scholarly journals Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Gry Høst Dørflinger ◽  
Charlotte Brink Holt ◽  
Steffen Thiel ◽  
Jakob Appel Østergaard ◽  
Troels Krarup Hansen
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Mannan Binding Lectin ◽  
Improved Glycaemic Control ◽  
Binding Lectin

Objective. Mannan-binding lectin (MBL) concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes. Methods. We measured MBL, fructosamine, and HbA1cat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy. Results. After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, P<0.0001). There was a significant decrease in HbA1c from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, P<0.0001) and in fructosamine levels (from 356 μmol/L to 311 μmol/L, P<0.0001). MBL levels decreased by 10% from 2165 μg/L (IQR 919–3389 μg/L) at baseline to 1928 μ/L (IQR 811–2758 μg/L) at follow-up (P=0.005), but MBL change was not significantly correlated with changes in insulin dose, HbA1c, or fructosamine. Conclusions. MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.

scholarly journals Insulin pump therapy of type 1 diabetes mellitus in children and adolescents in the Moscow region

2009 ◽  
Vol 12 (3) ◽  
pp. 60-63
Author(s):  
Elena Efimovna Petryaykina ◽  
Olga Viktorovna Dukhareva ◽  
Irina Georgievna Rybkina ◽  
Ekaterina Alexandrovna Pronina ◽  
Tatiana Dmitrievna Mikhaylova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Daily Insulin Dose

Aim. To assess dynamics of glycated hemoglobin levels and insulin doses per kg bw in children and adolescents with poorly controlled type 1 diabetes mellitus using insulin pumps. Materials and methods. Retrospective analysis of HbA1c levels and insulin doses per kg bw in children aged 2-17 years with DM1 (mean duration 5.3?3.1) before and 18 months after onset of insulin pump therapy (Medtronic Minimed 712 and 722) with a short-acting insulin analog Novopramid (Novo Nordisk) or Humalog (Ely Lilly) given to 55 (52,4%) and 50 (47,6%) of the patients respectively. НbА1с level and mean daily insulin dose per kg bw were determined when a patient visited the doctors office every 3 months. Results. Insulin pump therapy in patients with initially poorly controlled DM1 resulted in a decrease of HbA1c from 9.8?0.8 to 7,8?0,5% within 18 months after its beginning (p

scholarly journals Sex differences over time for glycemic control, pump use and insulin dose in patients aged 10–40 years with type 1 diabetes: a diabetes registry study

2021 ◽  
Vol 9 (2) ◽  
pp. e002494
Author(s):  
Claudia Boettcher ◽  
Sascha R Tittel ◽  
Thomas Meissner ◽  
Bettina Gohlke ◽  
Rainer Stachow ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Sex Differences ◽  
Glycemic Control ◽  
Metabolic Control ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Migrant Background

IntroductionTo evaluate sex differences in people with type 1 diabetes concerning changes in glycemic control and trends in insulin pump use and insulin dose over two decades in adolescents and one-and-a-half decades in adults.Research design and methodsPeople aged 10–20 years (data years 1999–2018) and 21–40 years (data years 2004–2018) with type 1 diabetes were identified in the Diabetes Prospective Follow-up Registry (DPV). All available patients’ data sets of the respective period were used for linear regression analyses to investigate trends in HbA1c, pump use, insulin doses and body mass index SD scores (BMI-SDS) in females and males. In addition, stratification by migrant background was made for the adolescent group.ResultsIn the youth group (n=68 662), both boys and girls showed an HbA1c decrease over the period examined. After stratification for migrant background, an HbA1c convergence between boys and girls was seen in those without migrant background as of 2016. Usage of insulin pumps increased continuously from 3% (boys and girls) to 47% (boys) and 54% (girls), respectively. The daily insulin dose in units per kilogram body weight and day increased continuously from 1999 to 2018. An insulin dose leveling between boys and girls occurred. BMI-SDS consistently increased in girls whereas only slight variations were observed in boys.The adult group (n=15 380) showed constant HbA1c sex differences from 2004 to 2018 with lower HbA1c level in females. The use of insulin pump therapy rose from 18% to 35% (males) and 30% to 50% (females).ConclusionsThe gap in metabolic control between boys and girls with type 1 diabetes seems to close, but predominantly in adolescents without a migrant background. Improved HbA1c was associated with increased insulin pump use, especially in girls.In adult patients, sex differences in metabolic control and insulin pump use persist: women show constantly lower HbA1c values and higher insulin pump use.

330-OR: A 30% Increased Insulin Dose Is Necessary to Control Postprandial Hyperglycemia for High Protein Meals in Individuals with Type 1 Diabetes Using Insulin Pump Therapy

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 330-OR
Author(s):  
MEGAN A. PATERSON ◽  
CARMEL E. SMART ◽  
JORDAN RAFFERTY ◽  
BRETT FENTON ◽  
DARRELL PRICE ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Insulin Dose ◽  
Postprandial Hyperglycemia ◽  
High Protein ◽  
Insulin Pump Therapy ◽  
Pump Therapy

scholarly journals Marked improvements in glycaemic outcomes following insulin pump therapy initiation in people with type 1 diabetes: a nationwide observational study in Scotland

Diabetologia ◽  
2021 ◽  
Author(s):  
Anita Jeyam ◽  
◽  
Fraser W. Gibb ◽  
John A. McKnight ◽  
Brian Kennon ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Mixed Models ◽  
Rate Ratio ◽  
Insulin Pump ◽  
Event Rate ◽  
Statistical Significance ◽  
Insulin Pump Therapy ◽  
Pump Therapy

Abstract Aims/hypothesis Our aim was to assess the use of continuous subcutaneous insulin infusion (CSII) in people with type 1 diabetes in Scotland and its association with glycaemic control, as measured by HbA1c levels, frequency of diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH), overall and stratified by baseline HbA1c. Methods We included 4684 individuals with type 1 diabetes from the national Scottish register, who commenced CSII between 2004 and 2019. We presented crude within-person differences from baseline HbA1c over time since initiation, crude DKA and SHH event-rates pre-/post-CSII exposure. We then used mixed models to assess the significance of CSII exposure, taking into account: (1) the diffuse nature of the intervention (i.e. structured education often precedes initiation); (2) repeated within-person measurements; and (3) background time-trends occurring pre-intervention. Results HbA1c decreased after CSII initiation, with a median within-person change of −5.5 mmol/mol (IQR −12.0, 0.0) (−0.5% [IQR −1.1, 0.0]). Within-person changes were most substantial in those with the highest baseline HbA1c, with median −21.0 mmol/mol (−30.0, −11.0) (−1.9% [−2.7, −1.0]) change in those with a baseline >84 mmol/mol (9.8%) within a year of exposure, that was sustained: −19.0 mmol/mol (−27.6, −6.5) (−1.7% [−2.5, −0.6]) at ≥5 years. Statistical significance and magnitude of change were supported by the mixed models results. The crude DKA event-rate was significantly lower in post-CSII person-time compared with pre-CSII person-time: 49.6 events (95% CI 46.3, 53.1) per 1000 person-years vs 67.9 (64.1, 71.9); rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.61 (95% credible interval [CrI] 0.47, 0.77; posterior probability of reduction pp = 1.00). The crude overall SHH event-rate in post-CSII vs pre-CSII person-time was also lower: 17.8 events (95% CI 15.8, 19.9) per 1000 person-years post-exposure vs 25.8 (23.5, 28.3) pre-exposure; rate ratio from Bayesian mixed models adjusting for pre-exposure trend: 0.67 (95% CrI 0.45, 1.01; pp = 0.97). Conclusions/interpretation CSII therapy was associated with marked falls in HbA1c especially in those with high baseline HbA1c. CSII was independently associated with reduced DKA and SHH rates. CSII appears to be an effective option for intensive insulin therapy in people with diabetes for improving suboptimal glycaemic control. Graphical abstract

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