scholarly journals Retrospective Evaluation on the Use of a New Polysaccharide Complex in Managing Paediatric Type 1 Diabetes with Metabolic Syndrome (MetS)

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3517
Author(s):  
Stefano Stagi ◽  
Valeria Papacciuoli ◽  
Daniele Ciofi ◽  
Barbara Piccini ◽  
Giovanni Farello ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Type 1 Diabetes ◽  
Metabolic Response ◽  
Insulin Dose ◽  
Standard Deviation Score ◽  
Dose Requirement ◽  
Glycaemic Variability ◽  
Paediatric Patients ◽  
Increased Risk

Background: Children and adolescents affected by type 1 diabetes have an increased risk of being overweight or obese and of suffering from cardiometabolic symptoms. Aims: To retrospectively evaluate the effects of a new complex of polysaccharide macromolecules, Policaptil Gel Retard® (PGR), on auxological and metabolic parameters, glycaemic variability and control parameters in paediatric patients with type 1 diabetes and metabolic syndrome (MetS). Patients and Methods: Data for 27 paediatric patients with a diagnosis of type 1 diabetes in conjunction with obesity and MetS of at least 5 years’ standing were collected and retrospectively studied. Of these, 16 (median age 12.9, range 9.5–15.8 years) had been adjunctively treated with PGR and 11 (median age 12.6, range 9.4–15.6 years) had not been treated with PGR. Auxological, metabolic and glycaemic control and variability parameters and insulin dosing were compared after 6 months in the two groups. Results: PGR significantly reduced BMI standard deviation score (SDS) (p < 0.005), waist SDS (p < 0.005), HbA1c (p < 0.05) and daily mean insulin dose requirement (p < 0.005). A significant improvement was also observed in the metabolic and glycaemic variability parameters of mean daily blood glucose (BG) levels (p < 0.005), SD of daily BG levels (p < 0.0001), mean coefficient of variation (p < 0.05), LBGI (p < 0.0001), HBGI (p < 0.0001), J-index (p < 0.005), total cholesterol (p < 0.005), HDL-cholesterol (p < 0.005) and LDL-cholesterol (p < 0.005) and triglycerides (p < 0.05). Conclusions: PGR produces a good auxological and metabolic response in obese patients with MetS who are affected by type 1 diabetes. It led to a significant reduction in BMI SDS, waist SDS and an improvement in glucose control and variability as well as in other MetS parameters. The use of polysaccharide compounds, especially if associated with appropriate dietary changes, may help achieve treatment targets in type 1 diabetes and reduce the risk that patients develop metabolic syndrome.

scholarly journals Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial

2021 ◽  
Author(s):  
Xiuzhen Zhang ◽  
Dan Xu ◽  
Ping Xu ◽  
Shufen Yang ◽  
Qingmei Zhang ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Dose ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Insulin Requirement ◽  
Cvd Risk ◽  
Open Label ◽  
Metformin Therapy ◽  
Increased Risk

Introduction: Metformin has been demonstrated to enhance cardioprotective benefits in type 1 diabetes (T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evaluating the effect of metformin on GV in T1DM. Objectives: In the present study, the effects of adjuvant metformin therapy on GV and metabolic control in T1DM were explored. Patients and methods: A total of 65 adults with T1DM were enrolled and subjected to physical examination, fasting laboratory tests and continuous glucose monitoring, and subsequently randomized 1:1 to 3 months of 1000- 2000 mg metformin daily add-on insulin (MET group, n=34) or insulin (Non-MET group, n=31). After, baseline measurements were repeated. Results: The mean amplitude of glycemic excursions was substantially reduced in MET group, compared with Non-MET group [-1.58 (-3.35,0.31) mmol/L versus 1.36 (-1.12,2.24) mmol/L, P=0.004]. In parallel, the largest amplitude of glycemic excursions [-2.83 (-5.47,-0.06) mmol/L versus 0.45 (-1.29,4.48) mmol/L, P=0.004], the standard deviation of blood glucose [-0.85 (-1.51,0.01) mmol/L versus -0.14 (-0.68,1.21) mmol/L, P=0.015], and the coefficient of variation [-6.66 (-15.00,1.50) % versus -1.60 (-6.28,11.71) %, P=0.012] all demonstrated improvement in the MET group, compared with the Non-MET group. Significant reduction in insulin dose, body mass index and body weight were observed in patients in MET, not those in Non-MET group. Conclusion: Additional metformin therapy improved GV in adults with T1DM, as well as improving body composition and reducing insulin requirement. Hence, metformin as adjunctive therapy has potential prospects in reducing the CVD risk in patients with T1DM in the long term.

scholarly journals Does Exposure to Type 1 Diabetes In Utero Increase the Risk of Metabolic Syndrome, Especially Abdominal Obesity, in Young Adults?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1692-1692
Author(s):  
Suzanne Summer ◽  
Jane Khoury ◽  
Katherine Bowers ◽  
Taylor Lima ◽  
Jennifer Hunt ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Type 1 Diabetes ◽  
Abdominal Obesity ◽  
Population Sample ◽  
In Utero ◽  
Healthy Eating Index ◽  
Z Score ◽  
Increased Risk ◽  
The Impact

Abstract Objectives Metabolic syndrome (MetS) is a clustering of metabolic abnormalities including abdominal obesity that can lead to cardiovascular disease, diabetes, and stroke. Exposure to maternal diabetes in utero increases MetS risk in offspring. Consuming a healthy diet may reduce the risk. The MetS severity z-score (MetS-z) is a sex- and race-specific score developed by Gurka et al. to indicate MetS risk or severity on a continuous scale. We sought to examine if offspring of mothers with Type 1 Diabetes (T1D) have greater risk or severity of MetS, particularly with respect to abdominal obesity, compared to subjects from the National Health and Nutrition Examination Survey (NHANES). Methods The Transgenerational Effects of Adult Morbidity (TEAM) study is a prospective cohort study investigating the impact of gestational exposure to maternal T1D on metabolic health of offspring. To date, 100 young adult (24–42 y) offspring of mothers with T1D have been enrolled. TEAM participants were compared to a population sample of ∼1:2 age-, sex- and race-matched controls from NHANES 2015–2016. Abdominal obesity was assessed by sagittal abdominal diameter (SAD), an indicator of abdominal visceral fat. Usual diet was estimated by averaging intake from multiple 24-hour diet recall interviews. MetS-z was calculated with equations specific for sex, age, and race, and diet quality was assessed by the Healthy Eating Index (HEI)-2015 score. Descriptive and regression analyses were employed to compare TEAM and NHANES participants on MetS-z and SAD. HEI score was examined as a covariate and a potential moderator. Results SAD was higher in TEAM than NHANES participants (23.4 vs 21.8 cm, P = 0.005). No material differences in MetS-z (–0.02 vs −0.17, P = 0.18) or HEI score (51.3 vs 48.9, P = 0.26) were observed. SAD and MetS-z were highly correlated (r = 0.72, P &lt; 0.001). HEI score exhibited a weak inverse correlation with both SAD and MetS-z (r = −0.19 and r = −0.17). HEI was not found to modify the association between cohort membership and MetS-z or SAD. Conclusions We observed higher SAD in offspring of mothers with T1D compared to NHANES participants and this effect persisted after controlling for HEI. SAD is associated with increased risk for MetS, yet no material difference in MetS z-score was observed between the groups. Funding Sources NIH, NIDDK R01DK109956; 5UL1TR001425–04.

scholarly journals The effect of metabolic and hormonal parameters on microalbuminuria in adolescents with type 1 diabetes mellitus

2013 ◽  
Vol 141 (5-6) ◽  
pp. 315-319 ◽  
Author(s):  
Maja Jesic ◽  
Milos Jesic ◽  
Silvija Sajic ◽  
Dragana Bogicevic ◽  
Svetlana Buljugic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Dose ◽  
Small Sample ◽  
Urine Samples ◽  
Night Time ◽  
Increased Risk

Introduction. The prevalence of microalbuminuria (MA), the most important early marker of incipient nephropathy in patients with type 1 diabetes mellitus (T1DM), increases during puberty, the period of exaggerated physiological insulin resistance. Objective. To assess the prevalence of MA and the relationship between MA and metabolic risk factors and pubertal hormones in adolescents with T1DM. Methods. In a cross-section study involving a group of 100 adolescents of both sexes of mean age 14.90?2.18 years and with mean duration of T1DM 5.99?3.64 years, we assessed the presence of MA. In all patients, we determined albumin-to-creatinine ratio (ACR) in two or three morning first-void urine samples in the period up to 6 months. Persistent MA was confirmed in the patients with the finding of ACR rating 2.5-25 mg/mmol in males and 3.5-25 mg/mmol in females in two out of three first morning urine samples. Results. MA developed in 16 (16.0%) patients. Predictors of MA determined by using multiple logistic regression were high HbA1c (OR 4.6; 95% CI 2.1-10.0), higher night-time SBP (OR 1.9; 95% CI 0.8-1.3) and higher insulin dose (OR 62.6; 95% CI 2.3-1678.5). Markers of insulin resistance such as higher body mass index (BMI) which was statistically significantly related to MA (?= 0.241, p<0.05) and higher dehydroepiandrosterone sulfate (DHEA-S) which was significantly higher in patients with MA (7.82 ?mol/L vs. 5.02 ?mol/L, p<0.01), were also identified as predictors but did not remain significant by multivariate analysis, possibly because of a small sample of subjects with persistent MA. Conclusion. In addition to poor glycemic control and higher night-time systolic blood pressure, markers of insulin resistance (higher insulin dose, higher BMI and higher DHEA-S) contribute to the increased risk of MA.

scholarly journals Sodium-glucose Co-transporter-2 Inhibitors in Type 1 Diabetes—a Dangerous Ally

2017 ◽  
Vol 13 (02) ◽  
pp. 75 ◽  
Author(s):  
Gagan Priya ◽  
Sanjay Kalra ◽  
Vishal Bhambri ◽  
◽  
◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetic Ketoacidosis ◽  
Insulin Dose ◽  
Unmet Need ◽  
Sglt2 Inhibitors ◽  
Dose Requirement ◽  
Dual Inhibitors ◽  
Recurrent Hypoglycemia

There is an unmet need for adjunctive non-insulin-based therapies in type 1 diabetes (T1D). Weight gain, recurrent hypoglycemia and suboptimal glycemic control remain significant challenges. Sodium-glucose co-transporter-2 (SGLT2) inhibitors and dual inhibitors of sodium-glucose co-transporter-1 (SGLT1) and SGLT2 may have a potential role as an add-on therapy to insulin. The benefits include improved glycemic control, weight reduction, and reduced insulin dose requirement. However, the risk of diabetic ketoacidosis with SGLT2 inhibitors is significant and the diagnosis may be delayed due to absence of significant hyperglycemia. At present, SGLT2 inhibitors are not approved for use in T1D, and the risks should be discussed at length with the patient. We propose strategies to minimize the risk of diabetic ketoacidosis associated with off-label use of SGLT2 inhibitors in T1D.

scholarly journals Metformin Improves Glycemic Variability in Adults with Type 1 Diabetes Mellitus: an open-label randomized control trial

2021 ◽  
Author(s):  
XIUZHEN zhang ◽  
Dan Xu ◽  
ping xu ◽  
Shufen Yang ◽  
Qingmei Zhang ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Dose ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Insulin Requirement ◽  
Cvd Risk ◽  
Open Label ◽  
Metformin Therapy ◽  
Increased Risk

Introduction: Metformin has been demonstrated to enhance cardioprotective benefits in type 1 diabetes(T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evaluating the effect of metformin on GV in T1DM. Objectives: In the present study, the effects of adjuvant metformin therapy on GV and metabolic control in T1DM were explored. Patients and methods: A total of 65 adults with T1DM were enrolled and subjected to physical examination, fasting laboratory tests and continuous glucose monitoring, and subsequently randomized 1:1 to 3 months of 1000- 2000 mg metformin daily add-on insulin (MET+INS, n=34) or insulin (INS, n=31). After, baseline measurements were repeated. Results: The mean amplitude of glycemic excursions was substantially reduced in the MET+INS group, compared with the INS group (-1.47±3.39 mmol/L versus 1.05±4.24 mmol/L, P=0.012). In parallel, the largest amplitude of glycemic excursions (-2.28±4.71 mmol/L versus 1.77±5.71 mmol/L, P=0.003), the standard deviation of blood glucose (- 0.62±1.15 mmol/L versus 0.08±1.23 mmol/L, P=0.023), and the coefficient of variation (-6.08±12.31 % versus 2.29±11.57 %, P=0.008) all demonstrated improvement in the MET+INS group, compared with the INS group. Significant reduction in the insulin dose, body mass index and body weight were observed in patients with MET+INS, not those with INS. Conclusion: Additional metformin therapy improved GV in adults with T1DM, as well as improving body composition and reducing insulin requirement. Hence, metformin as adjunctive therapy has potential prospects in reducing the CVD risk in patients with T1DM in the long term.

Immune status is associated with the mode of delivery in infants at increased risk for Type 1 Diabetes

2014 ◽  
Vol 9 (S 01) ◽  
Author(s):  
O D'Orlando ◽  
R Puff ◽  
A Henniger ◽  
S Krause ◽  
F Haupt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Immune Status ◽  
Mode Of Delivery ◽  
Increased Risk
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