Vestibular Function in Children with Type 1 Diabetes: Videonystagmography Testing

2021 ◽  
pp. 1-9
Author(s):  
Sherifa A. Hamed ◽  
Ali F. ElHadad ◽  
Amira M. Oseily
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Multiple Logistic Regression Analysis ◽  
Age At Onset ◽  
Vestibular Function ◽  
Multiple Logistic Regression ◽  
Duration Of Illness ◽  
Control And Prevention ◽  
Hba1c Levels

<b><i>Background:</i></b> Vestibular system is critical for maintaining balance and learning complex tasks. This study aimed to determine the frequencies, types, and predictors of vestibular dysfunctions (VDs) in children with type 1 diabetes (T1D) using videonystagmography (VNG). <b><i>Patients and Methods:</i></b> This study included 65 patients (children with T1D = 40; controls = 25). The patients underwent VNG. <b><i>Results:</i></b> Patients (boys = 15; girls = 25) had a mean age of 14.05 ± 1.82 years and duration of illness of 6.30 ± 2.84 years. The majority had frequent attacks of diabetic ketoacidosis (DKA) (65%) and hypoglycemia (40%). Dizziness was reported in 20%. VNG abnormalities were reported in 70% (<i>n</i> = 28), of them 71.43 and 28.57% had central and peripheral VDs, respectively. Dizziness was associated with peripheral VD. Compared to patients without VDs, those with VDs were older and had earlier age at onset and longer duration of diabetes (&#x3e;5 years), higher levels of HbA1c (&#x3e;7%), higher frequencies of DKA and hypoglycemic attacks, comorbid medical conditions, and diabetic complications. Multiple logistic regression analysis showed that presence of VNG abnormalities (VDs) was independently correlated with diabetes duration &#x3e;5 years (odds ratio [OR] = 4.52 [95% confidence interval [CI] = 3.55–7.04], <i>p</i> = 0.001), HbA1c% levels &#x3e;7% (OR = 3.42 [95% CI = 2.84–5.75], <i>p</i> = 0.001), and presence of hypoglycemic attacks (OR = 4.65 [95% CI = 2.85–7.55]). <b><i>Conclusions:</i></b> -VDs are prevalent in children with T1D and correlated with the duration and severity of diabetes and the occurrence of hypoglycemic attacks. Therefore, optimizing glycemic control and prevention and treatment of diabetic complications and comorbidities are important. Multidisciplinary follow-ups are required for early detection and management of diabetic VDs.

scholarly journals Trajectories in HbA1c and other risk factors among adults with type 1 diabetes by age at onset

2021 ◽  
Vol 9 (1) ◽  
pp. e002187
Author(s):  
Jon Edqvist ◽  
Araz Rawshani ◽  
Aidin Rawshani ◽  
Martin Adiels ◽  
Stefan Franzén ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Risk Factor ◽  
Ldl Cholesterol ◽  
Age At Onset ◽  
Glycemic Load ◽  
Gradient Boosting ◽  
Life Years ◽  
Hba1c Levels

IntroductionIn type 1 diabetes, potential loss of life-years is greatest in those who are youngest at the time of onset. Using data from a nationwide cohort of patients with type 1 diabetes, we aimed to study risk factor trajectories by age at diagnosis.Research design and methodsWe stratified 30 005 patients with type 1 diabetes aged 18–75 years into categories based on age at onset: 0–10, 11–15, 16–20, 21–25, and 26–30 years. HbA1c, albuminuria, estimated glomerular filtration rate (eGFR), body mass index (BMI), low-denisty lipoprotein (LDL)-cholesterol, systolic blood pressure (SBP), and diastolic blood pressure trends were analyzed using mixed models. Variable importance for baseline HbA1c was analyzed using conditional random forest and gradient boosting machine approaches.ResultsIndividuals aged ≥16 years at onset displayed a relatively low mean HbA1c level (~55–57 mmol/mol) that gradually increased. In contrast, individuals diagnosed at ≤15 years old entered adulthood with a mean HbA1c of approximately 70 mmol/mol. For all groups, HbA1c levels stabilized at a mean of approximately 65 mmol/mol by about 40 years old. In patients who were young at the time of onset, albuminuria appeared at an earlier age, suggesting a more rapid decrease in eGFR, while there were no distinct differences in BMI, SBP, and LDL-cholesterol trajectories between groups. Low education, higher age, and poor risk factor control were associated with higher HbA1c levels.ConclusionsYoung age at the diabetes onset plays a substantial role in subsequent glycemic control and the presence of albuminuria, where patients with early onset may accrue a substantial glycemic load during this period.

scholarly journals Size for gestational age affects the risk for type 1 diabetes in children and adolescents: a Swedish national case–control study

Diabetologia ◽  
2021 ◽  
Vol 64 (5) ◽  
pp. 1113-1120
Author(s):  
Nina Lindell ◽  
Marie Bladh ◽  
Annelie Carlsson ◽  
Ann Josefsson ◽  
Karin Aakesson ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Logistic Regression ◽  
Gestational Age ◽  
Multiple Logistic Regression Analysis ◽  
Equal Proportion ◽  
Multiple Logistic Regression ◽  
Quality Register ◽  
Increased Risk ◽  
Maternal Bmi

Abstract Aim/hypothesis Environmental factors are believed to contribute to the risk of developing type 1 diabetes. The aim of this study was to investigate how size for gestational age affects the risk of developing childhood type 1 diabetes. Methods Using the Swedish paediatric diabetes quality register and the Swedish medical birth register, children with type 1 diabetes diagnosed between 2000 and 2012 (n = 9376) were matched with four control children (n = 37,504). Small for gestational age (SGA) and large for gestational age (LGA) were defined according to Swedish national standards. Data were initially analysed using Pearson’s χ2 and thereafter by single and multiple logistic regression models. Results An equal proportion of children were born appropriate for gestational age, but children with type 1 diabetes were more often born LGA and less often born SGA than control children (4.7% vs 3.5% and 2.0% vs 2.6%, respectively, p < 0.001). In the multiple logistic regression analysis, being born LGA increased (adjusted OR 1.16 [95% CI 1.02, 1.32]) and SGA decreased (adjusted OR 0.76 [95% CI 0.63, 0.92]) the risk for type 1 diabetes, regardless of maternal BMI and diabetes. Conclusions/interpretation Size for gestational age of Swedish children affects the risk of type 1 diabetes, with increased risk if the child is born LGA and decreased risk if the child is born SGA. Being born LGA is an independent risk factor for type 1 diabetes irrespective of maternal BMI and diabetes. Thus, reducing the risk for a child being born LGA might to some extent reduce the risk for type 1 diabetes. Graphical abstract

scholarly journals Association of estimated glucose disposal rate and chronic diabetic complications in patients with type 1 diabetes

2021 ◽  
Author(s):  
César Ernesto Lam‐Chung ◽  
Néstor Martínez Zavala ◽  
Raúl Ibarra‐Salce ◽  
Francisco Javier Pozos Varela ◽  
Tania S. Mena Ureta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Complications ◽  
Glucose Disposal ◽  
Estimated Glucose Disposal Rate ◽  
Glucose Disposal Rate

scholarly journals Association between Physical Activity and Sport Participation on Hemoglobin A1c Among Children and Adolescents with Type 1 Diabetes

2021 ◽  
Vol 18 (14) ◽  
pp. 7490
Author(s):  
Kristi M. King ◽  
Jason R. Jaggers ◽  
Lindsay J. Della ◽  
Timothy McKay ◽  
Sara Watson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 1 Diabetes ◽  
Medical Records ◽  
Hemoglobin A1c ◽  
Pediatric Patients ◽  
Sport Participation ◽  
Multiple Linear Regression Model ◽  
Significant Difference ◽  
Hba1c Levels

Purpose: To determine associations between physical activity (PA) and sport participation on HbA1c levels in children with type 1 diabetes (T1D). Method: Pediatric patients with T1D were invited to complete a PA and sport participation survey. Data were linked to their medical records for demographic characteristics, diabetes treatment and monitoring plans, and HbA1c levels. Results: Participants consisted of 71 females and 81 males, were 13 ± 3 years old with an average HbA1c level of 8.75 ± 1.81. Children accumulating 60 min of activity 3 days or more a week had significantly lower HbA1c compared to those who accumulated less than 3 days (p < 0.01) of 60 min of activity. However, there was no significant difference in HbA1c values based on sport participation groups. A multiple linear regression model indicated that PA, race, age, duration of diagnosis, and CGM use all significantly predicted HbA1c (p < 0.05). Conclusion: This study demonstrated the significant relationship between daily PA and HbA1c. Those in this sample presented with lower HbA1c values even if accumulating less than the recommended number of days of activity. Further, it was shown that sport participation alone may not be adequate enough to impact HbA1c in a similar manner.

scholarly journals Effectiveness of Multiple Daily Injections or Continuous Subcutaneous Insulin Infusion for Children with Type 1 Diabetes Mellitus in Clinical Practice

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Chun-xiu Gong ◽  
Li-ya Wei ◽  
Di Wu ◽  
Bing-yan Cao ◽  
Xi Meng ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glucose Control ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Blood Glucose Control ◽  
Insulin Dosage ◽  
Subcutaneous Insulin ◽  
Multiple Daily Injections ◽  
Hba1c Levels

Aims. To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration.Methods. Subjects were grouped according to early (≤1 year after disease onset; 1A) or late (1–3 years after onset; 2A) MDIs/CSII treatment initiation. Corresponding control groups (1B, 2B) received insulin injections twice daily.Results. HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; allP<0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%;P=0.04). Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%;P<0.05). Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy. HbA1c levels were only negatively related to insulin dosage.Conclusions. Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment. Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation. MDIs/CSII therapy should be combined with comprehensive management.

Negative association between type 1 diabetes and HLA DQB1*0602-DQA1*0102 is attenuated with age at onset

1999 ◽  
Vol 26 (2-3) ◽  
pp. 117-127
Author(s):  
Jinko Graham ◽  
Ingrid Kockum ◽  
Carani B. Sanjeevi ◽  
Mona Landin-Olsson ◽  
Lennarth Nyström ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age At Onset ◽  
Negative Association

Efficacy of Insulin Pump Therapy in Type 1 Diabetes Mellitus with a Focus on HbA1c Levels in Relation to Patient Age

2019 ◽  
Vol 2 (1) ◽  
pp. 20-21
Author(s):  
Jan Broz ◽  
Denisa Janickova Zdarska ◽  
Michal Policar ◽  
Viera Donicova ◽  
Marek Brabec ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Patient Age ◽  
Patient Âgé ◽  
Hba1c Levels

Type 1 diabetes and celiac disease in adults: glycemic control and diabetic complications

2012 ◽  
Vol 50 (3) ◽  
pp. 319-324 ◽  
Author(s):  
Sjoerd F. Bakker ◽  
Maarten E. Tushuizen ◽  
Mary E. von Blomberg ◽  
Chris J. Mulder ◽  
Suat Simsek
Keyword(s):  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Glycemic Control ◽  
Diabetic Complications
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