SGLT2i. Treatment was initiated for improving glycemic control (as reported by 61.8% versus 81.7% of GLP-1RA and SGLT2i users, respectively), weight loss/appetite suppression (51.4% versus 23.2%) and to reduce insulin requirement (13.2% versus 11%). Most participants (86.8% of GLP-1RA and 89.0% of SGLT2i users) reported ⩾1 benefit attributed to therapy. Reported benefits were improved glycemic control (reported by 58.8% versus 82.9% of GLP-1RA and SGLT2i users, respectively), weight loss/appetite suppression (63.2% versus 30.5%), and reduced insulin requirement (27.9% versus 34.1%). More GLP-1RA users reported side effects versus SGLT2i users (63.2% versus 36.6%); 22.6% discontinued GLP-1RA due to side effects versus 11.0% SGLT2i users. Diabetic ketoacidosis (DKA) was reported by 4.9% of SGLT2i users, but none in GLP-1RA users. Of those who discontinued medication, 60.7% of GLP-1RA versus 56.0% of SGLT2i prior users were willing to reinitiate treatment. Conclusions Patients with T1DM report initiating adjuvant treatment with GLP-1RA and/or SGLT2i to improve glycemic control and lose weight; most patients reported perceived benefits from these therapies. Side effects (including DKA) are reported more commonly in real life than in clinical trials. Given patient interest in these medications, further studies should evaluate the long-term risk-benefits ratio in larger cohorts.
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Affiliation(s)
| | - Aleksandra Uruska
- Department of Internal Medicine and
Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Duda-Sobczak
- Department of Internal Medicine and
Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Ildiko Lingvay
- Department of Internal Medicine/Endocrinology,
Department of Population and Data Sciences, University of Texas Southwestern
Medical Center, Dallas, TX, USA
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Duda-Sobczak A, Zozulinska-Ziolkiewicz D, Wyganowska M. Better Gingival Status in Patients with Comorbidity of Type 1 Diabetes and Thyroiditis in Comparison with Patients with Type 1 Diabetes and No Thyroid Disease-A Preliminary Study. Int J Environ Res Public Health 2023; 20:3008. [PMID: 36833702 PMCID: PMC9963864 DOI: 10.3390/ijerph20043008] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Periodontal disease has been postulated as one of the chronic complications of diabetes. The prevalence of autoimmune thyroiditis in type 1 diabetes (T1D) is higher. The aim of the study was to determine the association between the presence of thyroiditis and gingival status in adults with T1D. A total of 264 patients, 119 men aged 18-45, diagnosed with T1D were included. For further analysis, the study group was divided into two subgroups, with or without autoimmune thyroiditis. Gingival status was assessed with the use of gingival indices. Patients diagnosed with T1D and thyroiditis presented lower plaque accumulation (p = 0.01) and lower-grade gingivitis (p = 0.02). Approximal Plaque Index (API) in all study groups correlated positively with age (Rs = 0.24; p = 0.0001), body mass index (BMI) (Rs = 0.22; p = 0.0008), hemoglobin A1c (HbA1c) (Rs = 0.18; p = 0.006), high-sensitivity C-Reactive Protein (hsCRP) (Rs = 0.17; p = 0.009), total cholesterol (T-Chol) (Rs = 0.17; p = 0.01) and negatively with thyroid-stimulating hormone (TSH) (Rs = -0.2; p = 0.02). Stepwise multivariate linear regression analysis indicated TSH, BMI and gender as independent predictors of dental plaque accumulation in patients with T1D. Autoimmune thyroiditis was associated with a lower accumulation of dental plaque and better gingival status in patients with T1D.
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Affiliation(s)
- Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, 60-830 Poznan, Poland
| | - Dorota Zozulinska-Ziolkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, 60-830 Poznan, Poland
| | - Marzena Wyganowska
- Chair and Department of Dental Surgery, Periodontology and Oral Mucosa Diseases, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
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3
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Krawczyk J, Duda-Sobczak A, Zozulińska-Ziółkiewicz D. Fear of hypoglycaemia — from normality to pathology. Diagnostic criteria and therapeutic directions. Clinical Diabetology 2020. [DOI: 10.5603/dk.2020.0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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4
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Falkowski B, Duda-Sobczak A, Araszkiewicz A, Chudzinski M, Urbas M, Gajewska E, Borucki L, Zozulinska-Ziolkiewicz D. Insulin resistance is associated with impaired olfactory function in adult patients with type 1 diabetes: A cross-sectional study. Diabetes Metab Res Rev 2020; 36:e3307. [PMID: 32129918 DOI: 10.1002/dmrr.3307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/26/2020] [Accepted: 02/27/2020] [Indexed: 01/13/2023]
Abstract
AIM To investigate whether insulin resistance is a predictor for decreased olfactory function in adult type 1 diabetes patients (T1DM). MATERIALS AND METHODS The following parameters were examined in the group of 113 T1DM participants: body mass index (BMI), waist-hip ratio (WHR), TG/HDL ratio, glycated hemoglobin (HbA1c ), visceral fat (VF) in body bioimpedance, specific calculators (eGDR, VAI). Bilateral olfactory test score (BOTS) was performed using 12-odour-tests from Sniffin' Sticks. Then participants were allocated to one of two groups: normosmia (10-12 odours identified) or hyposmia/anosmia (0-9 odours). The association between BOTS and insulin resistance indicators was analyzed using: Spearman's rank correlation, multivariate linear regression analysis, and receiver operating characteristic (ROC) curve. RESULTS 49.6% participants were diagnosed with hyposmia/anosmia, median BOTS was 10. BOTS correlated significantly with: WHR, TG, VF index, TG/HDL ratio, VAI, and eGDR. In multivariate linear regression analysis higher WHR turned out to be statistically significant independent predictor of lower BOTS (β = -0.36; P = .005) after adjustment for age, sex, TG and peripheral neuropathy (R2 = 0.19; P = .0005). The ROC analysis indicated a WHR cut-off of 0.92 [area under the ROC curve (AUC): 0.737; 95% confidence interval (CI): 0.647-0.828, P < .0001] as the best among evaluated factors significantly affecting hyposmia/anosmia occurrence (sensitivity of this cut-off 0.50 and specificity 0.86). CONCLUSIONS We have provided evidence of an association between lowered insulin sensitivity expressed in bioelectrical impedance analysis, anthropometrical (WHR), laboratory (TG/HDL ratio) measurements, specific calculators (eGDR, VAI) and deteriorated olfactory function.
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Affiliation(s)
- Bogusz Falkowski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Araszkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Chudzinski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Urbas
- Department of Otorhinolaryngology, Raszeja City Hospital, Poznan, Poland
| | - Ewa Gajewska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Lukasz Borucki
- Department of Otorhinolaryngology, Raszeja City Hospital, Poznan, Poland
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Wyganowska-Swiatkowska M, Duda-Sobczak A, Corbo A, Matthews-Brzozowska T. Atelocollagen Application in Human Periodontal Tissue Treatment-A Pilot Study. Life (Basel) 2020; 10:life10070114. [PMID: 32708681 PMCID: PMC7400082 DOI: 10.3390/life10070114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of this study is the clinical observation of gingival tissue condition after atelocollagen injection. Methods: In 18 patients, 97 gingival class I Miller recessions were divided according to recession height, gingival papillae loss and thickness of gingivae. Atelocollagen (Linerase, 100 mg) was injected into keratinized gingivae twice or thrice, at two-week intervals. Results: Statistically significant changes in gingival recession, amount of gingival papillae loss and thickness of gingiva were observed, after both two and three collagen injections. Although the degree (height) of recession decreased and gingival tissue thickness increased with every injection; there was no difference in gingival papillae loss between second and third collagen injections. Conclusions: The injectable form of atelocollagen is a promising material for gingival soft tissue regeneration and stimulation and allows for reduction in the number of procedures and support in a variety of surgical scenarios. This is a pilot study that clinically measures the impact of injected atelocollagen on periodontal tissue biotype, including the thickness of gingivae and gingival papillae regeneration.
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Affiliation(s)
- Marzena Wyganowska-Swiatkowska
- Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
- Correspondence:
| | - Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Mickiewicza 2, 60-830 Poznan, Poland;
| | - Andrea Corbo
- Private Practice Medical Spa, Via Cassia 1840, 00123 Rome, Italy;
| | - Teresa Matthews-Brzozowska
- The Chair and Clinic of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
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Duda-Sobczak A, Falkowski B, Araszkiewicz A, Zozulinska-Ziolkiewicz D. Association Between Self-reported Physical Activity and Skin Autofluorescence, a Marker of Tissue Accumulation of Advanced Glycation End Products in Adults With Type 1 Diabetes: A Cross-sectional Study. Clin Ther 2018; 40:872-880. [DOI: 10.1016/j.clinthera.2018.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/22/2018] [Indexed: 01/03/2023]
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Tarnowski M, Duda-Sobczak A, Lipski J, Zozulinska-Ziolkiewicz D, Wyganowska-Swiatkowska M. Tobacco smoking decreases clinical symptoms of gingivitis in patients with type 1 diabetes-a cross-sectional study. Oral Dis 2018; 24:1336-1342. [PMID: 29757485 DOI: 10.1111/odi.12889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/23/2018] [Accepted: 04/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Periodontal disease may develop on the background of microvascular complications of diabetes. However, some modifying factors, such as tobacco smoking, should be taken into consideration when assessing risk of development of chronic complications. The aim of the study was the clinical assessment of the periodontal status in patients with type 1 diabetes according to tobacco smoking. SUBJECTS AND METHODS A total of 362 subjects aged 29 (IQR 22-35) years, type 1 diabetes duration 12 (8-18) years, hemoglobin A1c, HbA1c 8.0 (7.2-9.1)% were included. We used Gingival Index, Approximal Plaque Index, and Sulcus Bleeding Index to assess periodontal health. Patients were divided into two subgroups according to current cigarette smoking. RESULTS No differences in age, diabetes duration, and chronic complications were found between subgroups. A better metabolic control of diabetes expressed by lower HbA1c (p = 0.00001) and triglyceride levels (p = 0.004) was shown in nonsmokers. Smokers presented significantly lower gingival bleeding, p = 0.009. HbA1c correlated with API in study group (Rs = 0.16; p = 0.002) and in nonsmokers subgroup (Rs = 0.2;p = 0.004), however, not in smoker's subgroup. In multivariable regression analysis, smoking cigarettes (β = -0.26; p = 0.0002), hs-CRP (β = 0.15; p = 0.03) and age (β = -0.19; p = 0.007) occurred to be independent predictors of SBI after adjustment for confounding variables (R2 = 0.13; p = 0.001). CONCLUSIONS Patients with type 1 diabetes smoking cigarettes presented lower gingival sulcus bleeding and worse metabolic control of diabetes than nonsmoking patients.
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Affiliation(s)
- Mateusz Tarnowski
- Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jakub Lipski
- Department of Dental Surgery and Periodontology, Poznan University of Medical Sciences, Poznan, Poland
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Duda-Sobczak A, Zozulinska-Ziolkiewicz D, Wyganowska-Swiatkowska M. Type 1 Diabetes and Periodontal Health. Clin Ther 2018; 40:823-827. [PMID: 29429766 DOI: 10.1016/j.clinthera.2018.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/20/2018] [Accepted: 01/23/2018] [Indexed: 02/02/2023]
Abstract
It is well established that hyperglycemia affects periodontal outcomes. A body of evidence, predominantly over the past 20 years supports significant independent associations between periodontal disease and glycemic control or complications of diabetes. Association between periodontal tissue and hyperglycemia is possible through altered cellular immunity, increased proliferation of bacteria, microangiopathy, and formation of the advanced glycation end products. However, most studies focus solely on patients with type 2 diabetes or diabetes in general. There is still the paucity of data concerning patients with type 1 diabetes (T1D). Here, the authors consider the possible mechanisms linking periodontal disease with diabetes, focusing mainly on T1D and discuss possible diagnostic and therapeutic approaches.
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Affiliation(s)
- Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
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9
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Duda-Sobczak A, Lipski J, Tarnowski M, Surdacka A, Zozulińska-Ziółkiewicz D, Wyganowska-Świątkowska M. Association of skin autofluorescence with periodontal inflammation in adults with type 1 diabetes. Pol Arch Intern Med 2017; 127:708-711. [PMID: 29162792 DOI: 10.20452/pamw.4129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Falkowski B, Chudziński M, Jakubowska E, Duda-Sobczak A. Association of olfactory function with the intensity of self-reported physical activity in adults with type 1 diabetes. Pol Arch Intern Med 2017; 127:476-480. [PMID: 28817540 DOI: 10.20452/pamw.4073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Olfactory function is impaired in patients with type 1 diabetes and can be recognized as a form of diabetic neuropathy. Physical activity has various beneficial effects on type 1 diabetes. OBJECTIVES The aim of this study was to assess a relation between physical activity and olfactory function in patients with type 1 diabetes. PATIENTS AND METHODS We enrolled 120 patients with type 1 diabetes referred to an outpatient diabetes clinic. Patients with diabetes duration of less than 5 years, age above 65 years, concomitant diabetic ketoacidosis, and those using drugs affecting nasal mucosa were excluded. The final study sample included 90 patients. A control group comprised 22 healthy participants. Olfactory function was assessed using 12 odor‑emitting apens called Sniffin' Sticks. Physical activity was measured using the short version of the International Physical Activity Questionnaire (IPAQ‑SF). RESULTS There was a significant difference in the occurrence of hyposmia between diabetic patients and healthy controls (70.0% vs 45.5%, respectively; P = 0.03). There were no significant differences in IPAQ‑SF results between the groups. Moreover, IPAQ‑SF results correlated positively with olfactory test scores (r = 0.25; P = 0.02) and negatively with age. Additionally, patients with retinopathy and autonomic neuropathy obtained lower IPAQ‑SF scores than patients without those complications. A stepwise multivariable linear regression analysis indicated IPAQ scores, body mass index, and peripheral neuropathy as predictors of the olfactory test score (R = 0.2). CONCLUSIONS Our study confirms the beneficial role of physical activity in type 1 diabetes within the structures of the central nervous system.
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Duda-Sobczak A, Zozulińska-Ziółkiewicz D, Wierusz-Wysocka B. Prevalence of depressive symptoms and diagnosed depression among subjects with longstanding type 1 diabetes and no serious chronic complications, hospitalized due to inadequate metabolic control of diabetes. Clinical Diabetology 2017. [DOI: 10.5603/dk.2016.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gawrecki A, Naskret D, Niedzwiecki P, Duda-Sobczak A, Araszkiewicz A, Zozulinska-Ziolkiewicz D. High-intensity Exercise in Men with Type 1 Diabetes and Mode of Insulin Therapy. Int J Sports Med 2017; 38:329-335. [PMID: 28255965 DOI: 10.1055/s-0042-123046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to evaluate the impact of high intensity exercise on glucose levels and risk of metabolic decompensation in males with type 1 diabetes (T1D), depending on the method of insulin administration. The study comprised 29 males (aged 25.3±5.1 years; duration of diabetes 10.3±3.2 years) treated with continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injections (MDI). Treadmill exercise test was performed twice in each patient until subjective exhaustion as maximum according to the Borg scale. All the patients achieved ≥85% of the maximal heart rate. Distance during the test was 4 500±1 400 m and 4 473±1 559 m in the MDI and CSII groups, respectively, which was achieved in 31±8 min. During the test and in the 6 h after, no clinically significant episodes of hypoglycemia occurred. Mean glucose levels did not exceed 10 mmol/L in most patients. The risk of the composite endpoint (hypoglycemia<3.8 mmol/L, hyperglycemia≥16.6 mmol/L, ketones≥0.6 mmol/L, and lactate>2.2 mmol/L) was higher in patients treated with MDI than CSII (OR3.75, 95%CI:1.22-11.52, p=0.02). In conclusion, planned high intensity physical effort in men with well-controlled T1D is metabolically safe. CSII shows greater metabolic advantage over MDI during and after high intensity exercise in men with T1D.
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Affiliation(s)
- Andrzej Gawrecki
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Dariusz Naskret
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Pawel Niedzwiecki
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Duda-Sobczak
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Araszkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
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Duda-Sobczak A, Araszkiewicz A, Urbas M, Borucki L, Kulas K, Chudzinski M, Suwalska A, Zozulinska-Ziolkiewicz D. Impaired olfactory function is related to the presence of neuropathy in adults with type 1 diabetes. Diab Vasc Dis Res 2017; 14:139-143. [PMID: 28103703 DOI: 10.1177/1479164116679079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Olfactory dysfunction is suggested to be a clinical manifestation of central diabetic neuropathy. The aim of the study was to assess olfactory function in adult patients with type 1 diabetes. MATERIALS AND METHODS A total of 106 patients with type 1 diabetes and 30 healthy subjects were included in the study. We evaluated the metabolic control of diabetes and the presence of chronic complications. Olfactory function was assessed with Sniffin' Sticks. RESULTS We found a negative correlation between olfactory identification scores and body mass index ( Rs -0.2; p = 0.04) and triglycerides ( Rs = -0.2; p = 0.04). We showed lower olfactory identification scores in neuropathy group versus non-neuropathy group [8 (interquartile range, 7-9) vs 10 (interquartile range, 9-11) points; p = 0.005]. In multivariate linear regression, impaired olfaction was independently associated with neuropathy (beta, -0.3; p = 0.005). In multivariate logistic regression, diabetes duration (odds ratio, 1.06; 95% confidence interval, 1.00-1.11; p = 0.04) and olfactory identification score (odds ratio, 0.61; 95% confidence interval, 0.43-0.85; p = 0.003) were independently associated with neuropathy. CONCLUSION Olfactory dysfunction is observed in patients with type 1 diabetes and diabetic peripheral neuropathy.
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Affiliation(s)
- Anna Duda-Sobczak
- 1 Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Araszkiewicz
- 1 Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Urbas
- 2 Department of Otorhinolaryngology, Raszeja City Hospital, Poznań, Poland
| | - Lukasz Borucki
- 2 Department of Otorhinolaryngology, Raszeja City Hospital, Poznań, Poland
| | - Katarzyna Kulas
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Chudzinski
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksandra Suwalska
- 3 Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
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Wyganowska-Świątkowska M, Duda-Sobczak A, Tarnowski M, Lipski J, Surdacka A, Zozulińska-Ziółkiewicz D. [The assessment of periodontal status in smoking and non-smoking patients with type 1 diabetes]. Przegl Lek 2016; 73:750-753. [PMID: 29689677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Chronic microvascular complications of type 1 diabetes relate to small and medium-sized vessels and clinically manifest as retinopathy, nephropathy and neuropathy as well as periodontitis. Cigarette smoking significantly modifies the course of inflammation in subjects without diabetes. The aim of the study was to assess the periodontal status in smoking and non-smoking subjects with type 1 diabetes. MATERIALS AND METHODS 115 subjects with type 1 diabetes, median age 32 years (IQR 25-38), median HbA1c 8.3% (7.4-9.4) were included. Assessed gingival indices comprised API, SBI, GI. RESULTS Smoking cigarettes was more frequent among men compared to women (p = 0.03). API was lower among women compared to men (p = 0.004). There was no correlation between HbA1c and gingival indexes, however, people achieving good metabolic control (HbA1c≤6.5%) had a lower API (p = 0.039). Smokers presented lower SBI compared to non- -smokers (p = 0.03). CONCLUSIONS People with type 1 diabetes smoking cigarettes present lower gingival bleeding compared to non-smokers. In people with poor metabolic control of type 1 diabetes there is an increased accumulation of dental plaque in comparison with well-controlled type 1 diabetic patients.
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Duda-Sobczak A, Wierusz-Wysocka B. [Diabetes mellitus and psychiatric diseases]. Psychiatr Pol 2011; 45:589-598. [PMID: 22232984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Metabolic disorders, especially diabetes mellitus, occur more often in patients diagnosed with psychiatric diseases than in the general population. The suggested reasons include common environmental factors, like a lifestyle leading to obesity and insulin resistance, social and economic status. Moreover, these disorders partially share a common genetic background. The influence of antipsychotic therapy itself also plays an important role. An increased risk of metabolic disorders, like glucose dysregulation, dyslipidemia or weight gain, exists during antipsychotic treatment. These drugs influence the hypothalamic regions controlling food intake, impair the insulin release by beta cells or induce insulin resistance. Therefore the choice of antipsychotic drug should be dependent on the actual patient's metabolic status and his comorbidities. Patients treated with antipsychotics should be screened for several metabolic disorders. Periodic checks for abnormalities of body weight, waist circumference, blood glucose or lipid profile are recommended in these patients. Any abnormality noticed during such a check is the indication for antipsychotic treatment modification and adequate metabolic disorder treatment.
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Affiliation(s)
- Anna Duda-Sobczak
- Katedra i Klinika Chorób Wewnetrznych i Diabetologii UM im. K. Marcinkowskiego w Poznaniu
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