المؤلفون: Wu, Zekai, Lebbar, Maha, Taleb, Nadine, Legault, Laurent, Messier, Virginie, Rabasa‐Lhoret, Rémi

المصدر: Diabetes, Obesity & Metabolism; Jan2023, Vol. 25 Issue 1, p310-313, 4p

مصطلحات موضوعية: TYPE 1 diabetes, GLUCOSE, YOUNG adults, INSULIN, TEENAGERS, GLYCEMIC control

مستخلص: 3 Wu Z, Yardley JE, Messier V, Legault L, Grou C, Rabasa-Lhoret R. Comparison of nocturnal glucose after exercise among dual-hormone, single-hormone algorithm-assisted insulin delivery system and usual care in adults and adolescents living with type 1 diabetes: a pooled analysis [published online ahead of print June 24, 2022]. Keywords: automated insulin delivery system; children and adolescents; glucagon; nocturnal glucose; type 1 diabetes EN automated insulin delivery system children and adolescents glucagon nocturnal glucose type 1 diabetes 310 313 4 12/13/22 20230101 NES 230101 BACKGROUND Automated insulin delivery (AID) systems combine insulin pump(s), continuous glucose monitoring (CGM) and a dosing algorithm automatically delivering insulin (single-hormone AID [SH-AID]) or insulin + glucagon (dual-hormone AID [DH-AID]). Histogram (mean) of glucagon delivery profile during dual-hormone automated insulin delivery intervention in children and adolescents with type 1 diabetes (N = 123 nights) Footnotes 1 Zekai Wu is the senior author. Comparing dual-hormone and single-hormone automated insulin delivery systems on nocturnal glucose management among children and adolescents with type 1 diabetes: A pooled analysis. [Extracted from the article]

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المؤلفون: Itzkovitz, Alexandra, Maggio, Vanessa, Roy‐Fleming, Amélie, Legault, Laurent, Brazeau, Anne‐Sophie

المصدر: Diabetic Medicine; Nov2022, Vol. 39 Issue 11, p1-9, 9p

مصطلحات موضوعية: NUTRITION, CROSS-sectional method, TYPE 1 diabetes, HEALTH literacy, COMPARATIVE studies, T-test (Statistics), FOOD, QUESTIONNAIRES, DESCRIPTIVE statistics

مصطلحات جغرافية: CANADA

مستخلص: Aim: Nutrition and food literacy encompasses knowledge, skills and confidence to prepare healthy meals. This project aimed to assess and compare the proportion of young Canadian adults (18–29 years old) living with type 1 diabetes and without diabetes (controls) who demonstrated adequate nutritional health literacy. Methods: This cross‐sectional study involved participants completing an online survey that included questions on socio‐economic status, nutrition knowledge, confidence and skills in meal preparation and the Short Food Literacy Questionnaire (SFLQ). Proportion of participants with adequate SFLQ score (i.e. ≥34/52) was compared between the groups (two‐sample t‐test). Results: Among the 236 people living with type 1 diabetes and 191 controls (81.5% women), mean age was 24 ± 3 years for people living with type 1 diabetes and 22 ± 3 years for controls (p < 0.001). More people living with type 1 diabetes reported adequate SFLQ score (people living with type 1 diabetes 88.0% vs. Controls 68.0%; p < 0.001). Similarly, majority of people living with type 1 diabetes prepared their own meals compared to the controls (74.5% vs. 47.6%; p < 0.001). Enhanced SFLQ score was associated with higher cooking skills (p = 0.02) and confidence (p < 0.01) in preparing healthy meals. Conclusions: Living with type 1 diabetes was associated with greater SFLQ scores among young Canadian adults. Having the independence, the confidence and skills in meal preparation were contributing factors. [ABSTRACT FROM AUTHOR]

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المؤلفون: Damanhoury, Samah, Morrison, Katherine M., Mian, Rajibul, McPhee, Patrick G., Kozyrskyj, Anita L., Newton, Amanda S., Buchholz, Annick, Chanoine, Jean‐Pierre, Hamilton, Jill, Ho, Josephine, Laberge, Anne‐Marie, Legault, Laurent, Thabane, Lehana, Tremblay, Mark S., Zenlea, Ian, Ball, Geoff D. C.

المصدر: Clinical Obesity; Feb2022, Vol. 12 Issue 1, p1-9, 9p

المؤلفون: Tsoukas, Michael A., Cohen, Elisa, Legault, Laurent, von Oettingen, Julia E., Yale, Jean‐François, Vallis, Michael, Odabassian, Madison, El Fathi, Anas, Rutkowski, Joanna, Jafar, Adnan, Ghanbari, Milad, Gouchie‐Provencher, Nikita, René, Jennifer, Palisaitis, Emilie, Haidar, Ahmad

المصدر: Diabetes, Obesity & Metabolism; Sep2021, Vol. 23 Issue 9, p2090-2098, 9p

مصطلحات موضوعية: ARTIFICIAL pancreases, CLOSED loop systems, PILOT projects, CARBOHYDRATES, FEASIBILITY studies, INSULIN aspart

مستخلص: Aim: To assess whether a FiASP‐and‐pramlintide closed‐loop system has the potential to replace carbohydrate counting with a simple meal announcement (SMA) strategy (meal priming bolus without carbohydrate counting) without degrading glycaemic control compared with a FiASP closed‐loop system. Materials and Methods: We conducted a 24‐hour feasibility study comparing a FiASP system with full carbohydrate counting (FCC) with a FiASP‐and‐pramlintide system with SMA. We conducted a subsequent 12‐day outpatient pilot study comparing a FiASP‐and‐placebo system with FCC, a FiASP‐and‐pramlintide system with SMA, and a FiASP‐and‐placebo system with SMA. Basal‐bolus FiASP‐and‐pramlintide were delivered at a fixed ratio (1 U:10 μg). Glycaemic outcomes were measured, surveys evaluated gastrointestinal symptoms and diabetes distress, and participant interviews helped establish a preliminary coding framework to assess user experience. Results: Seven participants were included in the feasibility analysis. Time spent in 3.9‐10 mmol/L was similar between both interventions (81%‐84%). Four participants were included in the pilot analysis. Time spent in 3.9‐10 mmol/L was similar between the FiASP‐and‐placebo with FCC and FiASP‐and‐pramlintide with SMA interventions (70%), but was lower in the FiASP‐and‐placebo with SMA intervention (60%). Time less than 3.9 mmol/L and gastrointestinal symptoms were similar across all interventions. Emotional distress was moderate at baseline, after the FiASP‐and‐placebo with FCC and SMA interventions, and fell after the FiASP‐and‐pramlintide with SMA intervention. SMA reportedly afforded participants flexibility and reduced mealtime concerns. Conclusions: The FiASP‐and‐pramlintide system has the potential to substitute carbohydrate counting with SMA without degrading glucose control. [ABSTRACT FROM AUTHOR]

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المؤلفون: Major, Sandrine, El Fathi, Anas, Palisaitis, Emilie, Kearney, Robert, Von Oettingen, Julia E., Krishnamoorthy, Preetha, Legault, Laurent, Haidar, Ahmad

المصدر: Diabetes, Obesity & Metabolism; Aug2020, Vol. 22 Issue 8, p1474-1477, 4p

مصطلحات موضوعية: ARTIFICIAL pancreases, INSULIN, CLOSED loop systems, CALCULATORS

مستخلص: Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed‐loop systems. We analysed data retrospectively from a cohort study evaluating a closed‐loop artificial pancreas system conducted in a diabetes camp over a period of 11 days. Meal boluses with negative correction (n = 98) of 47 participants aged 8 to 22 years were examined. If there was no insulin‐on‐board from previous boluses at mealtime, the postprandial hyperglycaemia rate increased with increased duration of insulin suspension (P =.03), with odds ratios being exaggerated by 17% per 10 minutes of suspension. However, if there was insulin‐on‐board from previous boluses, the hyperglycaemia rate did not change with increased duration of insulin suspension (P =.24). When there was no insulin‐on‐board, the rate of hyperglycaemia after meals preceded by no suspension was 21% (3/14), compared with 52% (12/23) and 64% (9/14) after meals preceded by suspensions of ≥50 and ≥70 minutes, respectively. Meal size did not influence these results. We conclude that, in the absence of insulin‐on‐board, negative prandial corrections may not be necessary following long insulin suspensions. [ABSTRACT FROM AUTHOR]

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المؤلفون: Gingras, Véronique, Taleb, Nadine, Roy‐Fleming, Amélie, Legault, Laurent, Rabasa‐Lhoret, Rémi

المصدر: Diabetes, Obesity & Metabolism; Feb2018, Vol. 20 Issue 2, p245-256, 12p

مصطلحات موضوعية: TYPE 1 diabetes, CLOSED loop systems, INSULIN therapy, TREATMENT of diabetes, ARTIFICIAL pancreases, PATIENTS

مستخلص: For patients with type 1 diabetes, closed‐loop delivery systems (CLS) combining an insulin pump, a glucose sensor and a dosing algorithm allowing a dynamic hormonal infusion have been shown to improve glucose control when compared with conventional therapy. Yet, reducing glucose excursion and simplification of prandial insulin doses remain a challenge. The objective of this literature review is to examine current meal‐time strategies in the context of automated delivery systems in adults and children with type 1 diabetes. Current challenges and considerations for post‐meal glucose control will also be discussed. Despite promising results with meal detection, the fully automated CLS has yet failed to provide comparable glucose control to CLS with carbohydrate‐matched bolus in the post‐meal period. The latter strategy has been efficient in controlling post‐meal glucose using different algorithms and in various settings, but at the cost of a meal carbohydrate counting burden for patients. Further improvements in meal detection algorithms or simplified meal‐priming boluses may represent interesting avenues. The greatest challenges remain in regards to the pharmacokinetic and dynamic profiles of available rapid insulins as well as sensor accuracy and lag‐time. New and upcoming faster acting insulins could provide important benefits. Multi‐hormone CLS (eg, dual‐hormone combining insulin with glucagon or pramlintide) and adjunctive therapy (eg, GLP‐1 and SGLT2 inhibitors) also represent promising options. Meal glucose control with the artificial pancreas remains an important challenge for which the optimal strategy is still to be determined. [ABSTRACT FROM AUTHOR]

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المؤلفون: Dias, Christel, Giordano, Mara, Frechette, Rosalie, Bellone, Simonetta, Polychronakos, Constantin, Legault, Laurent, Deal, Cheri L, Goodyer, Cynthia Gates

المصدر: Journal of Cellular & Molecular Medicine; Nov2017, Vol. 21 Issue 11, p2985-2999, 15p

مصطلحات موضوعية: GROWTH of children, STATURE, HUMAN growth hormone, LOCUS (Genetics), HUMAN genetic variation, GENETICS

مستخلص: GH plays an essential role in the growing child by binding to the growth hormone receptor (GHR) on target cells and regulating multiple growth promoting and metabolic effects. Mutations in the GHR gene coding regions result in GH insensitivity (dwarfism) due to a dysfunctional receptor protein. However, children with idiopathic short stature (ISS) show growth impairment without GH or GHR defects. We hypothesized that decreased expression of the GHR gene may be involved. To test this, we investigated whether common genetic variants (microsatellites, SNPs) in regulatory regions of the GHR gene region were associated with the ISS phenotype. Genotyping of a GT-repeat microsatellite in the GHR 5′UTR in a Montreal ISS cohort ( n = 37 ISS, n = 105 controls) revealed that the incidence of the long/short (L/S) genotype was 3.3× higher in ISS children than controls ( P = 0.04, OR = 3.85). In an Italian replication cohort ( n = 143 ISS, n = 282 controls), the medium/short (M/S) genotype was 1.9× more frequent in the male ISS than controls ( P = 0.017, OR = 2.26). In both ISS cohorts, logistic regression analysis of 27 SNPs showed an association of ISS with rs4292454, while haplotype analysis revealed specific risk haplotypes in the 3′ haploblocks. In contrast, there were no differences in GT genotype frequencies in a cohort of short stature (SS) adults versus controls (CARTaGENE: n = 168 SS, n = 207 controls) and the risk haplotype in the SS cohort was located in the most 5′ haploblock. These data suggest that the variants identified are potentially genetic markers specifically associated with the ISS phenotype. [ABSTRACT FROM AUTHOR]

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المؤلفون: Taleb, Nadine, Haidar, Ahmad, Messier, Virginie, Gingras, Véronique, Legault, Laurent, Rabasa‐Lhoret, Rémi

المصدر: Diabetes, Obesity & Metabolism; Jan2017, Vol. 19 Issue 1, p13-23, 11p

مصطلحات موضوعية: GLUCAGON, ARTIFICIAL pancreases, DIAGNOSIS of diabetes, PEOPLE with diabetes, GLYCEMIC index

مستخلص: The role of glucagon in the pathophysiology of diabetes has long been recognized, although its approved clinical use has so far been limited to the emergency treatment of severe hypoglycaemia. A novel use of glucagon as intermittent mini-boluses is proposed in the dual-hormone version (insulin and glucagon) of the external artificial pancreas. Short-term studies suggest that the incorporation of glucagon into artificial pancreas systems has the potential to further decrease hypoglycaemic risk and improve overall glucose control; however, the potential long-term safety and benefits also need to be investigated given the recognized systemic effects of glucagon. In the present report, we review the available animal and human data on the physiological functions of glucagon, as well as its pharmacological use, according to dosing and duration (acute and chronic). Along with its main role in hepatic glucose metabolism, glucagon affects the cardiovascular, renal, pulmonary and gastrointestinal systems. It has a potential role in weight reduction through its central satiety function and its role in increasing energy expenditure. Most of the pharmacological studies investigating the effects of glucagon have used doses exceeding 1 mg, in contrast to the mini-boluses used in the artificial pancreas. The available data are reassuring but comprehensive human studies using small but chronic glucagon doses that are close to the physiological ranges are lacking. We propose a list of variables that could be monitored during long-term trials of the artificial pancreas. Such trials should address the questions about the risk-benefit ratio of chronic glucagon use. [ABSTRACT FROM AUTHOR]

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المؤلفون: Wu, Zekai, Lebbar, Maha, Taleb, Nadine, Legault, Laurent, Messier, Virginie, Rabasa‐Lhoret, Rémi

المصدر: Diabetes, Obesity & Metabolism; Jan2023, Vol. 25 Issue 1, pC4-C4, 1p

مصطلحات موضوعية: TYPE 1 diabetes

مستخلص: The cover image is based on the Research Letter I Comparing dual-hormone and single-hormone automated insulin delivery systems on nocturnal glucose management among children and adolescents with type 1 diabetes: A pooled analysis i by Zekai Wu MD et al., https://doi.org/10.1111/dom.14850Test. [Extracted from the article]

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المؤلفون: Rousseau, Marie‐Claude, El‐Zein, Mariam, Conus, Florence, Legault, Laurent, Parent, Marie‐Elise

المصدر: Paediatric & Perinatal Epidemiology; Mar2016, Vol. 30 Issue 2, p141-148, 8p

مصطلحات موضوعية: BCG vaccines, TUBERCULOSIS vaccines, VACCINATION of infants, DIABETES in children, DIABETES, IMMUNIZATION, TYPE 1 diabetes, LONGITUDINAL method, MATERNAL age, RESEARCH funding, PATERNAL age effect

مصطلحات جغرافية: QUEBEC (Province)

مستخلص: Background: A narrow time window in infancy may be relevant for the aetiology of immune-mediated type 1 diabetes. We investigated whether a non-specific immune stimulation in the first year of life, as resulting from Bacillus Calmette-Guérin (BCG) vaccination, was associated with childhood diabetes.Methods: Using data from a birth cohort assembled through linkage of administrative databases, 78,492 subjects born in 1974 were the object of the present analysis. Information was extracted from the birth, death, and BCG vaccination registries. Diabetes-related health services were obtained from administrative health databases (physician billing claims and hospitalisation data) until 1994. Subjects were classified as having diabetes according to two validated definitions: (1) ≥2 diabetes-related medical visits within 2 years or ≥1 hospitalisation for diabetes; and 2) ≥4 diabetes-related medical visits within 2 years. Cox proportional hazards regression was used to estimate adjusted hazard ratios (HR) and 95% confidence interval (CI), adjusted for potential confounders.Results: Forty-four per cent of subjects were BCG vaccinated in the first year of life. According to the first and second definition, respectively, 293 (0.37%) and 230 (0.29%) subjects were classified as having diabetes. There was no association between BCG vaccination in the first year of life and risk of diabetes with either definition (HR(def1)  = 0.92, 95% CI 0.73, 1.17; HR(def2)  = 1.04, 95% CI 0.80, 1.37), and results did not differ by sex.Conclusions: Given the potentially critical importance of the exposure window and paucity of studies addressing BCG vaccination timing in relation to diabetes risk, this question deserves further investigation. [ABSTRACT FROM AUTHOR]

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