scholarly journals Masked Hypertension in Adolescents with Type 1 Diabetes Mellitus: An Exploratory Study

Author(s):  
Bachar Afandi ◽  
Bassam Bernieh ◽  
Sana Roubi ◽  
Juma Al Kaabi

<b><i>Introduction:</i></b> Masked hypertension (MHTN) is the finding of elevated out-of-office blood pressure (BP) measurement. This is a pilot study to evaluate the prevalence of MHTN in adolescents with type 1 diabetes mellitus (T1DM). <b><i>Patients and Methods:</i></b> Normotensive, adolescents with T1DM were recruited from Tawam Adolescents Diabetes Clinic at Tawam hospital, Al Ain, UAE. They consented to wear the ambulatory BP monitoring (ABPM) device. The heart rate and ambulatory BP were recorded at 15-min intervals for 24 h. Abnormal systolic BP (SBP) and diastolic BP (DBP) were defined as readings above 135 and 85 mm Hg; respectively. <b><i>Results:</i></b> Thirteen patients (10 females) were recruited from “Tawam Adolescents Diabetes Clinic.” The median age was 17 (15–19) years, median BMI 21.4 (14.8–29), and median diabetes duration 9 (3–12) years. All patients had normal retinal examination within the past 12 months. Family history of hypertension (HTN) was present in 6/13 (46%) patients. Office BP measurements revealed a mean DBP ± SD of 72 ± 6.9 mm Hg and mean SBP ± SD116 ± 5.5 mm Hg. The median HbA1c was 8.4% (5.6–13.7) and median GFR 125 mL/min/m<sup>2</sup> (87–134). Two patients had microalbuminuria. Twenty-four hour ABPM revealed elevated SBP and DBP in 12.2 and 5.8% of the values; respectively. Further analysis confirmed MHTN in 4 (30%) patients, nondipping pattern of BP in 5 (38%) patients, and elevated pulse pressure in 8 (61.5%) patients. Only 4 (30%) patients had normal studies. <b><i>Conclusions:</i></b> ABPM uncovered a very high prevalence of MHTN in our patients. Whenever available, ABPM provides an excellent tool for diagnosis and hence early evaluation and management of HTN in adolescents with T1DM. Well-designed large-scale studies are needed to examine the magnitude of MHTN among adolescents with T1DM.

2013 ◽  
Vol 114 (4) ◽  
pp. 258-262 ◽  
Author(s):  
M. R. Manaviat ◽  
Nasim Oveisi ◽  
A. Zare-Bidoki

There is a proved relationship between diabetes mellitus and the cataract formation. The incidence of this is usually related to the duration of diabetes. In this manuscript we report a 15 years old female presented to the emergency room with a 4 hour history of rapid bilateral diminished vision, initially diagnosed with idiopathic cataracts, but after more laboratory evaluations revealed new-onset type 1 diabetes mellitus without ketosis.


2018 ◽  
Vol 67 (6) ◽  
pp. 93-99
Author(s):  
Roman V. Kapustin ◽  
Natalia V. Borovik ◽  
Ekaterina V. Musina ◽  
Olga N. Arzhanova ◽  
Maria I. Yarmolinskaya ◽  
...  

Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.


2012 ◽  
Vol 15 (4) ◽  
pp. 28-32
Author(s):  
Tatiana Vasil'evna Nikonova ◽  
Yulia Viktorovna Alekseeva

Type 1 diabetes mellitus is commonly recognized as an autoimmune disease characterized by progressive destruction of pancreatic ?-beta-cells. Progress in diagnostics at preclinical stage is accompanied with active development of preventive measures. So far, there are no specific therapeutic agents approved for clinical practice. However, ongoing large-scale studies have outlined some promising solutions, antigen-specific immunotherapy being one of them.


2016 ◽  
Vol 11 ◽  
Author(s):  
Ravinder Goswami ◽  
Abilash Nair ◽  
Randeep Guleria ◽  
Devasenathipathy Kandasamy ◽  
Raju Sharma ◽  
...  

Background: There is limited information on prevalence of pulmonary tuberculosis (PTB) in patients with type-1- diabetes. We assessed the prevalence of PTB in patients with type-1-diabetes attending the outpatient-clinic in a tertiary-care hospital. Methods: 151 patients with type-1-diabetes were screened for PTB by clinical examination and chest-radiography. Sputum Acid-Fast Bacilli Test (AFB) and Mycobacterium tuberculosis (M.tb) culture were performed in patients with clinical and radiological features suggestive of a possibility of PTB and also in those with history of PTB in the past. Their average glycated haemoglobin (HbA1c) during preceding 2 years was assessed. Sputum culture positive patients were managed by a pulmonologist. Results: 5/151 patients had respiratory symptoms and radiographic findings suggestive of PTB. 20/151 patients were asymptomatic but had history of PTB. Four of the five symptomatic patients and 12 with past PTB were positive for sputum M.tb by culture, giving a prevalence of 10.6 % sputum culture positive in type-1-diabetes. Average HbA1c was comparable in patients with and without positive sputum culture. ESR and Mantoux test were not discriminatory in these groups. Four clinically symptomatic M.tb culture positive and four asymptomatic patients with sputum culture positive for M.tb on two occasions (6 weeks apart) were put on antitubercular treatment (ATT). Patients who were culture positive for M.tb only on one occasion were kept on a close follow up. Conclusions: Patients with type-1-diabetes mellitus in India have high prevalence of PTB. They need to be actively screened for PTB by sputum M.tb culture in order to initiate early treatment and to prevent transmission in the community.


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