Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Diabetes Mellitus Tipo 1/complicações , Humanos , Injeções Subcutâneas , Sistemas de Infusão de Insulina , Prognóstico , Fatores de RiscoRESUMO
OBJECTIVES: Structural, metabolic, and functional signs of skeletal muscle damage have been identified in individuals affected by type 1 diabetes (T1D), but, to our knowledge, no guidelines for the diagnosis and treatment of muscle impairment exist and studies on T1D and muscle health remain limited. The aim of this study was to evaluate the prevalence of sarcopenia in a long-term T1D population and to assess the effects of some clinical parameters on muscle mass and function. METHODS: Thirty-nine patients affected by T1D were enrolled. Body mass index (BMI), body composition (appendicular lean mass index [ALMI] and fat mass [FM]), and muscle strength were measured. Additionally, the relationship between Mediterranean diet adherence and sarcopenia was assessed. RESULTS: In the present sample (mean age 49.32 ± 13.49 y, 41.1% women, mean duration of diabetes 30.13 ± 12.28 y), the prevalence of sarcopenia was 7.7% (12.5 % in women and 4.35% in men). The prevalence of low ALMI was 23.1% (25% in women and 21.74% in men). Significant inverse correlations were found between ALMI and duration of diabetes and ALMI and FM; and significant positive correlations between ALMI and BMI, physical activity level, and muscle strength. At the same time, significant inverse correlations were observed between muscle strength and duration of diabetes and muscle strength and FM. CONCLUSIONS: We observed a high prevalence of low muscle mass, similar to those found in the older age groups of the general population (25 years in advance) and our findings suggest a possible pathogenetic role of T1D duration on muscle trophism and function.
Assuntos
Diabetes Mellitus Tipo 1 , Sarcopenia , Masculino , Humanos , Feminino , Idoso , Adulto , Pessoa de Meia-Idade , Sarcopenia/epidemiologia , Sarcopenia/etiologia , Sarcopenia/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Força Muscular , Índice de Massa Corporal , Composição Corporal/fisiologia , Músculo Esquelético , Força da Mão/fisiologiaRESUMO
AIMS: Aim of the present study was to evaluate the impact of once-weekly semaglutide on different end-points indicative of metabolic control, cardiovascular risk, dietary behavior, and treatment satisfaction in T2DM. METHODS: This was a retrospective observational study conducted in a diabetes clinic. Changes in HbA1c, fasting blood glucose (FBG), weight, blood pressure, lipid profile, and number of antihypertensive drugs at 32 weeks (T1) after the first prescription of semaglutide (T0) were analyzed. Furthermore, at T1 patients were asked to fill-in the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Control of Eating Questionnaire (COEQ). RESULTS: Overall, 104 patients were identified (mean age 63.6 ± 10.4 years, 58.7% men, diabetes duration 12.7 ± 8.7 years). After 32 weeks of treatment with semaglutide, HbA1c levels were reduced by 1.38%, FBG by - 56.53 mg/dl, weight by 6.03 kg. Systolic and diastolic blood pressure, total, HDL-, LDL-, and non -HDL cholesterol, and triglycerides significantly improved. The number of glucose-lowering and antihypertensive drugs also decreased. At T1, DTSQ score was 32.23 ± 1.44, whereas COEQ indicated low levels of hunger and good control of eating. CONCLUSIONS: The study documented benefits of semaglutide on metabolic control and multiple CV risk factors, simplification of therapeutic schemes and high satisfaction with diabetes treatment, and eating behaviors indicative of healthy diet and reduced food intake.
Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Idoso , Anti-Hipertensivos/uso terapêutico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Comportamento Alimentar , Feminino , Peptídeos Semelhantes ao Glucagon , Hemoglobinas Glicadas/metabolismo , Fatores de Risco de Doenças Cardíacas , Humanos , Hipoglicemiantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
AIM: Sensor-augmented pumps with predictive low glucose suspend function (PLGS-SAP) help patients avoid hypoglycemia and improve quality of life: in this retrospective study, we investigated long-term effects of PLGS-SAP on metabolic outcomes, acute and chronic diabetic complications, in particular cardiovascular events. MATERIALS AND METHODS: One hundred thirty-nine adults with type 1 diabetes (T1D) treated for more than 10 years with continuous subcutaneous insulin infusion (CSII) were followed for 5 years; 71 (Group 1) started to use PLGS-SAP, and 68 (Group 2) maintained on their non-PLGM insulin pump. Glucose control measures (hemoglobin A1c [HbA1c], acute diabetic complications), clinical outcomes (body mass index [BMI], arterial hypertension, dyslipidemia), chronic diabetes-related complications, and device utilization (continuous glucose monitoring utilization, use of temporary basal rates or special boluses, carbohydrate counting usage) were assessed. RESULTS: The reduction of HbA1c was significant in Group 1 (from 7.5% ± 1.1% to 7.0% ± 1.0%, P = .02), while in Group 2 it did not reach statistical significance (from 7.5% ± 1.1% to 7.4% ± 0.9%, P = .853). BMI increased significantly in Group 2 (from 25.3 ± 2.8 to 25.7 ± 3.4, P < .001), but not in Group 1 (from 25.2 ± 3.5 to 25.2 ± 2.8, P = .887). There were no statistically significant differences in occurrence of acute diabetes complications, other clinical outcomes, prevalence of diabetes-related complications, or device utilization between the groups. CONCLUSIONS: In our five-year follow-up experience with T1D CSII users, PLGS-SAP has resulted efficient in improving metabolic control and maintaining the body weight.