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2.
Pediatr Obes ; 18(10): e13065, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37414578

RESUMO

This study aimed to investigate how the COVID-19 pandemic since 2020 has affected the homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI) and degree of obesity among Japanese children. HOMA-IR, BMI and degree of obesity were calculated for 378 children 14-15 years old (boys/girls, 208/170) who underwent checkups during 2015-2021. Changes in these parameters over time and correlations between parameters were assessed, and the proportions of participants with IR (HOMA-IR ≥2.5) were compared. HOMA-IR values increased significantly over the study period (p < 0.001), with a significantly large proportion of participants with IR in 2020-2021 (p < 0.001). Conversely, BMI and degree of obesity did not change significantly. HOMA-IR did not correlate with BMI or degree of obesity during 2020-2021. In conclusion, the COVID-19 pandemic may have had an impact on the increase in the proportion of children with IR, regardless of BMI or degree of obesity.


Assuntos
COVID-19 , Resistência à Insulina , Masculino , Criança , Feminino , Humanos , Adolescente , Índice de Massa Corporal , Pandemias , COVID-19/epidemiologia , Obesidade/epidemiologia , Estudantes , Insulina
3.
Diabetol Int ; 13(4): 606-614, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36117921

RESUMO

Aims: To investigate the changes in patient background and treatment lines between 2016-2019 and contributing factors when sodium-glucose co-transporter 2 inhibitors (SGLT2i) are newly prescribed for type 2 diabetes mellitus patients. Methods: The subjects comprised patients who had attended outpatient clinics at the four Jikei University School of Medicine-affiliated hospitals. One-way analysis of variance was used to evaluate annual changes in patients' characteristics. Logistic regression analysis was also used to explore factors contributing to the treatment lines. Results: The age of the 1951 subjects [mean ± SD] was 59.1 ± 12.8 years; BMI 27.5 ± 4.9 kg/m2; HbA1c 8.15 ± 1.24%; eGFR 74.2 ± 25.3 ml/min/1.73m2. SGLT2i was the 2.86th (± 1.22) new prescription among antidiabetic drugs, and at increasingly earlier treatment lines between 2016 and 2019 (3.28 ± 1.16 to 2.59 ± 1.19; P < 0.001). The age of initial SGLT2i prescription significantly increased over time (P < 0.001). In contrast, the patients' BMI and eGFR values decreased over time. Again, the proportions of patients with chronic kidney disease (CKD) and cardiovascular disease-heart failure disease (CVD-HF) tended to increase over time. The patients for whom SGLT2i had been prescribed in the first line were more likely to have obesity and HF (1.64 [1.15-2.34] and 1.84 [1.12-3.02], respectively). Conclusions: SGLT2i was more likely to be newly prescribed to patients with CVD-HF and CKD, older patients, and to be prescribed in earlier treatment lines in recent years. Obesity and HF were predictor of SGLT2i prescriptions in the first line. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-022-00577-y.

4.
Diabetol Int ; 13(4): 672-678, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36117922

RESUMO

Objective: To investigate glycemic excursions and changes in time in hypoglycemia (hyT) in Japanese type 1 diabetes (T1D) patients 2 months after the first initiation of intermittently scanned continuous glucose monitoring (isCGM). Methods: We enrolled 15 adult T1D patients on insulin therapy to evaluate changes in the parameters for glycemic excursions 2 months after initiating isCGM by using the Wilcoxon signed-rank test. Binomial logistic regression analyses were also used to identify predictors of hypoglycemia. Results: A total of 14 patients were available for analysis. Median HbA1c decreased significantly from 7.6% (interquartile range, 6.9-8.3%) to 7.2% (6.7-7.8%) (P = 0.047). Mean glucose, standard deviation of glucose, time in range, and time above range were not significantly different from baseline, while time below range (from 2.2 [1.0-6.9] to 5.0 [2.0-10.8]%; P = 0.016), hyT (from 26.8 [14.5-75.5] to 56.8 [21.7-110.9] min/day; P = 0.030), and time in severe hypoglycemia (shT, from 4.3 [0.0-8.9] to 11.0 [0.0-24.3] min/day; P = 0.022) increased significantly. Additionally, shT increased significantly only during daytime. The factor associated with hyT was found to be the reduction in total insulin dose after 2 months. Conclusions: In T1D patients with a median HbA1c of 7.6%, HbA1c was significantly decreased 2 months after initiating isCGM, while hyT increased, particularly during daytime. Study results suggest that a reduction in the total insulin dose of about 0.10 U/kg may be required in some cases. These findings need to be taken into account when initiating isCGM. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-022-00585-y.

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