المؤلفون: Amy Hess-Fischl, M. Sue Kirkman, Irl B. Hirsch, Barbara Ludwig, Anne L. Peters, Eric Renard, Richard I. G. Holt, Tomasz Klupa, Ruth S. Weinstock, Jeremy Pettus, J. Hans DeVries, Jay S. Skyler, Frank J. Snoek, Kirsten Nørgaard

المساهمون: University of Southampton, University Hospital Southampton NHS Foundation Trust, University of Amsterdam [Amsterdam] (UvA), Amsterdam UMC, Profil Institute for Metabolic Research GmbH, University of Chicago, Seattle University [Seattle], University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), University Hospital Carl Gustav Carus [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU Dresden), IT University of Copenhagen, Steno Diabetes Center of Copenhagen, University of California [San Diego] (UC San Diego), University of California, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), University of Miami Leonard M. Miller School of Medicine (UMMSM), Vrije Universiteit Amsterdam [Amsterdam] (VU), SUNY Upstate Medical University, State University of New York (SUNY), Keck School of Medicine [Los Angeles], University of Southern California (USC), Amsterdam UMC - Amsterdam University Medical Center, IT University of Copenhagen (ITU), University of California (UC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Guerineau, Nathalie C., Medical psychology, APH - Health Behaviors & Chronic Diseases, APH - Mental Health, Amsterdam Reproduction & Development (AR&D), General Internal Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Endocrinology, Medical Psychology, University of Zurich, Holt, Richard I G

المصدر: Diabetologia
Diabetologia, Springer Verlag, 2021, ⟨10.1007/s00125-021-05568-3⟩
Holt, R I G, DeVries, J H, Hess-Fischl, A, Hirsch, I B, Kirkman, M S, Klupa, T, Ludwig, B, Nørgaard, K, Pettus, J, Renard, E, Skyler, J S, Snoek, F J, Weinstock, R S & Peters, A L 2021, ' The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) ', Diabetologia, vol. 64, no. 12, pp. 2609-2652 . https://doi.org/10.1007/s00125-021-05568-3Test
Diabetes Care
Diabetes Care, 2021, pp.dci210043. ⟨10.2337/dci21-0043⟩
Holt, R I G, Devries, J H, Hess-Fischl, A, Hirsch, I B, Kirkman, M S, Klupa, T, Ludwig, B, Nørgaard, K, Pettus, J, Renard, E, Skyler, J S, Snoek, F J, Weinstock, R S & Peters, A L 2021, ' The management of type 1 diabetes in adults. A consensus report by the American diabetes association (ADA) and the European association for the study of diabetes (EASD) ', Diabetes Care, vol. 44, no. 11, pp. 2589-2625 . https://doi.org/10.2337/dci21-0043Test
Diabetes Care, 44(11), 2589-2625. American Diabetes Association Inc.
Diabetes care, 44(11), 2589-2625. American Diabetes Association Inc.
Diabetologia, 64(12), 2609-2652. Springer Verlag
Diabetologia, 2021, ⟨10.1007/s00125-021-05568-3⟩
Diabetes Care, American Diabetes Association, 2021, pp.dci210043. ⟨10.2337/dci21-0043⟩

مصطلحات موضوعية: Blood Glucose, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 10265 Clinic for Endocrinology and Diabetology, 0302 clinical medicine, Diabetic ketoacidosis, Glucose monitoring, Diagnosis, Health care, Insulin, Medicine, Adjunctive therapy, 030212 general & internal medicine, Psychosocial care, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, 3. Good health, [SDV] Life Sciences [q-bio], 2712 Endocrinology, Diabetes and Metabolism, Type 1 diabetes, Psychosocial, Schedule of care, Adult, medicine.medical_specialty, Consensus, Consensus Report, 610 Medicine & health, 030209 endocrinology & metabolism, Hypoglycemia, 03 medical and health sciences, Diabetes mellitus, Internal Medicine, Hypoglycemic Agents, Humans, Association (psychology), Exercise, Nutrition, American diabetes association, Advanced and Specialized Nursing, Transplantation, business.industry, Blood Glucose Self-Monitoring, medicine.disease, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, 2724 Internal Medicine, Family medicine, Hypoglycaemia, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology

الوصف: The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycaemia, behavioural considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that healthcare professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors. [Figure not available: see fulltext.]

وصف الملف: Holt2021_Article_TheManagementOfType1DiabetesIn.pdf - application/pdf; text

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab3df907ad19780569fb44812fd42c82Test
https://doi.org/10.2337/dci21-0043Test

المؤلفون: Amy Criego, Sarah A. Macleish, Jennifer L. Sherr, Jordan E. Pinsker, Ruth S. Weinstock, Anders L. Carlson, Anuj Bhargava, Richard M. Bergenstal, Thomas C. Jones, Daniel J. DeSalvo, Grazia Aleppo, Carol J. Levy, Bruce W. Bode, Sanjeev N. Mehta, Gregory P. Forlenza, Viral N. Shah, Bruce A. Buckingham, Irl B. Hirsch, David W Hansen, Sue A. Brown, Lori M. Laffel, Trang T. Ly

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Blood Glucose, medicine.medical_specialty, Adolescent, Diabetic ketoacidosis, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Hypoglycemia, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Emerging Technologies: Data Systems and Devices, Internal medicine, Multicenter trial, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Prospective Studies, 030212 general & internal medicine, Child, Prospective cohort study, Aged, Glycemic, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Incidence (epidemiology), Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, business

الوصف: OBJECTIVE Advances in diabetes technology have transformed the treatment paradigm for type 1 diabetes, yet the burden of disease is significant. We report on a pivotal safety study of the first tubeless, on-body automated insulin delivery system with customizable glycemic targets. RESEARCH DESIGN AND METHODS This single-arm, multicenter, prospective study enrolled 112 children (age 6–13.9 years) and 129 adults (age 14–70 years). A 2-week standard therapy phase (usual insulin regimen) was followed by 3 months of automated insulin delivery. Primary safety outcomes were incidence of severe hypoglycemia and diabetic ketoacidosis. Primary effectiveness outcomes were change in HbA1c and percent time in sensor glucose range 70–180 mg/dL (“time in range”). RESULTS A total of 235 participants (98% of enrolled, including 111 children and 124 adults) completed the study. HbA1c was significantly reduced in children by 0.71% (7.8 mmol/mol) (mean ± SD: 7.67 ± 0.95% to 6.99 ± 0.63% [60 ± 10.4 mmol/mol to 53 ± 6.9 mmol/mol], P < 0.0001) and in adults by 0.38% (4.2 mmol/mol) (7.16 ± 0.86% to 6.78 ± 0.68% [55 ± 9.4 mmol/mol to 51 ± 7.4 mmol/mol], P < 0.0001). Time in range was improved from standard therapy by 15.6 ± 11.5% or 3.7 h/day in children and 9.3 ± 11.8% or 2.2 h/day in adults (both P < 0.0001). This was accomplished with a reduction in time in hypoglycemia CONCLUSIONS This tubeless automated insulin delivery system was safe and allowed participants to significantly improve HbA1c levels and time in target glucose range with a very low occurrence of hypoglycemia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9602f5bfa556f234a1c900cd9088422aTest
https://doi.org/10.2337/dc21-0172Test

المؤلفون: German Tapia, Grethe S. Tell, Geir Joner, Torild Skrivarhaug, Lars C. Stene, Maryam Saeed, Inger Ariansen, Ingebjørg Seljeflot

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Research design, Cardiovascular and Metabolic Risk, medicine.medical_specialty, Galectin 3, Endocrinology, Diabetes and Metabolism, Population, Coronary Disease, 030209 endocrinology & metabolism, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Child, education, Advanced and Specialized Nursing, Type 1 diabetes, education.field_of_study, Tissue Inhibitor of Metalloproteinase-1, business.industry, medicine.disease, Coronary heart disease, Diabetes Mellitus, Type 1, Galectin-3, Cohort, business, Cohort study

الوصف: OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at RESULTS Of 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5–16). IL-6 (aHR 1.32 [95% CI 1.07–1.63]), galectin-3 (aHR 1.44 [95% CI 1.09–1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04–1.81]) were significant predictors of CHD after adjustment for conventional risk factors. CONCLUSIONS Galectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::37fcd446da0c44f20b140d30fab2a213Test
https://doi.org/10.2337/dc20-1712Test

المؤلفون: Wenjun Jiang, Jake A. Kushner, Michael J Davies, Helena W. Rodbard, Pablo Lapuerta, Ketan Dhatariya, Anne L. Peters, Phillip Banks, Darren K. McGuire, Sangeeta Sawhney, Thomas Danne

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Male, Research design, medicine.medical_specialty, Diabetic ketoacidosis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Placebo, Diabetic Ketoacidosis, 03 medical and health sciences, Sodium-Glucose Transporter 1, 0302 clinical medicine, Double-Blind Method, Insulin, Regular, Human, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Glycosides, 030212 general & internal medicine, Adverse effect, Sodium-Glucose Transporter 2 Inhibitors, Advanced and Specialized Nursing, Type 1 diabetes, 3-Hydroxybutyric Acid, Emerging Therapies: Drugs and Regimens, business.industry, Incidence, Insulin, Incidence (epidemiology), medicine.disease, Diabetes Mellitus, Type 1, Treatment Outcome, Drug Therapy, Combination, Female, business, Follow-Up Studies

الوصف: OBJECTIVE To evaluate the incidence and risk factors for diabetic ketoacidosis (DKA) and related adverse events (AEs) in adults with type 1 diabetes treated with sotagliflozin adjunctive to insulin. RESEARCH DESIGN AND METHODS Data from two identically designed, 52-week, randomized studies were pooled and analyzed for DKA, changes in β-hydroxybutyrate (BHB), and percentage of patients with BHB >0.6 and >1.5 mmol/L. The patients were administered placebo, sotagliflozin 200 mg, or sotagliflozin 400 mg once daily. RESULTS A total of 191 ketosis-related AEs were reported, and 98 underwent adjudication. Of these, 37 events (36 patients) were adjudicated as DKA, with an exposure-adjusted incidence rate of 0.2, 3.1, and 4.2 events per 100 patient-years for placebo, sotagliflozin 200 mg, and sotagliflozin 400 mg, respectively. No patient died of a DKA event. From a baseline BHB of ∼0.13 mmol/L, sotagliflozin treatment led to a small median increase over 52 weeks (≤0.05 mmol/L at all time points). Of sotagliflozin-treated patients, approximately 47% and 7% had ≥1 BHB measurement >0.6 mmol/L and >1.5 mmol/L, respectively (vs. 20% and 2%, respectively, of placebo-treated patients). Subsequent to the implementation of a risk mitigation plan, annualized DKA incidence was lower versus preimplementation in both the sotagliflozin 200 and 400 mg groups. CONCLUSIONS In patients with type 1 diabetes, confirmed DKA incidence increased when sotagliflozin was added to insulin compared with insulin alone. A lower incidence of DKA was observed following the implementation of an enhanced risk mitigation plan, suggesting that this risk can be managed with patient education.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1307dedc63a32d96131b84cbcb4384f7Test
https://doi.org/10.2337/dc20-0924Test

المؤلفون: Virginia Gabo, Ravi Reddy, Peter G. Jacobs, Deborah Branigan, Brian Senf, Navid Resalat, Florian H. Guillot, Katrina Ramsey, Nichole S. Tyler, Jessica R. Castle, Joseph El Youssef, Joseph Leitschuh, Isabelle Isa Kristin Steineck, Leah M. Wilson

المصدر: Diabetes Care. 43:2721-2729

مصطلحات موضوعية: Adult, Blood Glucose, Male, Pancreas, Artificial, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Urology, 030209 endocrinology & metabolism, Hypoglycemia, Artificial pancreas, Glucagon, Oregon, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Diabetes mellitus, Outpatients, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Exercise physiology, Exercise, Advanced and Specialized Nursing, Type 1 diabetes, Cross-Over Studies, business.industry, Middle Aged, medicine.disease, Crossover study, Diabetes Mellitus, Type 1, Hyperglycemia, Feasibility Studies, Female, business

الوصف: OBJECTIVE To assess the efficacy and feasibility of a dual-hormone (DH) closed-loop system with insulin and a novel liquid stable glucagon formulation compared with an insulin-only closed-loop system and a predictive low glucose suspend (PLGS) system. RESEARCH DESIGN AND METHODS In a 76-h, randomized, crossover, outpatient study, 23 participants with type 1 diabetes used three modes of the Oregon Artificial Pancreas system: 1) dual-hormone (DH) closed-loop control, 2) insulin-only single-hormone (SH) closed-loop control, and 3) PLGS system. The primary end point was percentage time in hypoglycemia ( RESULTS DH reduced hypoglycemia compared with SH during and after exercise (DH 0.0% [interquartile range 0.0–4.2], SH 8.3% [0.0–12.5], P = 0.025). There was an increased time in hyperglycemia (>180 mg/dL) during and after exercise for DH versus SH (20.8% DH vs. 6.3% SH, P = 0.038). Mean glucose during the entire study duration was DH, 159.2; SH, 151.6; and PLGS, 163.6 mg/dL. Across the entire study duration, DH resulted in 7.5% more time in target range (70–180 mg/dL) compared with the PLGS system (71.0% vs. 63.4%, P = 0.044). For the entire study duration, DH had 28.2% time in hyperglycemia vs. 25.1% for SH (P = 0.044) and 34.7% for PLGS (P = 0.140). Four participants experienced nausea related to glucagon, leading three to withdraw from the study. CONCLUSIONS The glucagon formulation demonstrated feasibility in a closed-loop system. The DH system reduced hypoglycemia during and after exercise, with some increase in hyperglycemia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::239d793cfe1b212548d7861dba424a0dTest
https://doi.org/10.2337/dc19-2267Test

المؤلفون: Ionut Bebu, Pearl G. Lee, Barbara H. Braffett, David S. Schade, William I. Sivitz, William H. Herman, Gayle M. Lorenzi, Victoria R. Trapani, Rodica Pop-Busui, John M. Lachin, Amisha Wallia, John I. Malone

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Blood Glucose, Male, Risk, Research design, medicine.medical_specialty, Pediatrics, Time Factors, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Glycemic Control, Cohort Studies, Diabetes Complications, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Epidemiology, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Age of Onset, Epidemiology/Health Services Research, Child, Glycemic, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Proportional hazards model, Age Factors, nutritional and metabolic diseases, Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, Child, Preschool, Cohort, Female, Observational study, business

الوصف: OBJECTIVE This epidemiological analysis of the pooled Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort describes the equivalence of a 1-percentage point increase in HbA1c (such as from 7% to 8%) and years of additional age or duration of type 1 diabetes (T1D) relative to the risk of complications. RESEARCH DESIGN AND METHODS Separate Cox proportional hazards models determined the number of additional years of age and/or duration of T1D that would result in the same increase in risk of microvascular (retinopathy, nephropathy, and neuropathy) and cardiovascular complications and mortality as a 1-percentage point increase in HbA1c. RESULTS The risk of any cardiovascular disease associated with a 1-percentage point increase in HbA1c was equivalent to the risk associated with 4.3 (95% CI 2.7–5.9) additional years of age or 5.6 (95% CI 2.7–6.5) additional years’ duration of T1D. The risk of estimated glomerular filtration rate CONCLUSIONS Our results help evaluate the impact of glycemia on advanced complications in a way that may be more interpretable to health care providers and individuals with T1D.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0046c08a0022081de6e5a0e7820a2096Test
https://doi.org/10.2337/dc20-0226Test

المؤلفون: Esko Wiltshire, Martin de Bock, Jenny Rayns, Barbara C. Galland, Shelley Rose, Paul A Tomlinson, Sara E Boucher, Benjamin J Wheeler, Andrew R Gray, Huan Chan, Karen E MacKenzie

المصدر: Diabetes Care. 43:2388-2395

مصطلحات موضوعية: Adult, Blood Glucose, Male, Research design, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Glycemic Control, law.invention, Glucose testing, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, Risk Factors, law, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, 030212 general & internal medicine, Glycemic, Glycated Hemoglobin, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Blood Glucose Self-Monitoring, medicine.disease, Hypoglycemia, Diabetes Mellitus, Type 1, Treatment Outcome, chemistry, Hyperglycemia, Usual care, Quality of Life, Female, Glycated hemoglobin, business, New Zealand

الوصف: OBJECTIVE To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control. RESEARCH DESIGN AND METHODS This multicenter 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13–20 years with established type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75 mmol/mol). Participants were allocated to 6-month intervention (isCGM; FreeStyle Libre; Abbott Diabetes Care, Witney, U.K.) (n = 33) or control (SMBG; n = 31) using minimization. The primary outcome was the difference in change in HbA1c from baseline to 6 months. RESULTS There was no evidence of a difference between groups for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for isCGM [95% CI −0.9 to 0.5] [−2.1 mmol/mol (95% CI −9.6 to 5.4)]; P = 0.576). However, glucose-monitoring frequency was 2.83 (95% CI 1.72–4.65; P < 0.001) times higher in the isCGM group compared with that in the SMBG group at 6 months. The change in the Diabetes Treatment Satisfaction Questionnaire mean item score also favored isCGM at 6 months (P = 0.048), with no significant differences between groups for fear of hypoglycemia and quality of life (both general and diabetes specific) (all P > 0.1). CONCLUSIONS For youth with high-risk glycemic control, isCGM led to improvements in glucose testing frequency and diabetes treatment satisfaction. However, these did not translate to greater improvement in glycemic control over usual care with SMBG at 6 months.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7c295211223a836c3666d00803cfc6f8Test
https://doi.org/10.2337/dc20-0613Test

المؤلفون: Angela S Lee, Margaret McGill, Nathan A. Johnson, Connie Luo, Jencia Wong, Jeff R. Flack, Callum J. Baker, Jane Overland, Stephen M. Twigg, Sergio F. Martinez-Huenchullan

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Blood Glucose, Male, Cardiovascular and Metabolic Risk, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Glycemic Control, High-Intensity Interval Training, Overweight, Interval training, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Heart Rate, law, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Insulin, Obesity, 030212 general & internal medicine, Glycemic, Advanced and Specialized Nursing, Type 1 diabetes, Cross-Over Studies, business.industry, Blood Glucose Self-Monitoring, Body Weight, Middle Aged, medicine.disease, Crossover study, Diabetes Mellitus, Type 1, Treatment Outcome, Body Composition, Female, medicine.symptom, business, High-intensity interval training

الوصف: OBJECTIVE To study the effect of 12 weeks of high-intensity interval training (HIIT) on glycemic control in adults with type 1 diabetes and overweight or obesity. RESEARCH DESIGN AND METHODS Thirty inactive adults with type 1 diabetes who had BMI ≥25 kg/m2 and HbA1c ≥7.5% were randomized to 12 weeks of either HIIT exercise intervention consisting of 4 × 4-min HIIT (85–95% peak heart rate) performed thrice weekly or usual care control. In a partial crossover design, the control group subsequently performed the 12-week HIIT intervention. The primary end point was the change in HbA1c from baseline to 12 weeks. Glycemic and cardiometabolic outcomes were measured at 0, 12, and 24 weeks. RESULTS Participants were aged 44 ± 10 years with diabetes duration 19 ± 11 years and BMI 30.1 ± 3.1 kg/m2. HbA1c decreased from 8.63 ± 0.66% at baseline to 8.10 ± 1.04% at 12 weeks in the HIIT intervention group (P = 0.01); however, this change was not significantly different from the control group (HIIT −0.53 ± 0.61%, control −0.14 ± 0.48%, P = 0.08). In participants who undertook at least 50% of the prescribed HIIT intervention, the HbA1c reduction was significantly greater than control (HIIT −0.64 ± 0.64% [n = 9], control −0.14 ± 0.48% [n = 15], P = 0.04). There were no differences in insulin dose, hypoglycemia on continuous glucose monitoring, blood pressure, blood lipids, body weight, or body composition between groups. CONCLUSIONS Overall, there was no significant reduction in HbA1c with a 12-week HIIT intervention in adults with type 1 diabetes. However, glycemic control may improve for people who undertake HIIT with greater adherence.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a45404ca431985fb82aee4c1f90a184bTest
https://doi.org/10.2337/dc20-0342Test

المؤلفون: Björn Eliasson, Andrew J. Palmer, Ann-Marie Svensson, Josh Knight, Thomas Lung, Philip Clarke, An Tran-Duy, Dennis Petrie, William H. Herman

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Male, Research design, medicine.medical_specialty, Adolescent, Cost-Benefit Analysis, Endocrinology, Diabetes and Metabolism, Statistics as Topic, Population, 030209 endocrinology & metabolism, Cohort Studies, Diabetes Complications, Young Adult, 03 medical and health sciences, Life Expectancy, 0302 clinical medicine, Risk Factors, Internal Medicine, Humans, Medicine, Longitudinal Studies, Registries, 030212 general & internal medicine, Epidemiology/Health Services Research, Risk factor, Child, education, Sweden, Advanced and Specialized Nursing, Type 1 diabetes, education.field_of_study, Proportional hazards model, business.industry, Absolute risk reduction, Middle Aged, Models, Theoretical, Prognosis, medicine.disease, Patient Outcome Assessment, Diabetes Mellitus, Type 1, Emergency medicine, Linear Models, Life expectancy, Female, business, Cohort study

الوصف: OBJECTIVE To develop a patient-level simulation model for predicting lifetime health outcomes of patients with type 1 diabetes and as a tool for economic evaluation of type 1 diabetes treatment based on data from a large, longitudinal cohort. RESEARCH DESIGN AND METHODS Data for model development were obtained from the Swedish National Diabetes Register. We derived parametric proportional hazards models predicting absolute risk of diabetes complications and death based on a wide range of clinical variables and history of complications. We used linear regression models to predict risk factor progression. Internal validation was performed, estimates of life expectancies for different age-sex strata were computed, and the impact of key risk factors on life expectancy was assessed. RESULTS The study population consisted of 27,841 patients with type 1 diabetes with a mean duration of follow-up of 7 years. Internal validation showed good agreement between predicted and observed cumulative incidence of death and 10 complications. Simulated life expectancy was approximately 13 years lower than that of the sex- and age-matched general population, and patients with type 1 diabetes could expect to live with one or more complications for approximately 40% of their remaining life. Sensitivity analysis showed the importance of preventing renal dysfunction, hypoglycaemia and hyperglycaemia, and lowering HbA1c in reducing the risk of complications and death. CONCLUSIONS Our model was able to simulate risk factor progression and event histories that closely match the observed outcomes, and project events occurring over patients’ lifetimes. The model can serve as a tool to estimate the impact of changing clinical risk factors on health outcomes to inform economic evaluations of interventions in type 1 diabetes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::337652e89f041fa27c77a8a3d1ce12f3Test
https://doi.org/10.2337/dc19-2249Test

المؤلفون: Robin Goland, Magdalena M. Bogun, Carla J. Greenbaum, Brian N. Bundy

المصدر: Diabetes Care

مصطلحات موضوعية: Adult, Blood Glucose, Male, Research design, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Cohort Studies, Diagnostic Techniques, Endocrine, C peptide levels, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal medicine, Insulin Secretion, Internal Medicine, medicine, Humans, Longitudinal Studies, 030212 general & internal medicine, Oral glucose tolerance, Child, Pathophysiology/Complications, Insulin secretion, Meals, Monitoring, Physiologic, Advanced and Specialized Nursing, Type 1 diabetes, C-Peptide, business.industry, Glucose Tolerance Test, Middle Aged, medicine.disease, Prevention Study, Diabetes Mellitus, Type 1, Child, Preschool, Clinical diagnosis, Disease Progression, Female, business, Follow-Up Studies

الوصف: OBJECTIVE Insulin secretion declines rapidly after diagnosis of type 1 diabetes, followed by a slower rate of change. Previous studies have demonstrated that the C-peptide decline begins before the clinical diagnosis. Changes in insulin secretion in the same individuals studied from preclinical stages through and after clinical diagnosis have not been previously reported. RESEARCH DESIGN AND METHODS Antibody-positive relatives undergo sequential oral glucose tolerance testing (OGTT) as part of TrialNet’s Pathway to Prevention study and continue both OGTT and mixed-meal tolerance testing (MMTT) as part of the Long-term Investigational Follow-up in TrialNet study if they develop type 1 diabetes. We analyzed glucose and C-peptide data obtained from 80 TrialNet subjects who had OGTT before and after clinical diagnosis. Separately, we compared C-peptide response to OGTT and MMTT in 127 participants after diagnosis. RESULTS C-peptide did not change significantly until 6 months before the clinical diagnosis of type 1 diabetes and continued to decline postdiagnosis, and the rates of decline for the first 6 months postdiagnosis were similar to the 6 months prediagnosis. There were no significant differences in MMTT and OGTT C-peptide responses in paired tests postdiagnosis. CONCLUSIONS This is the first analysis of C-peptide levels in longitudinally monitored patients with type 1 diabetes studied from before diagnosis and continuing to the postdiagnosis period. These data highlight the discordant timing between accelerated β-cell dysfunction and the current glucose thresholds for clinical diagnosis. To preserve β-cell function, disease-modifying therapy should start at or before the acute decline in C-peptide.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::837997b314519bf09b18915940301c3cTest
https://doi.org/10.2337/dc19-2288Test