Increased Incidence of Type 1 Diabetes during the COVID-19 Pandemic in Romanian Children.

Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the ß-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996-2015 and 0.8% in the interval 2015-2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p < 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.

Fabrication of Flexible Supercapacitor Electrode Materials by Chemical Oxidation of Iron-Based Amorphous Ribbons.

A flexible electrode constructed from Fe-based amorphous ribbons decorated with nanostructured iron oxides, representing the novelty of this research, was successfully achieved in one-step via a chemical oxidation method, using a low concentration of NaOH solution. The growth of metal oxides on a conductive substrate, which forms some metal/oxide structure, has been demonstrated to be an efficient method for increasing the charge transfer efficiency. Through the control and variation of synthetic parameters, different structures and morphologies of iron oxide were obtained, including hexagonal structures with a hollow ball shape and rhombohedral structures with rhombus-like shapes. Structural and morphological characterization methods such as X-ray diffraction and SEM morphology were used on the as-synthesized composite materials. The supercapacitor properties of the as-developed amorphous ribbons decorated with Fe2O3 nanoparticles were investigated by cyclic voltammetry, galvanostatic charge discharge, and electrochemical impedance spectroscopy. The flexible supercapacitor negative electrode demonstrates a specific capacitance of 5.96 F g-1 for the 0.2 M NaOH treated sample and 8.94 Fg-1 for the 0.4 M NaOH treated sample. The 0.2 M treated negative electrodes deliver 0.48 Wh/kg at a power density of 20.11 W/kg, and the 0.4 M treated electrode delivers 0.61 Wh/kg at a power density of 20.85 W/kg. The above results show that these flexible electrodes are adequate for integration in supercapacitor devices, for example, as negative electrodes.

Self-Powered Photodetector Based on FTO/n-TiO2/p-CuMnO2 Transparent Thin Films.

A self-powered photodetector with the FTO/n-TiO2/p-CuMnO2 configuration, representing the novelty of the work, was successfully achieved for the first time and presumes two steps: deposition of the n-type semiconductor (TiO2) by the doctor blade method and of the p-type semiconductor (CuMnO2) by the spin coating technique, respectively. Investigation techniques of the structural and morphological characteristics of the as-synthesized heterostructures, such as XRD, UV-VIS analysis, and SEM/EDX and AFM morphologies, were used. The I-t measurements of the photodetector showed that the responsivity in the self-powered mode was 2.84 × 107 A W-1 cm2 and in the 1 V bias mode it was 1.82 × 106 A W-1 cm2. Additionally, a self-powered current of 14.2 nA was generated under UV illumination with an intensity of 0.1 mW/cm2. Furthermore, under illumination conditions, the response time (tres) and the recovery time (trec) of the sensor exhibited a good response; thus, tres = 7.30 s and trec = 0.4 s for the self-powered mode, and in the 1 V bias mode, these were tres = 15.16 s and trec = 2.18 s. The above results show that the transparent heterojunction device of n-TiO2/p-CuMnO2 exhibited a self-powered ultraviolet photodetector with high sensitivity.

Time Trends, Regional Variability and Seasonality Regarding the Incidence of Type 1 Diabetes Mellitus in Romanian Children Aged 0-14 Years, Between 1996 and 2015

OBJECTIVE: The incidence of type 1 diabetes mellitus in children is highly variable in the world. The aim of our study was to: 1) analyze the evolution of the incidence of childhood type 1 diabetes in Romania between 1996 and 2015, and: 2) to search for differences amongst age groups, gender, geographic regions and month of diagnosis. METHODS: Data on all new cases of type 1 diabetes, aged <15 years, obtained from two independent sources, were included in the study. The statistical methods included modeling of the incidence rates, adjusting for age, sex, calendar year, geographic region and seasonality. RESULTS: The study group was composed of 5422 children, with overall completeness of ascertainment estimated at 93.7%. The incidence rate (per 100.000 person-years) rose continuously, from 4.7 [95% confidence interval (CI) 3.9-5.7] in 1996 to 11.0 (95% CI 9.9-12.2) in 2015, by a yearly rate of 5.1%, highest in the youngest and lowest in the oldest children. The mean incidence was significantly higher (p<0.0001) in Transylvania (7.9, 95% CI 7.6-8.3) than in Moldavia (6.5, 95% CI 6.2-6.9) and Muntenia (7.0, 95% CI 6.7-7.3), probably due to differences regarding ethnicity and lifestyle. The monthly incidence showed a sinusoidal pattern, peaking in January and being minimum in June. CONCLUSION: The incidence of type 1 diabetes mellitus in Romanian children increased continuously during the study period by a rate that, if maintained, would lead to its doubling every 14 years. Important differences were established between geographic regions and seasonality at diagnosis.

Efficacy of benfluorex in combination with sulfonylurea in type 2 diabetic patients: an 18-week, randomized, double-blind study.

OBJECTIVE: The aim of this study was to demonstrate the superiority of benfluorex over placebo as an add-on therapy in type 2 diabetic patients in whom diabetes is insufficiently controlled by sulfonylurea monotherapy and who have a limitation for the use of metformin. RESEARCH DESIGN AND METHODS: Type 2 diabetic patients with HbA(1c) (A1C) (7-10%) who were receiving the maximum tolerated sulfonylurea dose and had a contraindication to or poor tolerance of metformin were randomly assigned (double blind) to receive benfluorex 450 mg/day (n = 165) or placebo (n = 160) for 18 weeks. The main efficacy criterion was A1C, analyzed as the change from baseline to the end of treatment using ANCOVA with baseline and country as covariates. Secondary criteria were fasting plasma glucose (FPG), insulin resistance, and plasma lipid level. RESULTS: Both groups were similar at baseline in the intention-to-treat population. A1C significantly decreased with benfluorex from 8.34 +/- 0.83 to 7.52 +/- 1.04% (P < 0.001) and tended to increase with placebo from 8.33 +/- 0.87 to 8.52 +/- 1.36% (NS), resulting in a mean adjusted difference between groups of -1.01% (95% CI -1.26 to -0.76; P < 0.001). The target A1C (< or =7%) was achieved in 34% of patients receiving benfluorex versus 12% of patients receiving placebo. Significant between-group differences in favor of benfluorex were observed for mean FPG (-1.65 mmol/l) (P < 0.001) and for homeostasis model assessment of insulin resistance. Overall tolerance was similar in both groups. Serious adverse events were more frequent in the benfluorex group, without evidence of causality relationship. CONCLUSIONS: Benfluorex as an add-on therapy was superior to placebo in lowering A1C with a between-group difference of 1% in type 2 diabetic patients whose disease was insufficiently controlled with sulfonylurea alone and in whom metformin was contraindicated or not tolerated.

Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study.

BACKGROUND: The PREDATORR (PREvalence of DiAbeTes mellitus, prediabetes, overweight, Obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romania) study is the first national study analyzing the prevalence of diabetes mellitus (DM) and prediabetes, and their association with cardiometabolic, sociodemographic, and lifestyle risk factors in the Romanian population aged 20-79 years. METHODS: This was an epidemiological study with a stratified, cross-sectional, cluster random sampling design. Sociodemographic, lifestyle, and anamnestic data were collected through self- and interviewer-administered questionnaires, and biochemical assays and oral glucose tolerance tests were performed. RESULTS: In all, 2728 participants from 101 clinics of general practitioners were randomly selected, with a probability proportional to population size according to the 2002 Romanian Census. The participation rate was 99.6%. Impaired glucose regulation (prediabetes, known and unknown DM) was found in 28.1% of the study population. The overall age- and sex-adjusted prevalence of DM was 11.6% (95% CI 9.6%-13.6%), of which 2.4% (95% CI 1.7%-3.1%) had unknown DM. The prevalence of DM increased with age and was higher in men than in women. The age- and sex-adjusted prevalence of prediabetes was 16.5% (95%CI 14.8%-18.2%), with the highest percentage in the 60-79 year age group and in women. Obesity, abdominal obesity, dyslipidemia, low education level, and a family history of diabetes were associated with glucose metabolism disorders. CONCLUSIONS: The PREDATORR study shows a high prevalence of impaired glucose regulation in the adult Romanian population, providing data on the prevalence of DM and prediabetes and their association with several risk factors.

An increasing incidence of type 1 diabetes mellitus in Romanian children aged 0 to 17 years.

BACKGROUND: The epidemiology of type 1 diabetes mellitus may provide insights into the pathogenesis of the disease. OBJECTIVE: The aim of this work was to characterize the trend of the incidence of type 1 diabetes mellitus in Romanian children aged from 0 to 17 years over a 10-year interval. SUBJECTS AND METHODS: Data regarding new cases were obtained from two sources: (1) The Romanian Childhood Diabetes Registry and (2) Records of the Medical Center "Cristian Serban", Buzias. The demographic data were retrieved from the National Institute for Statistics. The incidence was calculated for the age groups 0-4, 5-9, 10-14, and 15-17 years. RESULTS: A total of 3196 new cases, aged below 18 years, were found by both the sources. There were significant differences between the groups (p=0.012), the mean incidence being highest in the age group 10-14 years (9.6/100,000/year, 95% CI 9-10.1) and lowest in children aged from 0 to 4 years (4.8/100,000/year, 95% CI 4.4-5.3). Boys were slightly more frequently affected than girls (p=0.038). The age and gender adjusted incidence of type 1 diabetes mellitus increased significantly (p<0.001) from 6.2/100,000/year (95% CI 5.5-6.9) in 2002 to 9.3/100,000/year (95% CI 8.4-10.3) in 2011. The raise in incidence was noticed in all age groups except for 15-17 years. CONCLUSION: Romania is a country with an intermediate incidence of type 1 diabetes mellitus in children, which is slightly higher in boys than in girls. The incidence of type 1 diabetes mellitus increased continuously during the 10-year survey, with the exception of the oldest teens.