scholarly journals Exercise-Induced Hypoglycemic Hemiplegia in a Child with Type 1 Diabetes: A Rare Find with Multiple Potential Causative Mechanisms

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
M. Constantine Samaan ◽  
Abeer Alassaf ◽  
Jonathan DellaVedova ◽  
Trisha Murthy
Keyword(s):  
Type 1 Diabetes ◽  
Motor Neurons ◽  
Intracellular Signaling ◽  
Rare Complication ◽  
Sudden Onset ◽  
The Body ◽  
Neurological Deficits ◽  
Oral Glucose ◽  
Normal Brain

A 10-year-old boy known to have type 1 diabetes presented to the emergency department with history of sudden onset of right-sided hemiplegia after exercise. He did not respond to oral glucose administration, but had an almost immediate resolution of symptoms with intravenous bolus of dextrose. Hemiplegic hypoglycemia is a rare complication in diabetic children, mostly affects the right side of the body, and is rarely recurrent. Children have normal brain imaging and angiography testing, and electroencephalogram may show slow-wave activity. The recovery takes place within 24 hours, and the prognosis is excellent with no focal neurological deficits noted. Our patient responded within minutes to intravenous dextrose, which is unusual and has not been reported previously. The mechanisms leading to development of hypoglycemic hemiplegia are unclear, but may involve effects of hypoglycemia on intracellular signaling pathways or molecules on motor neurons, as recent studies have shown normal brain cell glucose uptake and metabolism in hypoglycemia. While hypoglycemic hemiplegia is rare, it is a frightening experience to caregivers, and efforts should concentrate on its prevention by preventing hypoglycemia.

scholarly journals Insulin’s Discovery: New Insights on Its Hundredth Birthday: From Insulin Action and Clearance to Sweet Networks

2021 ◽  
Vol 22 (3) ◽  
pp. 1030
Author(s):  
Melanie Leroux ◽  
Martial Boutchueng-Djidjou ◽  
Robert Faure
Keyword(s):  
Type 1 Diabetes ◽  
Cell Surface ◽  
20Th Century ◽  
Insulin Action ◽  
100Th Anniversary ◽  
The Body ◽  
Nobel Lecture ◽  
Surface Receptors ◽  
The Third

In 2021, the 100th anniversary of the isolation of insulin and the rescue of a child with type 1 diabetes from death will be marked. In this review, we highlight advances since the ingenious work of the four discoverers, Frederick Grant Banting, John James Rickard Macleod, James Bertram Collip and Charles Herbert Best. Macleoad closed his Nobel Lecture speech by raising the question of the mechanism of insulin action in the body. This challenge attracted many investigators, and the question remained unanswered until the third part of the 20th century. We summarize what has been learned, from the discovery of cell surface receptors, insulin action, and clearance, to network and precision medicine.

The use of apple cider vinegar as a secondary treatment line with conventional diabetic treatment as a new medical hypothesis linking type 1 diabetes and type 2 diabetes

2021 ◽  
Vol 11 (2) ◽  
pp. 45-46
Author(s):  
Ahed J Alkhatib
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
The Body ◽  
Secondary Treatment ◽  
Therapeutic Approaches ◽  
Apple Cider ◽  
Treatment Line ◽  
Diabetic Treatment

The diabetes as a disease has been reported for 3500 years. Although diagnostic and therapeutic approaches have continuously developed, no definitive therapeutic approaches have so far been reached. Diabetes is not a single disease; it interferes with various systems in the body including nervous system and cardiovascular system. The therapeutic lines for type 1 diabetes start with insulin and will need another treatment such as metformin. On the other hand, type 2 diabetes treatment strategies start with metformin and there will be a need for another treatment, insulin according to the disease progression. At certain point, both types of diabetes are treated applying the same strategies. In this study, we followed another strategy by applying the use of apple cider vinegar in patient with type 1 diabetes, and patient with type 2 diabetes following getting each meal. The results showed that glucose levels were within reference range after five days. Taken together, the use of apple cider vinegar as a secondary treatment line with conventional diabetic treatment is promising and needs to be further investigated

scholarly journals Time to Peak Glucose and Peak C-Peptide During the Progression to Type 1 Diabetes in the Diabetes Prevention Trial and TrialNet Cohorts

2021 ◽  
Author(s):  
Michael G Voss ◽  
David D Cuthbertson ◽  
Mario M Cleves ◽  
Ping Xu ◽  
Carmella Evans-Molina ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Prevention ◽  
Prevention Trial ◽  
Oral Glucose ◽  
Z Score ◽  
C Peptide ◽  
Time To Peak ◽  
Diabetes Progression ◽  
Diabetes Development

<b>Objective:</b> To assess the progression of type 1 diabetes using time to peak glucose or C-peptide during oral glucose tolerance tests (OGTTs) in autoantibody positive (Ab+) relatives of people with type 1 diabetes. <p><b>Methods:</b> We examined 2-hour OGTTs of participants in the Diabetes Prevention Trial Type 1 (DPT-1) and TrialNet Pathway to Prevention (PTP) studies. We included 706 DPT-1 participants (Mean±SD age: 13.84±9.53 years; BMI-Z-Score: 0.33±1.07; 56.1% male) and 3,720 PTP participants (age: 16.01±12.33 Years, BMI-Z-Score 0.66±1.3; 49.7% male). Log-rank testing and Cox regression analyses with adjustments (age, sex, race, BMI Z-Score, HOMA-IR and peak Glucose/C-peptide levels, respectively) were performed. </p> <p><b>Results:</b> In each of DPT-1 and PTP, higher 5-year diabetes progression risk was seen in those with time to peak glucose >30 min and time to peak C-peptide >60 min (p<0.001 for all groups), before and after adjustments. In models examining strength of association with diabetes development, associations were greater for time to peak C-peptide versus peak C-peptide value (DPT-1: X<sup>2 </sup>= 25.76 vs. X<sup>2</sup> = 8.62 and PTP: X<sup>2 </sup>= 149.19 vs. X<sup>2</sup> = 79.98; all p<0.001). Changes in the percentage of individuals with delayed glucose and/or C-peptide peaks were noted over time.</p> <p><b>Conclusions: </b>In two independent at risk populations, we show that those with delayed OGTT peak times for glucose or C-peptide are at higher risk of diabetes development within 5 years, independent of peak levels. Moreover, time to peak C-peptide appears more predictive than the peak level, suggesting its potential use as a specific biomarker for diabetes progression. </p>

Cutaneous mucormycosis as a presenting feature of type 1 diabetes in a boy – case report and review of the literature

2018 ◽  
Vol 31 (6) ◽  
pp. 689-692
Author(s):  
Ganesh Jevalikar ◽  
Siddhnath Sudhanshu ◽  
Sanjay Mahendru ◽  
Smita Sarma ◽  
Khalid J. Farooqui ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rare Complication ◽  
Middle Finger ◽  
Surgical Debridement ◽  
Antifungal Treatment ◽  
Onset Of Diabetes ◽  
Cutaneous Mucormycosis ◽  
High Index Of Suspicion ◽  
Surgery Department

Abstract Background: Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen. Case presentation: We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture. Aggressive surgical debridement including amputation, antifungal treatment and glycemic control achieved a complete cure. Conclusions: Cutaneous mucormycosis is a rare complication of type 1 diabetes mellitus and can even be seen at the onset of diabetes. High index of suspicion, timely antifungal treatment and aggressive surgical debridement usually lead to recovery in the localized form of the disease.

scholarly journals Dynamic Rule-Based Algorithm to Tune Insulin-on-Board Constraints for a Hybrid Artificial Pancreas System

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Arthur Bertachi ◽  
Lyvia Biagi ◽  
Aleix Beneyto ◽  
Josep Vehí
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Infusion ◽  
Artificial Pancreas ◽  
The Body ◽  
Control Algorithms ◽  
Rule Based ◽  
Control Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels

The artificial pancreas (AP) is a system intended to control blood glucose levels through automated insulin infusion, reducing the burden of subjects with type 1 diabetes to manage their condition. To increase patients’ safety, some systems limit the allowed amount of insulin active in the body, known as insulin-on-board (IOB). The safety auxiliary feedback element (SAFE) layer has been designed previously to avoid overreaction of the controller and thus avoiding hypoglycemia. In this work, a new method, so-called “dynamic rule-based algorithm,” is presented in order to adjust the limits of IOB in real time. The algorithm is an extension of a previously designed method which aimed to adjust the limits of IOB for a meal with 60 grams of carbohydrates (CHO). The proposed method is intended to be applied on hybrid AP systems during 24 h operation. It has been designed by combining two different strategies to set IOB limits for different situations: (1) fasting periods and (2) postprandial periods, regardless of the size of the meal. The UVa/Padova simulator is considered to assess the performance of the method, considering challenging scenarios. In silico results showed that the method is able to reduce the time spent in hypoglycemic range, improving patients’ safety, which reveals the feasibility of the approach to be included in different control algorithms.

scholarly journals Liver disease in children and Adolescents with Type1 Diabetes Mellitus

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M H Elsayed ◽  
M T Hamza ◽  
M M Elsaeed ◽  
R A F Thabet
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Liver Disease ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Elevated Liver Enzymes ◽  
Liver Transaminases

Abstract Glycogenic hepatopathy (GH) is a very rare complication seen mostly in patients with type 1 diabetes mellitus (T1DM) in whom glycemic control has been poor for a long time. We assessed liver diseases in children and adolescents with type 1 diabetes mellitus by detection of elevated liver transaminases and confirmed by fibro scan and ultrasound. One hundred and seven children and adolescents with T1DM were subjected to detailed history, physical examination, laboratory investigation and radiological investigation. Liver transaminases, mean HbA1c and pelviabdominal ultrasound were done for all patients while fibro scan for those with elevated liver enzymes only. Patients with elevated liver enzymes were reassessed after one year. Only nine of our patients have elevated liver enzymes. HbA1c and fibro scan abnormalities (F stage) were significantly higher in patients with elevated liver enzymes. (p &lt; 0.001) After follow up a significant decrease in liver enzymes, fibro scan abnormalities and HbA1c in the group with elevated liver enzymes initially was detected. (p &lt; 0.001) We concluded that liver disease is not a common complication in patients with long standing uncontrolled diabetes which can be reversed after proper control.

scholarly journals A very rare complication of type 1 diabetes: insulin edema developed in a newly diagnosed type 1 diabetes

2013 ◽  
Vol 48 (1) ◽  
pp. 62-64
Author(s):  
Tolga Altug Sen ◽  
Aysegul Bukulmez ◽  
Adnan Narci ◽  
Meltem Ugras ◽  
Ozlem Guraksin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rare Complication ◽  
Newly Diagnosed

scholarly journals Associations of HbA1c with the timing of C‐peptide responses during the oral glucose tolerance test at the diagnosis of type 1 diabetes

2019 ◽  
Vol 20 (4) ◽  
pp. 408-413
Author(s):  
Heba M. Ismail ◽  
Carmella Evans‐Molina ◽  
Linda A. DiMeglio ◽  
Dorothy J. Becker ◽  
Ingrid Libman ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
C Peptide
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