Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 82.437
Filtrar
1.
Invest Ophthalmol Vis Sci ; 63(1): 5, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34985498

RESUMO

Purpose: The gut microbiome has been linked to disease pathogenesis through their interaction in metabolic, endocrine, and immune functions. The goal of this study was to determine whether the gut and plasma microbiota could transfer microbes to the retina in type 1 diabetic mice with retinopathy. Methods: We analyzed the fecal, plasma, whole globe, and retina microbiome in Akita mice and compared with age-matched wild-type (WT) mice using 16S rRNA sequencing and metatranscriptomic analysis. To eliminate the contribution of the ocular surface and plasma microbiome, mice were perfused with sterile saline solution, the whole globes were extracted, and the neural retina was removed under sterile conditions for retinal microbiome. Results: Our microbiome analysis revealed that Akita mice demonstrated a distinct pattern of microbes within each source: feces, plasma, whole globes, and retina. WT mice and Akita mice experienced transient bacteremia in the plasma and retina. Bacteria were identified in the retina of the Akita mice, specifically Corynebacterium, Pseudomonas, Lactobacillus, Staphylococcus, Enterococcus, and Bacillus. Significantly increased levels of peptidoglycan (0.036 ± 0.001 vs. 0.023 ± 0.002; P < 0.002) and TLR2 (3.47 ± 0.15 vs. 1.99 ± 0.07; P < 0.0001) were observed in the retina of Akita mice compared to WT. Increased IBA+ cells in the retina, reduced a- and b-waves on electroretinography, and increased acellular capillary formation demonstrated the presence of retinopathy in the Akita cohort compared to WT mice. Conclusions: Together, our findings suggest that transient bacteremia exists in the plasma and retina of both cohorts. The bacteria found in Akita mice are distinct from WT mice and may contribute to development of retinal inflammation and barrier dysfunction in retinopathy.


Assuntos
Bacteriemia/microbiologia , Bactérias/isolamento & purificação , Retinopatia Diabética/microbiologia , Fezes/microbiologia , Retina/microbiologia , Animais , Bactérias/genética , Diabetes Mellitus Tipo 1/microbiologia , Modelos Animais de Doenças , Eletrorretinografia , Ensaio de Imunoadsorção Enzimática , Olho/microbiologia , Microbioma Gastrointestinal/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microbiota/fisiologia , RNA Ribossômico 16S/genética
2.
Br J Nurs ; 31(1): 34-39, 2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35019739

RESUMO

With more people being diagnosed with diabetes and requiring insulin therapy as they live longer, an increasing number of individuals are needing access to blood and ketone monitoring that is simple to use and provides accurate results. Having access to a bolus advisor is equally important in order for people with diabetes to calculate accurate insulin doses based on the foods that they are eating. The use of app-based technology for healthcare purposes has increased over recent years and now includes the Diabetes:M application that can be used in conjunction with the 4SURE smart meters with no additional cost to the individual.


Assuntos
Diabetes Mellitus Tipo 1 , Aplicativos Móveis , Glicemia , Automonitorização da Glicemia , Humanos , Hipoglicemiantes/uso terapêutico , Insulina , Cetonas , Tecnologia
3.
BMC Health Serv Res ; 22(1): 46, 2022 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-35000599

RESUMO

BACKGROUND: The aim of this work was to develop a National Evaluation Framework to facilitate the standardization of delivery, quality, reporting, and evaluation of diabetes education and support programs delivered throughout Australia through the National Diabetes Services Scheme (NDSS). The NDSS is funded by the Australian Government, and provides access to diabetes information, education, support, and subsidized product across diverse settings in each state and territory of Australia through seven independent service-providers. This article reports the approach undertaken to develop the Framework. METHODS: A participatory approach was undertaken, focused on adopting nationally consistent outcomes and indicators, nominating objectives and measurement tools, specifying evaluation processes, and developing quality standards. Existing programs were classified based on related, overarching indicators enabling the adoption of a tiered system of evaluation. RESULTS: Two outcomes (i.e., improved clinical, reduced cost) and four indicators (i.e., improved knowledge and understanding, self-management, self-determination, psychosocial adjustment) were adopted from the Eigenmann and Colagiuri national consensus position statement for diabetes education. This allowed for the identification of objectives (i.e., improved empowerment, reduced distress, autonomy supportive program delivery, consumer satisfaction) and related measurement instruments. Programs were categorized as comprehensive, topic-specific, or basic education, with comprehensive programs allocated to receive the highest-level of evaluation. Eight quality standards were developed, with existing programs tested against those standards. Based on the results of testing, two comprehensive (OzDAFNE for people with type 1 diabetes, DESMOND for people with type 2 diabetes), and eight topic-specific (CarbSmart, ShopSmart, MonitorSmart, FootSmart, MedSmart, Living with Insulin, Insulin Pump Workshop, Ready Set Go - Let's Move) structured diabetes self-management education and support programs were nominated for national delivery. CONCLUSIONS: The National Evaluation Framework has facilitated consistency of program quality, delivery, and evaluation of programs delivered by multiple service providers across diverse contexts. The Framework could be applied by other service providers who facilitate multiple diabetes education and support programs and could be adapted for use in other chronic disease populations where education and support are indicated.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Educação em Enfermagem , Autogestão , Austrália , Humanos
4.
S D Med ; 75(1): 20-24, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35015939

RESUMO

BACKGROUND: Diabetic ketoacidosis (DKA) is a life-threatening complication seen in patients suffering from type I diabetes (T1D) with a cost burden of over $5 billion in the U.S. annually. Often, children are first diagnosed with T1D when they present with DKA. Our study examines the impact of payer type on pediatric DKA. We hypothesize that Medicaid payer type negatively impacts costs and care outcomes in pediatric patients with DKA as compared to private payers. METHODS: We utilized the Agency for Healthcare Research and Quality (AHRQ) 2012 Kids' Inpatient Database (KID) for analysis. Our inclusion criterion included All Patient Refined Diagnosis Related Groups (APR-DRG) coding for T1D DKA admissions with a uniform severity and an identifiable payer of Medicaid or private insurance. RESULTS: 27,241 weighted and severity-adjusted discharges met criterion (51.6 percent Medicaid payers, 48.4 percent private). Comparing Medicaid vs. private payer status, we found: length of stay (2.24 days vs. 2.09), number of procedures received (0.13 vs. 0.12), and total charges ($16,449 vs. $16,107). Limiting analysis to a crude measure of bottom quartile income showed: length of stay (2.26 days vs. 2.14), number of procedures received (0.12 vs. 0.12), and total charges ($15,393 vs. $14,063). CONCLUSIONS: Children admitted in DKA and covered by Medicaid had longer hospitalizations, more procedures performed, and higher total costs of care. Even after controlling for socioeconomic status, similar effects persisted. Further evaluations are warranted to reveal the causative factors behind these correlative findings which suggest DKA patients receive different care depending on their payer status.


Assuntos
Diabetes Mellitus Tipo 1 , Cetoacidose Diabética , Criança , Cetoacidose Diabética/epidemiologia , Cetoacidose Diabética/terapia , Hospitalização , Humanos , Medicaid , Estudos Retrospectivos , Classe Social , Estados Unidos/epidemiologia
5.
Diabetes Metab Res Rev ; 38(1): e3508, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34990520

RESUMO

Emerging evidence indicates a bi-directional relationship between SARS-CoV-2 and diabetes. The possibility exists that SARS-CoV-2 could induce diabetes, but it is not yet clear whether this might be a fulminant-type diabetes, autoimmune diabetes, or a new-onset transient hyperglycaemia. This viewpoint discusses mechanisms by which SARS-CoV-2 might trigger type 1 diabetes mellitus (T1DM). Specifically, we looked at the role of post-translational protein modifications (PTMs) and the generation of neoepitopes as a potential mechanism in the induction of islet autoimmunity, and the pathways via which coronavirus infections might exacerbate the formation of PTMs and, in so doing, provoke the onset of T1DM.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Processamento de Proteína Pós-Traducional , COVID-19/epidemiologia , COVID-19/metabolismo , Diabetes Mellitus Tipo 1/epidemiologia , Humanos
6.
J Colloid Interface Sci ; 605: 582-591, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34343731

RESUMO

Diabetes is a metabolic disease that is affecting an ever-increasing number of people worldwide, resulting in increased burdens on healthcare systems and societies. Constant monitoring of blood glucose levels is required to prevent serious or even deadly complications. One major challenge of diabetes management is the simple and timely administration of insulin to facilitate consistent blood glucose regulation and reduce the incidence of hypoglycemia. With this research, we construct an insulin delivery system, the delivery system is comprised of phenylboronic acid based fluorescent probes, which is used as glucose responsive linkers, mesoporous silica nanoparticles providing an insulin reservoir, and zinc oxide nanoparticles used as gate keepers. The system with glucose sensitive responsive linker exhibits controlled release of insulin under high glucose concentrations, providing prolonged blood glucose regulation and no risks of hypoglycemia. Furthermore, the system is combined with a hyaluronic-acid based microneedle patch, which exhibit efficient skin penetration for transdermal delivery. With our system, the nanoparticles provide outstanding in vivo glucose regulation when administrated by subcutaneous injection or via transdermal microneedle patch. We anticipate that our biocompatible smart glucose responsive microneedle patch (SGRM patch) will facilitate the development of clinically useful systems.


Assuntos
Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 1 , Hipoglicemia , Animais , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Sistemas de Liberação de Medicamentos , Humanos , Hipoglicemia/tratamento farmacológico , Insulina , Agulhas
7.
Support Care Cancer ; 30(1): 635-645, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34363110

RESUMO

BACKGROUND: OBJECTIVE: Having a child diagnosed with cancer is stressful for the whole family and may cause significant psychological impact on parents and siblings. Chronic, life-altering diseases may also have similar effects in siblings due to the daily life changes in the family to accommodate the child with chronic disease. We investigated the impact of having a sibling with cancer or type 1 diabetes mellitus (T1DM) on the psychological features of adolescents, with particular focus on self-conscious emotions such as guilt and shame-which are associated with the development of psychopathologies. METHOD: Sixty-four children who were siblings of patients diagnosed with cancer (CS group), 54 children who were siblings of patients diagnosed with T1DM (DMS group), and 200 adolescents with siblings who did not have any chronic disease (control group) were included in the study. The CS group was also divided into two subgroups with respect to cancer type (leukemia and non-leukemia). Feelings of guilt and shame were evaluated via the Test of Self-Consciousness Affect for Adolescents (TOSCA-A). The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used to determine the levels of depression and anxiety symptoms. Comparisons between groups were performed and within-group directional relationships between scores were analyzed. RESULTS: Guilt scores were significantly higher in CSs than controls (p = 0.009), and the guilt scores of CSs and DMSs were similar (p = 0.508). Other subdimension scores obtained from the TOSCA-A and the CDI and STAI scores were similar in all three groups. In the CS group, externalization scores of siblings with leukemia were significantly higher than that of siblings with non-leukemia cancer. Although shame scores were similar in the CS, DMS, and control groups, shame scores were found to be positively correlated with CDI and STAI total scores in each group (p < 0.05 for all), whereas guilt scores did not demonstrate any significant correlations. CONCLUSION: Our results support prior studies in showing that CSs feel a greater level of guilt compared to adolescents without disease-stricken siblings, whereas, interestingly, CSs and DMSs were found to experience similar levels of guilt. Despite lack of significant increase in the CS and DMS groups, shame levels were positively correlated with depression and anxiety scores in all groups, but the lower correlation coefficients for the CS group indicate the presence of other factors influencing this relationship. We believe our results warrant the need for future studies evaluating the needs of the siblings of children with other chronic diseases, preferably with longitudinal follow-up to determine situations associated with need for psychosocial support.


Assuntos
Diabetes Mellitus Tipo 1 , Neoplasias , Adolescente , Transtornos de Ansiedade , Criança , Emoções , Humanos , Irmãos
8.
Environ Res ; 203: 111859, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34389348

RESUMO

BACKGROUND: Evidence for the metabolic impact of long-term exposure to air pollution on diabetes is lacking. We investigated the association of particulate matter <10 µm (PM10) and <2.5 µm (PM2.5) with yearly averages of HbA1c, daily insulin dose (IU/kg) and rates of severe hypoglycaemia in type 1 diabetes (T1D). METHODS: We studied data of 44,383 individuals with T1D < 21 years which were documented in 377 German centres within the diabetes prospective follow-up registry (DPV) between 2009 and 2018. Outcomes were aggregated by year and by patient. PM10-and PM2.5-yearly averages prior to the respective treatment year were linked to individuals via the five-digit postcode areas of residency. Repeated measures linear and negative binomial regression were used to study the association between PM-quartiles (Q1 lowest, Q4 highest concentration) and yearly averages of HbA1c, daily insulin dose and rates of severe hypoglycaemia (confounders: sex, time-dependent age, age at diabetes onset, time-dependent type of treatment, migratory background, degree of urbanisation and socioeconomic index of deprivation). RESULTS: Adjusted mean HbA1c increased with PM10 (Q1: 7.96% [95%-CI: 7.95-7.98], Q4: 8.03% [8.02-8.05], p-value<0.001) and with PM2.5 (Q1: 7.97% [7.95-7.99], Q4: 8.02% [8.01-8.04], p < 0.001). Changes in daily insulin dose were inversely related to PM (PM10 and PM2.5: Q1 0.85 IU/kg [0.84-0.85], Q4: 0.83 IU/kg [0.82-0.83], p < 0.001). Adjusted rates of severe hypoglycaemia increased with PM-quartile groups (PM10 Q1:11.2 events/100 PY [10.9-11.5], PM10 Q4: 15.3 [14.9-15.7], p < 0.001; PM2.5 Q1: 9.9 events/100 PY [9.6-10.2], PM2.5 Q4: 14.2 [13.9-14.6], p < 0.001). DISCUSSION: Air pollution was associated with higher HbA1c levels and increased risk of severe hypoglycaemia in people with T1D, consequently indicating a higher risk of diabetes complications. Further studies are needed to explore causal pathways of the observed associations.


Assuntos
Poluentes Atmosféricos , Diabetes Mellitus Tipo 1 , Hipoglicemia , Adolescente , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Criança , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/epidemiologia , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/epidemiologia , Material Particulado/análise , Material Particulado/toxicidade , Estudos Prospectivos
9.
Life Sci ; 289: 120224, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34896343

RESUMO

BACKGROUND: T cell mediates immune response in type 1 diabetes mellitus (T1DM) through its trafficking into pancreatic islets. The role of A Disintigrin And Metalloproteinase 10 (ADAM10) and 17 (ADAM17) in pancreatic T-cells recruitment into the pancreatic islets during T1DM is not known. AIM: Explore the role of ADAM10 and ADAM17 in the processing of CXCL16 in T1DM and possible protective effect of simvastatin (SIM) in streptozotocin (STZ)-induced T1DM. MAIN METHODS: Balb/c mice were classified into 4 groups, 10 each. Control group received buffer while SIM group received 50 mg/kg, i.p daily for 12 days starting from day 4 of the experiment. Diabetic group; received STZ (55 mg/kg, i.p.) for 5 consecutive days starting from day 1 of the experiment. SIM + STZ group; received SIM (50 mg/kg, i.p.) daily for 12 days and STZ (55 mg/kg, i.p.) for 5 consecutive days. Biochemical, inflammatory and apoptotic markers as well as expression of CXCL16, ADAM10, NF-κB and pancreatic T-cells expression were analyzed. KEY FINDINGS: Significant increase in biochemical, inflammatory, apoptotic parameters, expression of ADAM10, ADAM17, CXCL16, NF-κB, and infiltrated T-cells to the pancreatic islets were found in STZ group. SIM treatment in the presence of STZ improved biochemical and inflammatory parameters as well as it reduced the expression of CXCL16, ADAM10, ADAM17, NF-κΒ, T-cells migration and apoptosis in the pancreatic islets. SIGNIFICANCE: SIM mitigated pancreatic ß-cell death induced by STZ through down regulation of ADAM10, ADAM17and CXCL16. Therefore, ADAM10/ADAM17 and CXCL16 may serve as novel therapeutic targets for T1DM.


Assuntos
Proteína ADAM10/biossíntese , Proteína ADAM17/biossíntese , Secretases da Proteína Precursora do Amiloide/biossíntese , Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 1 , Regulação para Baixo/efeitos dos fármacos , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Proteínas de Membrana/biossíntese , Sinvastatina/farmacologia , Animais , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/enzimologia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/enzimologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C
10.
Metabolism ; 126: 154924, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34728221

RESUMO

Basal insulin treatment is indispensable for patients with type 1 diabetes and often required by many with type 2 diabetes. Incremental advances lengthening the duration of action of insulin analogs and reducing pharmacodynamic variability have resulted in truly once-daily, long-acting basal insulin analogs. In the quest for better basal insulins to facilitate improvements in glycemic control and long-term outcomes, the driving need is to remove barriers delaying timely initiation of basal insulin, to maximize treatment adherence and persistence and reduce treatment burden without increasing risk of hypoglycemia. We review the range of investigational once-weekly insulins and their molecular strategies and profiles. Currently, the two most advanced clinical development programs are: (1) basal insulin icodec, an insulin analog acylated with a C20 fatty diacid (icosanedioic acid) side chain (Novo Nordisk) and (2) basal insulin Fc, a fusion protein that combines a single-chain insulin variant with a human immunoglobulin G fragment crystallizable domain (Eli Lilly). Available phase 2 data for these two once-weekly agents show comparable glycemic control to existing once-daily insulin analogs, with no greater risk of hypoglycemia. While phase 3 data are awaited to confirm efficacy and safety, we provide future clinical perspectives on practical considerations for the potential use of once-weekly insulins.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Insulina de Ação Prolongada/uso terapêutico , Glicemia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Humanos , Hipoglicemiantes/administração & dosagem , Insulina de Ação Prolongada/administração & dosagem
12.
Clin Dysmorphol ; 31(1): 11-17, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34654017

RESUMO

DNAJC3, a co-chaperone of BiP, is a member of the heat shock protein family. These proteins are produced in the endoplasmic reticulum (ER) to counter cell stress resulting from healthy functional protein processing. Dysregulation of unfolded proteins within the ER is implicated as a mechanism of genetic disease. Examples include Marinesco-Sjogren and Wolcott-Rallison syndromes that share similar clinical features, manifesting neurodegenerative disease and endocrine dysfunction. Recently, loss of function mutations in DNAJC3 was associated with syndromic diabetes mellitus in three families. The full phenotype included neurodegeneration, ataxia, deafness, neuropathy, adolescent-onset diabetes mellitus, growth hormone deficiency and hypothyroidism. A subsequent report of two unrelated individuals extended the phenotype to include early-onset hyperinsulinaemic hypoglycaemia. Here, we describe two siblings that recapitulate this extended phenotype in association with a homozygous novel mutation in the final exon of DNAJC3 [c.1367_1370delAGAA (p.Lys456SerfsTer85)] resulting in protein elongation predicted to abrogate the functional J domain. This report confirms DNAJC3 as a cause of syndromic congenital hyperinsulinaemic hypoglycaemia. Currently, PanelApp only includes this gene on diabetes mellitus panels. We propose DNAJC3 should be promoted from a red to a green gene on a wider number of panels to improve the diagnosis of this rare condition.


Assuntos
Diabetes Mellitus Tipo 1 , Doenças Neurodegenerativas , Adolescente , Criança , Deficiências do Desenvolvimento , Proteínas de Choque Térmico HSP40/genética , Humanos , Insulina , Mutação
13.
Arch. pediatr. Urug ; 92(2): e307, dic. 2021. ilus, tab
Artigo em Espanhol | LILACS, BNUY, UY-BNMED | ID: biblio-1339135

RESUMO

Las porfirias son un grupo complejo y heterogéneo de defectos en la vía de la síntesis del hemo. La porfiria hepato eritropoyética es un subtipo muy poco frecuente y de presentación en la infancia, con compromiso cutáneo predominante. Describimos el caso clínico de una paciente de 5 años, que se presenta con lesiones cutáneas e hipertricosis, se confirma el diagnóstico por elevación de uroporfirinas en orina y secuenciación del gen UROD.


Porphyria is a complex and heterogeneous group of heme synthesis disorder. Hepato-erythropoietic porphyria is a very rare subtype that onsets in childhood, and shows predominant skin involvement. We describe the clinical case of a 5-year-old patient who showed skin lesions and hypertrichosis and whose diagnosis was confirmed due to increased uroporphyrins in urine and UROD gene sequencing


A porfiria é um grupo complexo e heterogêneo de distúrbios da síntese do grupo heme. A porfiria hepato-eritropoiética é um subtipo muito raro que se inicia na infância e mostra envolvimento predominante da pele. Descrevemos o caso clínico de uma paciente de 5 anos que apresentou lesões cutâneas e hipertricose e cujo diagnóstico foi confirmado por aumento de uroporfirinas na urina e sequenciamento do gene UROD.


Assuntos
Humanos , Feminino , Pré-Escolar , Vesícula/etiologia , Porfiria Hepatoeritropoética/complicações , Porfiria Hepatoeritropoética/genética , Porfiria Hepatoeritropoética/urina , Diabetes Mellitus Tipo 1/complicações , Hipertricose/etiologia , Uroporfirinogênio Descarboxilase/análise , Uroporfirinas/urina , Vesícula/tratamento farmacológico , Coproporfirinas/urina , Hipertricose/tratamento farmacológico
14.
Pan Afr Med J ; 40: 100, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34909088

RESUMO

Introduction: flexible insulin therapy (FIT) is considered as a crucial turning point in the management of type 1 diabetes. The purpose of this study was to evaluate the impact of this optimum therapeutic approach on improving metabolic control and decreasing hypoglycemic events in patients with type 1 diabetes. Methods: thirty-seven type 1 diabetic patients were included in a five days training programme of FIT. They had an HbA1c between 7.5 and 10%. Those patients were enrolled in a flexible insulin program and we evaluate clinical and metabolic parameters (glycated haemoglobin (HbA1c), hypoglycemic events, body mass index (BMI) and the rate of blood glucose measurements) before the course of FIT and 3, 6 and 9 months after the course. Results: over a 9 months period of the study, the frequency of mild hypoglycemia decreased from 11.7 to 1.7 episodes/3 months (p = 0.005). The baseline HbA1c value improved by 1% at 3 months with an increase of 0.2% at 6 months, which remained unchanged at 9 months (p = <0.0001). Patients who were poorly controlled (HbA1c ≥ 8%) improved their baseline HbA1c value from 9.2% to 8.0% (p = <0.0001). Conclusion: the present study confirms that a structured training programme for FIT improves glycemic control and decreases hypoglycemic events in patients with type 1 diabetes and it can be adopted in countries with weak or intermediate income (e.g. Morocco), which allows those patients to take advantages of this therapeutic approach.


Assuntos
Diabetes Mellitus Tipo 1 , Hipoglicemia , Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hemoglobina A Glicada/análise , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/epidemiologia , Hipoglicemia/prevenção & controle , Hipoglicemiantes , Insulina
15.
J Prev Med Hyg ; 62(3): E673-E680, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34909495

RESUMO

Background: Saudi Arabia ranks the 4th country in the world in incidence rate of Type 1 Diabetes (T1D), which is usually diagnosed in children and teens. Managing T1D at school is important for children's short- and long-term health. Little is known about how much teachers are compatible to support students with diabetes in schools in northern Saudi Arabia. The aim of this study was to assess factual knowledge about T1D among teachers in public female elementary schools. Materials and methods: This was a cross-sectional survey conducted in 18 elementary schools in Hail region, during October 16, 2019 to January 23, 2020. A structured self- administered questionnaire approached all school teachers and other school staff caring students (n = 600). Results: A total of 504 questionnaires received completed (84.0% response rate). Overall, 220 (43.7%) teachers reported having had or currently having a student/s with T1D. Only a small percentage (10.8%) who stated that they had received training to support students with T1D. Participant attained an overall fair knowledge score (13.20 ± 3.81 on 20-point scale; 66.0%), however, only 27.3% who attained good score (≥ 80%) compatible with being an effective support person for students with diabetes. The multivariate logistic regression model, revealed that: (1) received training [adjusted Odds Ratio (aOR: 3.38; p < 0.001); (2) have/ever had diabetic student/s (aOR: 2.02; p = 0.002); (3) teacher himself is diabetic or have a near contact diabetic person (aOR: 2.35; p = 0.001); (4) family history of diabetes (aOR: 1.84; p = 0.015); and (5) teacher's capacity to inject insulin (aOR: 1; p = 0.003), were factors that predicted teacher's good knowledge. Conclusion: Teachers in female elementary schools in our region need to improve their knowledge about diabetes in children, especially recognizing and management of diabetic emergencies. Training programs are crucially needed to empower teachers with knowledge and self-confidence in helping students with diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Estudos Transversais , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Arábia Saudita/epidemiologia , Instituições Acadêmicas , Inquéritos e Questionários
16.
Rev Assoc Med Bras (1992) ; 67(12): 1816-1820, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34909955

RESUMO

OBJECTIVE: This study aims to determine the effect of group hope therapy on the self-efficacy of adolescents with type 1 diabetes. METHODS: This randomized clinical trial was conducted on 45 adolescent patients with type 1 diabetes in Iran. The subjects were randomly assigned into the intervention and control groups. The intervention group received eight 90-min sessions of group hope therapy using Snyder's method. RESULTS: The mean score of self-efficacies in the intervention group was significantly higher than the control group (p<0.05). CONCLUSION: The results of the study suggested that group hope therapy had a significant impact on self-efficacy of adolescents with type 1 diabetes but had no effect on academic self-efficacy and self-efficacy in blood glucose management.


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Diabetes Mellitus Tipo 1/tratamento farmacológico , Humanos , Irã (Geográfico) , Autoeficácia
17.
Am J Case Rep ; 22: e933879, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34910717

RESUMO

BACKGROUND Wounds affect millions of people world-wide, with care being costly and difficult to deliver remotely. The ongoing COVID-19 pandemic highlights the urgent need for telehealth solutions to play a larger role as part of remote care strategies for patient monitoring and care. We describe our findings on the use of a patient-facing wound care app (Swift Patient Connect App, Swift Medical, Canada) as an innovative solution in remote wound assessment and management of a diabetic patient's wound. CASE REPORT In February 2020, a 57-year-old man with type I diabetes and peripheral arterial disease presented with osteomyelitis in the left foot at the fifth metatarsal, arising from a chronic ulcer. The wound was deep, with purulent discharge and polymicrobial growth. A 6-week course of intravenous antibiotics was administered, with slow improvement of the wound. At a follow-up appointment in June 2020, The Patient Connect app was recommended to the patient to securely share calibrated images of his wound as well to communicate with his doctor. Between June 2020 and January 2021, wound closure was accurately monitored as part of the management of this diabetic foot infection. The app was also used in the management of 2 subsequent wounds and infection episodes. CONCLUSIONS Use of the Swift Patient Connect App designed to monitor and manage wounds by a patient with diabetes and foot ulcer as part of a remote care strategy resulted in numerous benefits expressed by the patient. After initial adoption, 3 successive wounds were managed with a combination of in-person and telehealth visits complemented by the app. Incorporation of this technology as part of a novel telemedicine strategy promises to have an extensive impact on remote care delivery during the current COVID-19 pandemic and beyond.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Pé Diabético , Aplicativos Móveis , Diabetes Mellitus Tipo 1/complicações , Pé Diabético/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Smartphone
18.
Nutrients ; 13(12)2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34960025

RESUMO

BACKGROUND AND AIMS: A higher frequency of dyslipidemia is reported in children with type 1 diabetes (T1D) and celiac disease (CD). Recently, continuous subcutaneous insulin infusion (CSII) has been associated with better lipid profiles in patients with T1D. The aim of this study was to investigate the association between treatment modality and lipid profile, metabolic control, and body mass index (BMI)-SDS in children with both T1D and CD. METHODS: Cross-sectional study in children registered in the international SWEET database in November 2020. Inclusion criteria were children (2-18 years) with T1D and CD with available data on treatment modality (CSII and injections therapy, IT), triglyceride, total cholesterol, HDL, LDL, dyslipidemia, HbA1c, and BMI-SDS. Overweight/obesity was defined as > +1 BMI-SDS for age. Data were analyzed by linear and logistical regression models with adjustment for age, gender, and diabetes duration. RESULTS: In total 1009 children with T1D and CD (female 54%, CSII 54%, age 13.9 years ±3.6, diabetes duration 7.2 years ±4.1, HbA1c 7.9% ±1.4) were included. Significant differences between children treated with CSII vs. IT were respectively found; HDL 60.0 mg/dL vs. 57.8 mg/dL, LDL 89.4 mg/dL vs. 94.2 mg/dL, HbA1c 7.7 vs. 8.1%, BMI-SDS 0.4 vs. 0.6, overweight and obesity 17% vs. 26% (all p < 0.05). CONCLUSIONS: CSII is associated with higher HDL and lower LDL, HbA1c, BMI-SDS, and percentage of overweight and obesity compared with IT in this study. Further prospective studies are required to determine whether CSII improves lipid profile, metabolic control and normalize body weight in children with both T1D and CD.


Assuntos
Doença Celíaca/terapia , Diabetes Mellitus Tipo 1/terapia , Hiperlipidemias/prevenção & controle , Insulina/uso terapêutico , Lipídeos/sangue , Adolescente , Criança , Pré-Escolar , Feminino , Hemoglobina A Glicada , Humanos , Hipoglicemiantes/uso terapêutico , Agências Internacionais , Masculino
19.
JAMA Netw Open ; 4(12): e2138775, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34905004

RESUMO

Importance: Patients with type 1 diabetes (T1D) and a family history of type 2 diabetes (T2D) appear to be at a high risk of diabetes complications and other cardiovascular diseases. However, estimates of individual risks in patients in Taiwan are largely unavailable or unreliable. Objective: To evaluate the risk of diabetes complications and major adverse cardiovascular events (MACEs) in patients with T1D with a family history of T2D. Design, Setting, and Participants: A population-based cohort study used the Taiwan National Health Insurance Research Database. Participants included all individuals registered in that database on December 31, 2017, and followed up since March 1, 1995. The data were analyzed from December 6, 2018, to December 5, 2019. Exposure: Patients with T1D and a family history of T2D were evaluated. Main Outcomes and Measures: The prevalence and hazard ratios (HRs) of diabetes complications and other cardiovascular diseases in patients with T1D were analyzed. The MACEs were identified by diagnostic or procedural codes and heritability was formulated by the registry data of beneficiaries. Results: Of 27 370 965 individuals included in the database, 11 237 (mean [SD] age, 22.7 [14.4] years; 54% were female) had T1D. The crude prevalence of T1D was 0.04%, with a female to male ratio of 1.22: 1. The adjusted HRs in individuals who had a first-degree relative with T2D were 2.61 (95% CI, 1.32-5.16) for MACEs at an age at diagnosis of less than 20 years. Adjusted HRs were 1.44 (95% CI, 1.27-1.64) for diabetic neuropathy, 1.28 (95% CI, 1.12-1.47) for retinopathy, and 1.24 (95% CI, 1.06-1.47) for neuropathy at all ages of diagnosis. Conclusions and Relevance: In this study of patients in Taiwan with T1D, having relatives with T2D was associated with an increase in the individual risks of developing diabetes complications. Patients with T1D and a family history of T2D might have more complications and require close management.


Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/etiologia , Retinopatia Diabética/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Bases de Dados Factuais , Nefropatias Diabéticas/epidemiologia , Retinopatia Diabética/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Anamnese , Pessoa de Meia-Idade , Prevalência , Modelos de Riscos Proporcionais , Fatores de Risco , Taiwan
20.
New Microbiol ; 44(4): 241-244, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34942009

RESUMO

Type 1 diabetes (T1DM) ethiopathogenesis is still being studied, since the role of environmental factors , especially viruses, is not yet clear. This study was conducted on 31 paediatric patients with T1DM at onset. We analysed: Coxsackieviruses A (CoxA), Coxsackieviruses B (CoxB), Echoviruses (Echo); Influenzavirus A and B (IV-A and IV-B); Adenovirus (AdV); Parainfluenza viruses 1-2 and 3 (PiV 1-2-3); Cytomegalovirus (CMV) and Respiratory Syncytial Virus (RSV). Enteroviruses, especially CoxB and Echo, are most represented. Unexpectedly, Parainfluenza viruses were detected in seasonal subgroups, with peaks in autumn and spring, and spread homogeneously in different age groups.


Assuntos
Diabetes Mellitus Tipo 1 , Infecções por Enterovirus , Infecções por Paramyxoviridae , Infecções Respiratórias , Vírus , Criança , Humanos , Lactente , Estações do Ano
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...