Higher free triiodothyronine concentration is associated with lower prevalence of microangiopathic complications and better metabolic control in adult euthyroid people with type 1 diabetes.

PURPOSE: Type 1 diabetes mellitus (T1DM) is a disorder of insulin deficiency but with a wide range of hormones simultaneously disturbed. The study was performed to explore relation of free triiodothyronine (FT3) with metabolic control and occurrence of microangiopathic complications. METHODS: A total of 266 adult T1DM participants [56% men; 32 (interquartile range, IQR: 25-39) years and disease duration 13 (IQR: 8-19) years] in euthyroid state with negative history for hypothyroidism were included to the study. Participants were screened for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and FT3. Moreover, microangiopathic complications (retinopathy, diabetic kidney disease, peripheral and autonomic neuropathy), markers of metabolic control such as glycated hemoglobin (HbA1c) were evaluated. RESULTS: A total of 114 (42.9%) people had diagnosed at least one microangiopathic complication. In multivariable linear regression higher HbA1c was statistically significant independent predictor of lower FT3 (ß = -0.25; p < 0.0001) after adjustment for sex, T1DM duration, HbA1c, waist-to-hip ratio (WHR) (R2 = 0.15, p < 0.0001). Higher FT3 was simultaneously a predictor of lower prevalence of microangiopathy in multivariate logistic regression analysis (odds ratio, 0.51; 95% confidence interval, 0.27-0.98; p = 0.04) after an adjustment for: age, hypertension, HbA1c, WHR and total cholesterol (TC). CONCLUSIONS: FT3 as tissue active hormone plays a clinically important role in T1DM people. The higher FT3 concentration is related to the lower prevalence of microangiopathy and better metabolic control of the disease in adult euthyroid people with T1DM.

Skin pH is lower in type 1 diabetes subjects and is related to glycemic control of the disease.

BACKGROUND: Diabetes is a systemic disease affecting many organs, including skin. Skin may reflect the condition of internal organs. The aim of our study was to measure skin pH in type 1 diabetes mellitus (T1DM) patients and in healthy controls and to evaluate the association between metabolic control of diabetes and skin acidity in T1DM patients. MATERIALS AND METHODS: The study was conducted on 105 patients with T1DM and 53 age- and sex-matched healthy people. Skin surface pH was measured in three different areas of the body (cheek, forearm, and foot) in diabetes patients and healthy controls. The results were compared for patients' and controls' clinical characteristics and for patients' metabolic control and also evaluated according to the presence of complications of diabetes. RESULTS: Patients with T1DM had lower skin pH compared with the control group in three measured areas: within the cheek (5.49 ± 0.42 vs. 5.69 ± 0.31; P = 0.001), forearm (5.41 ± 0.46 vs. 5.73 ± 0.69; P = 0.004), and foot (5.20 ± 0.53 vs. 5.41 ± 0.41; P = 0.008). In the multiple linear regression skin pH was negatively correlated with fasting plasma glucose on the cheek (ß = -0.34, P = 0.0004), forearm (ß = -0.30, P = 0.0009), and foot (ß = -0.18, P = 0.04). Diabetes patients with glycated hemoglobin (HbA1c) ≥ 8% had significantly lower skin pH than patients with better glycemic control (HbA1c < 8%). However, we observed a statistically significant difference only on the foot (5.09 ± 0.50 vs. 5.34 ± 0.55; P = 0.019). CONCLUSIONS: Skin surface pH is lower in individuals with diabetes, and it is negatively related to actual and chronic hyperglycemia.

[Assessment of antineutrophil-cytoplasmic autoantibodies (ANCA) in type 1 diabetic patients]. / Ocena wystepowania przeciwcial przeciwko cytoplazmie granulocytów obojetnochlonnych (ANCA) u chorych na cukrzye typu 1.

Polymorphonuclear neutrophils and inflammatory process play a key role in the development of late diabetic vascular complications. Antineutrophil-cytoplasmic autoantibodies (ANCA) are considered important serological markers for vasculitis. The aim of study was the assessment of prevalence ANCA in type 1 diabetic patients and evaluation of the relationship between ANCA and diabetic microangiopathy. 94 type 1 diabetic subjects, 47 male and 47 female, aged 30.7 +/- 9.6 years, with mean duration of diabetes 9.5 +/- 6.8 years and HbA1c 7.9 +/- 1.3% were included to this study. ANCA were detected by the indirect immunofluorescence test and the specificity was evaluated by ELISA test. The significantly positive result of ANCA was noticed in 11 subjects (12%), anti-myeloperoxidase (anti-MPO) in 9 and anti-proteinase 3 (anti-Pr-3c) in 2 subjects. It was not observed any differences in sex, parameters of metabolic control, duration of diabetes, C-reactive protein levels and diabetic retinopathy and nephropathy between group with ANCA and without ANCA (p>0.05). Moreover, we did not notice relationship between ANCA and the risk of late diabetic complications (retinopathy: OR 1.64; 95% CI 0.46-5.82, p = 0.52 and nephropathy: OR 0.16; 95% CI 0.02-1.35, p = 0.10). The obtained results do not fully confirm hypothesis that ANCA are connected with the development of diabetic microangiopathy.