-
1
المصدر: Diabetologia
مصطلحات موضوعية: 0301 basic medicine, Blood Glucose, Male, Time Factors, Endocrinology, Diabetes and Metabolism, Health Status, Blood Pressure, Coronary Disease, Angina, 0302 clinical medicine, Risk Factors, Epidemiology, Prevalence, Medicine, Health Status Indicators, Myocardial infarction, Prospective Studies, Prospective cohort study, education.field_of_study, Incidence, Smoking, Middle Aged, Prognosis, Cholesterol, Female, Diet, Healthy, Adult, medicine.medical_specialty, Population, 030209 endocrinology & metabolism, Lower risk, Risk Assessment, Article, 03 medical and health sciences, Young Adult, Diabetes mellitus, Internal medicine, Internal Medicine, Humans, Healthy Lifestyle, education, Exercise, Glycated Hemoglobin, Type 1 diabetes, business.industry, Pennsylvania, medicine.disease, 030104 developmental biology, Diabetes Mellitus, Type 1, business, Biomarkers, Follow-Up Studies
الوصف: AIMS/HYPOTHESIS: Type 1 diabetes increases CHD risk. We examined the use of the American Heart Association’s cardiovascular health metrics (blood pressure, total cholesterol, glucose/HbA(1c), BMI, physical activity, diet, smoking) to predict incidence of CHD among individuals with type 1 diabetes, with the hypothesis that a better American Heart Association health metric profile would be associated with lower incident CHD. METHODS: Prevalence of the seven cardiovascular health metrics was determined using first and second visits from adult participants (mean age 28.6 years) in the Epidemiology of Diabetes Complications prospective cohort study of childhood-onset type 1 diabetes. An ideal metric score (0–7) was defined as the sum of all metrics within the ideal range, and a total metric score (0–14) was calculated based on poor, intermediate and ideal categories for each metric. Incident CHD development (medical record-confirmed CHD death, myocardial infarction, revascularisation, ischaemic electrocardiogram changes or Epidemiology of Diabetes Complications physician-determined angina) over 25 years of follow-up was examined by metric scores. RESULTS: Among 435 participants, BMI, blood pressure, total cholesterol and smoking demonstrated the highest prevalence within the ideal range, while diet and HbA(1c) demonstrated the lowest. During 25 years of follow-up, 177 participants developed CHD. In Cox models, each additional metric within the ideal range was associated with a 19% lower risk (p=0.01), and each unit increase in total metric score was associated with a 17% lower risk (p
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::83accb7228075038aa72564513ae3359Test
https://pubmed.ncbi.nlm.nih.gov/33190165Test -
2
المؤلفون: Amy Kennedy, Terence T.L. Pang, Krishnarajah Nirantharakumar, Myriam Chimen, Robert Andrews, Partheepan Narendran
المصدر: Diabetologia. 55(3)
مصطلحات موضوعية: Adult, medicine.medical_specialty, Heart disease, Adolescent, Endocrinology, Diabetes and Metabolism, Population, Type 2 diabetes, Health Promotion, Motor Activity, Insulin resistance, Diabetes mellitus, Internal Medicine, medicine, Animals, Humans, Intensive care medicine, education, Child, Exercise, Type 1 diabetes, education.field_of_study, Evidence-Based Medicine, business.industry, Type 2 Diabetes Mellitus, medicine.disease, Blood pressure, Diabetes Mellitus, Type 1, Physical therapy, business
الوصف: Physical activity improves well-being and reduces the risk of heart disease, cancer and type 2 diabetes mellitus in the general population. In individuals with established type 2 diabetes, physical activity improves glucose and lipid levels, reduces weight and improves insulin resistance. In type 1 diabetes mellitus, however, the benefits of physical activity are less clear. There is poor evidence for a beneficial effect of physical activity on glycaemic control and microvascular complications, and significant risk of harm through hypoglycaemia. Here we review the literature relating to physical activity and health in type 1 diabetes. We examine its effect on a number of outcomes, including glycaemic control, lipids, blood pressure, diabetic complications, well-being and overall mortality. We conclude that whilst there is sufficient evidence to recommend physical activity in the management of type 1 diabetes, it is still unclear as to what form, duration and intensity should be recommended and whether there is benefit for many of the outcomes examined.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0e4fbd8342d274120519ee73c16a23cbTest
https://pubmed.ncbi.nlm.nih.gov/22189486Test -
3
المؤلفون: H Saelan, Bo Feldt-Rasmussen, Knut Borch-Johnsen, Kirsten Nørgaard, T Deckert
المصدر: Diabetologia. 33:407-410
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Population, Blood Pressure, Essential hypertension, Gastroenterology, Nephropathy, Diabetic nephropathy, Sex Factors, Diabetes mellitus, Internal medicine, Prevalence, Internal Medicine, medicine, Albuminuria, Humans, education, Retrospective Studies, Type 1 diabetes, education.field_of_study, Diabetic Retinopathy, business.industry, Age Factors, Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, Endocrinology, Blood pressure, Hypertension, Female, medicine.symptom, business
الوصف: The prevalence of hypertension in a representative sample (n = 10202) of the Danish general population aged 16-59 years was assessed to 4.4% based on three blood pressure readings. In Type 1 (insulin-dependent) diabetic patients of similar age (n = 1703) the prevalence was determined in a similar way to 14.7% (p less than 0.00001). The excess prevalence in Type 1 diabetic patients was due to hypertension in patients with incipient and clinical nephropathy as the prevalence of hypertension among diabetic patients with normal urinary albumin excretion (essential hypertension) was 3.9%, similar to that observed in the general population. The patients with Type 1 diabetes and essential hypertension had higher systolic (146 +/- 19 vs 133 +/- 18 mm Hg, p less than 0.00001) and diastolic blood pressure (87 +/- 12 vs 79 +/- 7 mm Hg, p less than 0.00001), but less changes in the eye background than patients with incipient nephropathy (urinary albumin excretion 30-300 mg/24 h) (p less than 0.03), indicating that the two groups were also different with respect to other microangiopathic lesions. Patients with essential hypertension were defined as having a normal urinary albumin excretion before and during antihypertensive treatment (if any). They were followed-up for a 58 (6-234) month period. We confirmed that hypertension is more common among Type 1 diabetic patients than in the general population and found the prevalence of essential hypertension similar in Type 1 diabetic patients to the non-diabetic population. This supports our hypothesis that hypertension is very unlikely to be the cause of diabetic nephropathy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1540bb3f52bf3b30226578f724cfdd82Test
https://doi.org/10.1007/bf00404089Test -
4
المؤلفون: J. H. Fuller, M Veglio, L. K. Stevens, M. Borra, Paolo Cavallo Perin
المصدر: Diabetologia. 42:68-75
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Population, Blood Pressure, Sudden death, QT interval, Electrocardiography, Diabetic Neuropathies, Surveys and Questionnaires, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Albuminuria, Humans, Heart rate variability, Diabetic Nephropathies, education, Sex Characteristics, education.field_of_study, Chi-Square Distribution, Diabetic Retinopathy, medicine.diagnostic_test, business.industry, Smoking, medicine.disease, Surgery, Europe, Long QT Syndrome, Diabetes Mellitus, Type 1, Blood pressure, Hypertension, Cardiology, Female, Complication, business, Diabetic Angiopathies
الوصف: The prevalence of QT interval prolongation is higher in people with diabetes and its complications. Sudden death has been reported as a common cause of death in insulin-dependent diabetic patients affected by autonomic neuropathy. It has been postulated that QT prolongation predisposes to cardiac arrhythmias and sudden death. In this analysis the prevalence of QT interval prolongation and its relation with diabetic complications were evaluated in the EURODIAB IDDM Complications Study (3250 insulin-dependent diabetic patients attending 31 centres in 16 European countries). Five consecutive RR and QT intervals were measured with a ruler on the V5 lead of the resting ECG tracing and the QT interval corrected for the previous cardiac cycle length was calculated according to the Bazett's formula. The prevalence of an abnormally prolonged corrected QT was 16 % in the whole population, 11 % in males and 21 % in females (p < 0.001). The mean corrected QT was 0.412 s in males and 0.422 s in females (p < 0.001). Corrected QT duration was independently associated with age, HbA1 c and blood pressure. Corrected QT was also correlated with ischaemic heart disease and nephropathy but this relation appeared to be stronger in males than in females. Male patients with neuropathy or impaired heart rate variability or both showed a higher mean adjusted corrected QT compared with male patients without this complication. The relation between corrected QT prolongation and autonomic neuropathy was not observed among females. In conclusion we have shown that corrected QT in insulin-dependent diabetic female patients is longer than in male patients, even in the absence of diabetic complications known to increase the risk of corrected QT prolongation. [Diabetologia (1999) 42: 68–75]
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c05cee429efd70fdb5717b7d5b48467aTest
https://doi.org/10.1007/s001250051115Test -
5
المؤلفون: Christoph Trautner, Ingrid Mühlhauser, U. Bott, Michael Berger, Viktor Jörgens, J. Siegrist, H. Overmann, R. Bender
المصدر: Diabetologia. 41:1139-1150
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, Hierarchy, Social, Hypoglycemia, Foot Diseases, Quality of life (healthcare), Patient Education as Topic, Internal medicine, Diabetes mellitus, Internal Medicine, Humans, Insulin, Medicine, Diabetic Nephropathies, Community Health Services, education, Aged, Quality of Health Care, Glycated Hemoglobin, education.field_of_study, Diabetic Retinopathy, business.industry, Middle Aged, medicine.disease, Surgery, Proteinuria, Diabetes Mellitus, Type 1, Blood pressure, Hypertension, Albuminuria, Female, medicine.symptom, business, Social status
الوصف: The objective of this study was to assess the degree of diabetes care and education achieved for Type I (insulin-dependent) diabetes mellitus at the community level in relation to social status and to elucidate potential pathways that mediate any social class gradient. A population-based sample of 684 adults with Type I diabetes (41 % women, mean ± SD age 36 ± 11, diabetes duration 18 ± 11 years) in the district of North-Rhine (9.5 million inhabitants), Germany, were examined in their homes using a mobile ambulance. Results: HbA1c (normal 4.3–6.1 %) 8.0 ± 1.5 %, incidence of severe hypoglycaemia (injection of glucose or glucagon) 0.21 cases per patient-year; 62 % of patients had participated in a structured group treatment and teaching programme for intensification of insulin therapy; 70 % used 3 or more insulin injections per day, 9 % were on continuous subcutaneous insulin infusion; 91 % reported to have had measurements of HbA1c during the preceding year, and 80 % to have had an examination of the retina by an ophthalmologist. Care was insufficient with respect to the quality of blood pressure control (70 % of patients on antihypertensive drugs had blood pressure values ≥ 160/95 mmHg), patient awareness of proteinuria/albuminuria (27 % of patients had not heard about it) and prevention of foot complications (only 42 % with a diabetes duration over 10 years had remembered to have a foot examination during the preceding 12 months). There was a pronounced social gradient with respect to micro- and macrovascular complications (prevalence of overt nephropathy 7 vs 20 % for highest vs lowest quintiles of social class [OR 3.5, 95 % CI 1.6–7.5, p = 0.002]) and diabetes-specific quality of life. HbA1c, blood pressure and smoking accounted for part of the association between social class and microvascular complications. The social class gradient was not due to inequality to access to health services, but to lower acceptance among low social class patients of preventive and health maintaining behaviour. In conclusion, achieved standards of care are high with respect to the implementation of intensified treatment regimens, the level of patient education achieved, treatment control and eye care, whereas areas for improvement are blood pressure control and preventive measures for foot care. A substantial social gradient in diabetes care persists despite equal access of patients to health services. [Diabetologia (1998) 41: 1139–1150]
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c464cc1cf7247153b9479c419aec4d8aTest
https://doi.org/10.1007/s001250051043Test -
6
المؤلفون: Mario Maioli, Gaetano Crepaldi, Enrico Brocco, I. Barzon, Romano Nosadini, M. R. Cipollina, Andrea Semplicini, C. G. Monciotti, M. Trevisan, A. Morocutti, C. Palaro, Paola Fioretto
المصدر: Università degli Studi di Padova-IRIS
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Erythrocytes, Time Factors, Adolescent, Systole, Endocrinology, Diabetes and Metabolism, Population, Group A, Gastroenterology, Antiporters, Group B, Nephropathy, Diabetic nephropathy, Diastole, Predictive Value of Tests, Internal medicine, Odds Ratio, Internal Medicine, Albuminuria, Humans, Medicine, Longitudinal Studies, education, Triglycerides, Glycated Hemoglobin, Sex Characteristics, education.field_of_study, Diabetic Retinopathy, business.industry, Middle Aged, Prognosis, medicine.disease, Cholesterol, Diabetes Mellitus, Type 1, Endocrinology, Blood pressure, Creatinine, Female, Microalbuminuria, business, Cation transport
الوصف: Pathogenetic mechanisms other than the quality of metabolic control may play a role in the development of diabetic nephropathy. Some cross-sectional studies have shown that elevated erythrocyte sodium-lithium countertransport (Na + /Li + CT) activity may be linked to incipient or overt nephropathy in insulin-dependent diabetic (IDDM) patients. The aim of the present work was to ascertain if high erythrocyte Na + /Li + CT activity anticipates the development of microalbuminuria in IDDM patients. Evaluation of this cation transport system was carried out in 159 normotensive, normoalbuminuric IDDM patients, who were divided into two groups: those with values above (Group A) and those with values below (Group B) the median level in the overall population (300 μmol/erythrocytes × h). A total of 79 patients in Group A and 80 in Group B underwent periodic examinations over a similar time period (5.2 years, range 3.3–7.4 years and 5.4 years, range 3.4–7.5 years, respectively). Median sodium-lithium countertransport activity was stable when evaluated after 2 and 4 years of follow-up. Only seven patients were excluded from the protocol because changes in their sodium-lithium countertransport activity placed them on the other side of the median value with respect to their baseline measurement. Thus, 152 patients completed the study (76 in Group A and 76 in Group B). Of the 76 patients in Group A, 17 developed persistent microalbuminuria (22.3 %). The number of patients in Group B showing persistent microalbuminuria was significantly lower (4 of 76; 5.2 %; p < 0.01). The sensitivity of erythrocyte Na + /Li + CT in predicting the development of microalbuminuria was 85 % and its specificity was 55 %. Seven patients of Group A and five of Group B developed arterial hypertension. Subjects in Group A had significantly higher mean HbA1 c values of twice yearly measurements than those in Group B (9.6 ± 1.7 vs 8.3 ± 1.7 %, p < 0.002, mean ± SD) despite similar daily insulin requirements. Systolic and diastolic blood pressure levels were also evaluated every 6 months and were significantly higher in the Group A than in the Group B patients, although on average within the normal range. The odds ratio for developing persistent microalbuminuria in IDDM with elevated baseline erythrocyte Na + /Li + CT activity after adjustment for gender and baseline albumin excretion rate, and mean 6 monthly plasma creatinine, HbA1 c and systolic and diastolic blood pressure levels was 4.2 (95 % confidence intervals 2.0–11.1). It was also found that the percentage of offspring having both parents with Na + /Li + CT activity above the median value was significantly higher in Group A than in Group B (Group A vs Group B: 35 vs 19 %; p < 0.01). On the contrary the percentage of offspring whose erythrocyte Na + /Li + CT was lower in both parents was lower in Group A than in Group B: 10 vs 38 %, p < 0.01). Parents of Group A offspring had arterial hypertension more frequently than those of Group B. These results indicate that erythrocyte Na + /Li + CT activity is a useful diagnostic tool in identifying normotensive, normoalbuminuric patients who may be predisposed to develop persistent microalbuminuria. This disorder in the cation transport system is associated with poor metabolic control, higher blood pressure, and male sex; it also appears to be, at least partly, genetically transmitted. [Diabetologia (1997) 40: 654–661]
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4d309e42f96cb04f3a3e6b4ed993073dTest
https://doi.org/10.1007/s001250050730Test -
7
المؤلفون: J. D. Ward, A. Nuber, L. K. Stevens, Solomon Tesfaye, C. Ionescu-Tirgoviste, Guido Pozza, J. H. Fuller, Judith Stephenson, M. E. Plater
المصدر: Diabetologia. 39:1377-1384
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Diabetic neuropathy, Adolescent, Diabetic ketoacidosis, Endocrinology, Diabetes and Metabolism, Population, Blood Pressure, Gastroenterology, Body Mass Index, Diabetic Ketoacidosis, Vibration perception, Diabetic Neuropathies, Risk Factors, Diabetes mellitus, Internal medicine, Prevalence, Internal Medicine, medicine, Humans, education, education.field_of_study, Diabetic Retinopathy, business.industry, Smoking, Peripheral Nervous System Diseases, Diabetic retinopathy, Middle Aged, medicine.disease, Lipids, Hypoglycemia, Europe, Diabetes Mellitus, Type 1, Peripheral neuropathy, Endocrinology, Cardiovascular Diseases, Body Constitution, Regression Analysis, Female, Microalbuminuria, business
الوصف: The EURODIAB IDDM Complications Study involved the examination of 3250 randomly selected insulin-dependent diabetic patients, from 31 centres in 16 European countries. Part of the examination included an assessment of neurological function including neuropathic symptoms and physical signs, vibration perception threshold, tests of autonomic function and the prevalence of impotence. The prevalence of diabetic neuropathy across Europe was 28% with no significant geographical differences. Significant correlations were observed between the presence of diabetic peripheral neuropathy with age (p < 0.05), duration of diabetes (p < 0.001), quality of metabolic control (p < 0.001), height (p < 0.01), the presence of background or proliferative diabetic retinopathy (p < 0.01), cigarette smoking (p < 0.001), high-density lipoprotein cholesterol (p < 0.001) and the presence of cardiovascular disease (p < 0.05), thus confirming previous associations. New associations have been identified from this study - namely with elevated diastolic blood pressure (p < 0.05), the presence of severe ketoacidosis (p < 0.001), an increase in the levels of fasting triglyceride (p < 0.001), and the presence of microalbuminuria (p < 0.01). All the data were adjusted for age, duration of diabetes and HbA1c. Although alcohol intake correlated with absence of leg reflexes and autonomic dysfunction, there was no overall association of alcohol consumption and neuropathy. The reported problems of impotence were extremely variable between centres, suggesting many cultural and attitudinal differences in the collection of such information in different European countries. In conclusion, this study has identified previously known and new potential risk factors for the development of diabetic peripheral neuropathy.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2c6a9350ea722e54bb63a8d49809e5cdTest
https://doi.org/10.1007/s001250050586Test -
8
المصدر: Diabetologia
Sander, B, Larsen, M, Andersen, E W & Lund-Andersen, H 2013, ' Impact of changes in metabolic control on progression to photocoagulation for clinically significant macular oedema:a 20 year study of type 1 diabetes ', Diabetologia, vol. 56, no. 11, pp. 2359-2366 . https://doi.org/10.1007/s00125-013-3027-5Testمصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Clinically significant macular oedema, HbA1c, Endocrinology, Diabetes and Metabolism, Population, Macular oedema, Blood Pressure, Macular Edema, Article, SDG 3 - Good Health and Well-being, Diabetes mellitus, Internal medicine, medicine, Internal Medicine, Humans, education, Retrospective Studies, Glycated Hemoglobin, education.field_of_study, Type 1 diabetes, business.industry, Incidence (epidemiology), Diabetic retinopathy, Middle Aged, medicine.disease, Surgery, Blood pressure, Diabetes Mellitus, Type 1, Risk factors, Metabolic control analysis, Cardiology, Female, sense organs, business
الوصف: Aims/hypothesisAlthough increasing hyperglycaemia, arterial hypertension and longer duration of diabetes raise the risk of progression of diabetic retinopathy, short-term benefits in terms of improved metabolic control and lowered blood pressure have not been demonstrated. We therefore examined the effect of changes in glycaemia and arterial blood pressure on the incidence of clinically significant macular oedema in a population of diabetic patients.MethodsWe performed a retrospective review of all patients with type 1 diabetes who attended the retinopathy screening clinic at the Steno Diabetes Center from 1988 to 2008, using the endpoint referral to first photocoagulation treatment for clinically significant diabetic macular oedema. The analysis included 1,878 patients (median observation, 8 years). Changes were defined as the inter-visit change; in the case of an event the last event-free interval before referral, where the median screening interval was 6 months.ResultsRisk of progression to photocoagulation for macular oedema increased with duration of diabetes (p 0.5 percentage points per 6 months was associated with HRs of 3.04 and 1.28, respectively, compared with lesser changes in HbA1c.Conclusions/interpretationIn this study, large recent changes in metabolic control and systolic blood pressure, irrespective of direction, were independent risk factors for progression to photocoagulation for diabetic macular oedema. The effects of metabolic and haemodynamic stability on diabetic retinopathy should be examined in prospective studies.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::80a7ebf5596c45b5c97c8d696f55c6a8Test
