All-cause mortality and risk factors in patients with type 1 diabetes in Castilla-La Mancha, Spain. DIACAM1 2010-2020 study.

INTRODUCTION: Despite better treatments and care for patients with type 1 diabetes (T1DM), all-cause and cardiovascular mortality still remains higher compared to the general population. We evaluated mortality and risk factors for mortality in a representative cohort of patients with T1DM. METHODS: DIACAM1 was a cross-sectional, multicenter study on adult patients (≥ 16 years old) and diabetes with at least 5 years since diabetes diagnosis conducted between 2009 and 2010. DIACAM1 2010-2020 study was a follow-up study, extension of DIACAM1, where vital status of patients was evaluated between June 2019 and June 2020. RESULTS: 4.03% [CI95%, 2.53-5.62) of the 1465 patients with T1DM included in the cohort of the DIACAM1 in 2010 had died. Survival was lower than in the sex- and age-matched general population in the same region. 40.7% of deaths were due to cardiovascular disease. HbA1c levels < 7% and triglyceride levels < 150 mg/dL were associated with lower mortality, whereas retinopathy and plasma creatinine were associated with increased mortality. CONCLUSIONS: We confirmed a lower survival in people with T1DM, with cardiovascular disease being the main cause of mortality. High HbA1c, high triglycerides, retinopathy, and high creatinine are factors associated with mortality.

Prevalencia de enfermedades autoinmunes en pacientes con diabetes mellitus tipo 1. Estudio DIACAM 1 2010-2020 / Prevalence of autoimmune diseases in patients with type 1 diabetes mellitus. DIACAM 1 study 2010-2020

Objective: To evaluate the prevalence of autoimmune diseases (AD) associated with type 1 diabetes mellitus (T1DM).Patients and methodsAnalytical cross-sectional study, nested in a multicenter prospective cohort of 1121 adults with DM1 with active follow-up in endocrinology clinics. Sociodemographic and clinical variables and the presence of AD were analysed in 2010 and 2020.ResultsIn this second analysis, 49,5% were male, mean age was 49.4 ± 12.8 years, median T1DM duration was 27,1 years (20,7-35,1) and mean glycated hemoglobin was 7.66 ± 1.06%. There is an absolute increase of 13% (95% CI 11-15) (p < 0.001) of patients with at least one AE and an absolute increase of 11.6% (95% CI 9.7-13.5) (p < 0.0001) of any type of autoimmune thyroid disease (ATD) after 10 years of follow-up. Likewise, the prevalence of celiac disease, autoimmune gastritis and other AD increased statistically significantly. In the multivariate logistic regression analysis, the factors that were independently associated with the presence of ATD were female gender [OR 2.9 (95% CI 2.3-3.7); p < 0.0001] and the presence of type 1 b diabetes (OR 0.5 [95% CI 0.3-0.9]; p = 0.041).ConclusionsAfter 10 years of follow-up, there is a substantial increase in other types of AE in patients with DM1. It seems necessary to carry out a systematic screening of these AD to optimize the follow-up of patients with 1 TDM, mainly of the ATD. (AU)

Objetivo: Conocer la prevalencia de las enfermedades autoinmunes (EA) asociadas a la diabetes mellitus tipo 1 (DM1).Pacientes y métodosEstudio transversal analítico, anidado en una cohorte prospectiva multicéntrica de 1.121 adultos con DM1 con seguimiento activo en consultas de endocrinología. Se analizaron variables sociodemográficas, clínicas y la presencia de EA en el año 2010 y en el año 2020.ResultadosEn este segundo análisis, la edad media fue de 49,4 ± 12,8 años, siendo el 49,5% varones, con una mediana de tiempo de evolución de la DM1 de 27,1 años (20,7-35,1) y una media de hemoglobina glicosilada de 7,66 ± 1,06%. Existe un incremento absoluto del 13% (IC 95% 11-15) (p < 0,001) de pacientes con al menos una EA y un incremento absoluto de 11,6% (IC 95% 9,7-13,5) (p < 0,0001) de cualquier tipo de enfermedad tiroidea autoinmune (ETA) tras 10 años de seguimiento. Así mismo, aumentó la prevalencia de manera estadísticamente significativa de la gastritis autoinmune, enfermedad celiaca y otras EA. En el análisis de regresión logística multivariante, los factores que se asociaron de manera independiente a la presencia de ETA fueron el género femenino (OR 2,9 [IC 95% 2,3-3,7]; p < 0,0001) y la DM1 tipo b (OR 0,5 [IC 95% 0,3-0,9]; p = 0,041).ConclusionesTras 10 años de seguimiento activo se produce un incremento sustancial de otro tipo de EA en pacientes con DM1. Parece necesario realizar un cribado sistemático de dichas EA para optimizar el seguimiento de los pacientes con DM1, fundamentalmente de la ETA. (AU)

Prevalence of autoimmune diseases in patients with type 1 diabetes mellitus. DIACAM 1 study 2010-2020. / Prevalencia de enfermedades autoinmunes en pacientes con diabetes mellitus tipo 1. Estudio DIACAM 1 2010-2020.

OBJECTIVE: To evaluate the prevalence of autoimmune diseases (AD) associated with type 1 diabetes mellitus (T1DM). PATIENTS AND METHODS: Analytical cross-sectional study, nested in a multicenter prospective cohort of 1121 adults with DM1 with active follow-up in endocrinology clinics. Sociodemographic and clinical variables and the presence of AD were analysed in 2010 and 2020. RESULTS: In this second analysis, 49,5% were male, mean age was 49.4 ± 12.8 years, median T1DM duration was 27,1 years (20,7-35,1) and mean glycated hemoglobin was 7.66 ± 1.06%. There is an absolute increase of 13% (95% CI 11-15) (p < 0.001) of patients with at least one AE and an absolute increase of 11.6% (95% CI 9.7-13.5) (p < 0.0001) of any type of autoimmune thyroid disease (ATD) after 10 years of follow-up. Likewise, the prevalence of celiac disease, autoimmune gastritis and other AD increased statistically significantly. In the multivariate logistic regression analysis, the factors that were independently associated with the presence of ATD were female gender [OR 2.9 (95% CI 2.3-3.7); p < 0.0001] and the presence of type 1 b diabetes (OR 0.5 [95% CI 0.3-0.9]; p = 0.041). CONCLUSIONS: After 10 years of follow-up, there is a substantial increase in other types of AE in patients with DM1. It seems necessary to carry out a systematic screening of these AD to optimize the follow-up of patients with 1 TDM, mainly of the ATD.

Ischemic colitis and short bowel disease due to choronavirus disease 2019 (COVID 19).

COVID-19 has spread worldwide, with more than 2.5 million cases and over 80,000 deaths reported by the end of April 2020. In addition to pulmonary symptoms, gastrointestinal symptoms have been increasingly recognized as part of the disease spectrum. COVID-19-associated coagulopathy has recently emerged as a major component of the disease, leading to high morbidity and mortality. Ischemic colitis has been reported to be associated with a hypercoagulable state, However few cases have been reported of COVID-19 associated with ischemic colitis. We would like to report a case of a 53 year old man with medical history of type 2 diabetes, and hypercholesterolemia, with ishchemic colitis as first manifestation of infection of COVID 19.

Valores de referencia y cribado universal de la función tiroidea en el primer trimestre de la población de mujeres gestantes del área de Toledo / Reference values and universal screening of thyroid function in the first trimester of the population of pregnant women in Toledo (Spain)

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