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By Brooke Manor Endocrinology
Solomon Tesfaye, Dinesh Selvarajah
Diabetic peripheral neuropathy (DPN) affects up to 50% of patients with diabetes and is a major cause of morbidity and increased mortality. Its clinical manifestations include painful neuropathic symptoms and insensitivity, which increases the risk for burns, injuries and foot ulceration. Several recent studies have implicated poor glycaemic control, duration of diabetes, hyperlipidaemia (particularly hypertryglyceridaemia), elevated albumin excretion rates and obesity as risk factors for the development of DPN...
February 2012: Diabetes/metabolism Research and Reviews
Freya MacMillan, Alison Kirk, Nanette Mutrie, Lynsay Matthews, Kenneth Robertson, David H Saunders
OBJECTIVE: To systematically review physical activity and/or sedentary behavior intervention studies for youth with type 1 diabetes. METHODS: Several databases were searched for articles reporting on randomized-controlled trials (RCTs) in youth (<18 yr) with type 1 diabetes. Data was extracted and bias assessed to evaluate study characteristics, intervention design, and efficacy of interventions on physical activity and health. Where sufficient data were available meta-analyses of health outcomes [for hemoglobin A1c (HbA1c)] were performed...
May 2014: Pediatric Diabetes
Beverley Balkau, Philip D Home, Maya Vincent, Michel Marre, Nick Freemantle
OBJECTIVE: Moderate weight gain is usual after starting insulin therapy. The identification and quantification of factors associated with weight gain may help target strategies for avoidance of weight gain. RESEARCH DESIGN AND METHODS: The noninterventional CREDIT (Cardiovascular Risk Evaluation in people with type 2 Diabetes on Insulin Therapy) study included data from people with type 2 diabetes starting any insulin in 314 centers, in 12 countries. From a number of predefined candidate explanatory variables, analyses identified factors associated with weight gain 1 year after starting insulin treatment, after adjusting for investigational site as a random factor...
August 2014: Diabetes Care
Elke E Fröhlich-Reiterer, Joachim Rosenbauer, Susanne Bechtold-Dalla Pozza, Sabine E Hofer, Edith Schober, Reinhard W Holl
OBJECTIVE: Increased weight gain has been reported prior to disease onset (accelerator hypothesis) and as a side effect of intensified insulin therapy in type 1 diabetes (T1D). Paediatric studies are complicated by the age-dependency and gender-dependency of BMI, and also by a trend towards obesity in the general population. The aim of this study was to evaluate factors related to the increase in BMI during the course of diabetes in children and adolescents with T1D in a large multicentre survey...
August 2014: Archives of Disease in Childhood
Edward W Gregg, Yanfeng Li, Jing Wang, Nilka Rios Burrows, Mohammed K Ali, Deborah Rolka, Desmond E Williams, Linda Geiss
BACKGROUND: Preventive care for adults with diabetes has improved substantially in recent decades. We examined trends in the incidence of diabetes-related complications in the United States from 1990 through 2010. METHODS: We used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System to compare the incidences of lower-extremity amputation, end-stage renal disease, acute myocardial infarction, stroke, and death from hyperglycemic crisis between 1990 and 2010, with age standardized to the U...
April 17, 2014: New England Journal of Medicine
Kirsi M Salonen, Samppa J Ryhänen, Josephine M Forbes, Taina Härkönen, Jorma Ilonen, Antti-Pekka Laine, Per-Henrik Groop, Mikael Knip
OBJECTIVE: We analyzed the relationship among soluble receptor for advanced glycation end products (sRAGEs), the clinical phenotype, HLA genotype, and risk-associated single nucleotide polymorphisms (SNPs) in the AGER gene in a large population of Finnish children with newly diagnosed type 1 diabetes. RESEARCH DESIGN AND METHODS: Samples from 2,115 clinically phenotyped children <15 years of age in whom type 1 diabetes was diagnosed and 316 control subjects were analyzed for sRAGEs...
July 2014: Diabetes Care
Kristen J Nadeau, Kelsey Chow, Suhyla Alam, Kara Lindquist, Sarah Campbell, Kim McFann, Georgeanna Klingensmith, Phillipe Walravens
BACKGROUND: Insulin resistance increases during adolescence in those with type 1 diabetes mellitus (T1DM), complicating glycemic control and potentially increasing cardiovascular disease (CVD) risk. Metformin, typically used in type 2 diabetes mellitus (T2DM), is a possible adjunct therapy in T1DM to help improve glycemic control and insulin sensitivity. OBJECTIVE: We hypothesized that metformin would improve metabolic parameters in adolescents with T1DM. DESIGN, SETTING, AND PARTICIPANTS: This randomized, double-blinded, placebo-controlled trial included 74 pubertal adolescents (ages: 13-20 yr) with T1DM...
May 2015: Pediatric Diabetes
Richard M Bergenstal, David C Klonoff, Satish K Garg, Bruce W Bode, Melissa Meredith, Robert H Slover, Andrew J Ahmann, John B Welsh, Scott W Lee, Francine R Kaufman
BACKGROUND: The threshold-suspend feature of sensor-augmented insulin pumps is designed to minimize the risk of hypoglycemia by interrupting insulin delivery at a preset sensor glucose value. We evaluated sensor-augmented insulin-pump therapy with and without the threshold-suspend feature in patients with nocturnal hypoglycemia. METHODS: We randomly assigned patients with type 1 diabetes and documented nocturnal hypoglycemia to receive sensor-augmented insulin-pump therapy with or without the threshold-suspend feature for 3 months...
July 18, 2013: New England Journal of Medicine
Mohammed K Ali, Kai McKeever Bullard, Jinan B Saaddine, Catherine C Cowie, Giuseppina Imperatore, Edward W Gregg
BACKGROUND: Tracking national progress in diabetes care may aid in the evaluation of past efforts and identify residual gaps in care. METHODS: We analyzed data for adults with self-reported diabetes from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to examine risk-factor control, preventive practices, and risk scores for coronary heart disease over the 1999-2010 period. RESULTS: From 1999 through 2010, the weighted proportion of survey participants who met recommended goals for diabetes care increased, by 7...
April 25, 2013: New England Journal of Medicine
Chirag Kapadia, Philip Zeitler
Laboratory measurements of hemoglobin A1c above 6.5% were approved as an additional diagnostic criteria for diabetes mellitus by the American Diabetes Association in 2010. Several recent pediatric studies have cast HbA1c measurement in children in an unfavorable light in the pediatric population, by comparing HbA1c measurements to results on oral glucose tolerance test (OGTT) or fasting plasma glucose (FPG). However, many of these studies do not recognize that diabetes diagnostic criteria are based upon long-term health outcomes...
December 20, 2012: International Journal of Pediatric Endocrinology
R Vukovic, K Mitrovic, T Milenkovic, S Todorovic, D Zdravkovic
An increase in the prevalence of pediatric type 2 diabetes mellitus (T2DM) has been reported by numerous studies in the United States during the past two decades. Available data from Europe are scarce, but also suggest the rising prevalence of this disease in overweight children. The aim of this study was to determine the prevalence of previously undiagnosed T2DM, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) in a clinic cohort of otherwise healthy overweight and obese Caucasian children and adolescents living in Serbia...
November 2012: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Mikael Knip, Suvi M Virtanen, Karri Seppä, Jorma Ilonen, Erkki Savilahti, Outi Vaarala, Antti Reunanen, Kari Teramo, Anu-Maaria Hämäläinen, Johanna Paronen, Hans-Michael Dosch, Timo Hakulinen, Hans K Akerblom
BACKGROUND: Early exposure to complex dietary proteins may increase the risk of beta-cell autoimmunity and type 1 diabetes in children with genetic susceptibility. We tested the hypothesis that supplementing breast milk with highly hydrolyzed milk formula would decrease the cumulative incidence of diabetes-associated autoantibodies in such children. METHODS: In this double-blind, randomized trial, we assigned 230 infants with HLA-conferred susceptibility to type 1 diabetes and at least one family member with type 1 diabetes to receive either a casein hydrolysate formula or a conventional, cow's-milk-based formula (control) whenever breast milk was not available during the first 6 to 8 months of life...
November 11, 2010: New England Journal of Medicine
Janet A Rowan, William M Hague, Wanzhen Gao, Malcolm R Battin, M Peter Moore
BACKGROUND: Metformin is a logical treatment for women with gestational diabetes mellitus, but randomized trials to assess the efficacy and safety of its use for this condition are lacking. METHODS: We randomly assigned 751 women with gestational diabetes mellitus at 20 to 33 weeks of gestation to open treatment with metformin (with supplemental insulin if required) or insulin. The primary outcome was a composite of neonatal hypoglycemia, respiratory distress, need for phototherapy, birth trauma, 5-minute Apgar score less than 7, or prematurity...
May 8, 2008: New England Journal of Medicine
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