المؤلفون: Lavik, Andrew R., Ebekozien, Osagie, Noor, Nudrat, Alonso, G. Todd, Polsky, Sarit, Blackman, Scott M., Chen, Justin, Corathers, Sarah D., Demeterco-Berggren, Carla, Gallagher, Mary Pat, Greenfield, Margaret, Garrity, Ashley, Rompicherla, Saketh, Rapaport, Robert, Jones, Nana-Hawa Yayah

المصدر: Journal of Clinical Endocrinology & Metabolism; Jul2022, Vol. 107 Issue 7, p1948-1955, 8p

مصطلحات موضوعية: TYPE 1 diabetes, KETOACIDOSIS, COVID-19 pandemic

مستخلص: Context: The impact of the COVID-19 pandemic on individuals with type 1 diabetes remains poorly defined. Objective: We examined United States trends in diabetic ketoacidosis (DKA) among individuals with type 1 diabetes (T1D) during the COVID-19 pandemic at 7 large US medical centers and factors associated with these trends. Methods: We compared DKA events among children and adults with T1D during COVID-19 surge 1 (March-May 2020) and COVID-19 surge 2 (August-October 2020) to the same periods in 2019. Analysis was performed using descriptive statistics and chi-square tests. Results: We found no difference in the absolute number of T1D patients experiencing DKA in 2019 vs 2020. However, a higher proportion of non-Hispanic Black (NHB) individuals experienced DKA in 2019 than non-Hispanic White (NHW) individuals (44.6% vs 16.0%; P < .001), and this disparity persisted during the COVID-19 pandemic (48.6% vs 18.6%; P < .001). DKA was less common among patients on continuous glucose monitor (CGM) or insulin pump in 2020 compared to 2019 (CGM: 13.2% vs 15.0%, P < .001; insulin pump: 8.0% vs 10.6%, P < .001). In contrast to annual DKA totals, a higher proportion of patients had DKA during COVID-19 surges 1 and 2 compared to the same months in 2019 (surge 1: 7.1% vs 5.4%, P < .001; surge 2: 6.6% vs 5.7%, P = .001). Conclusion: DKA frequency increased among T1D patients during COVID-19 surges with highest frequency among NHB patients. DKA was less common among patients using CGM or insulin pumps. These findings highlight the urgent need for improved strategies to prevent DKA among patients with T1D-not only under pandemic conditions, but under all conditions-especially among populations most affected by health inequities. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Clinical Endocrinology & Metabolism is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Doria, Alessandro, Galecki, Andrzej T, Spino, Cathie, Pop-Busui, Rodica, Cherney, David Z, Lingvay, Ildiko, Parsa, Afshin, Rossing, Peter, Sigal, Ronald J, Afkarian, Maryam, Aronson, Ronnie, Caramori, M Luiza, Crandall, Jill P, de Boer, Ian H, Elliott, Thomas G, Goldfine, Allison B, Haw, J Sonya, Hirsch, Irl B, Karger, Amy B, Maahs, David M, McGill, Janet B, Molitch, Mark E, Perkins, Bruce A, Polsky, Sarit, Pragnell, Marlon, Robiner, William N, Rosas, Sylvia E, Senior, Peter, Tuttle, Katherine, Umpierrez, Guillermo E, Wallia, Amisha, Weinstock, Ruth S, Wu, Chunyi, Mauer, Michael, PERL Study Group, Alicic, PERL Study Group Collaborator: Radica

المصدر: Articles, Abstracts, and Reports

مصطلحات موضوعية: Adult, Aged, Allopurinol, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Double-Blind Method, Enzyme Inhibitors, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Renin-Angiotensin System, Treatment Failure, Uric Acid, Xanthine Oxidase, Endocrinology, Diabetes, and Metabolism

الوصف: BACKGROUND: Higher serum urate levels are associated with an increased risk of diabetic kidney disease. Lowering of the serum urate level with allopurinol may slow the decrease in the glomerular filtration rate (GFR) in persons with type 1 diabetes and early-to-moderate diabetic kidney disease. METHODS: In a double-blind trial, we randomly assigned participants with type 1 diabetes, a serum urate level of at least 4.5 mg per deciliter, an estimated GFR of 40.0 to 99.9 ml per minute per 1.73 m RESULTS: A total of 267 patients were assigned to receive allopurinol and 263 to receive placebo. The mean age was 51.1 years, the mean duration of diabetes 34.6 years, and the mean glycated hemoglobin level 8.2%. The mean baseline iohexol-based GFR was 68.7 ml per minute per 1.73 m CONCLUSIONS: We found no evidence of clinically meaningful benefits of serum urate reduction with allopurinol on kidney outcomes among patients with type 1 diabetes and early-to-moderate diabetic kidney disease. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; PERL ClinicalTrials.gov number, NCT02017171.).

العلاقة: https://digitalcommons.psjhealth.org/publications/3311Test; https://pubmed.ncbi.nlm.nih.gov/32579810Test

الإتاحة: https://digitalcommons.psjhealth.org/publications/3311Test
https://pubmed.ncbi.nlm.nih.gov/32579810Test

المؤلفون: Polsky, Sarit, Foster, Nicole C., DuBose, Stephanie N., Agarwal, Shivani, Lyons, Sarah, Peters, Anne L., Uwaifo, Gabriel I., DiMeglio, Linda A., Sherr, Jennifer L., Levy, Carol J.

المساهمون: Pediatrics, School of Medicine

المصدر: Author

مصطلحات موضوعية: Type 1 diabetes mellitus, pregnancy, parity

الوصف: Objectives To assess risk factors and incidence of diabetes complications in women with type 1 diabetes (T1D) based on parity. Research design/methods Data were collected from women (16–40 years old) in the T1D Exchange completing pregnancy/childbirth questionnaires during 2011–2013 and 2016–2018. Incidence of risk factors and diabetes complications were compared between women with a first pregnancy at/within 1-year of enrollment (n = 28) and never pregnant women by year 5 (n = 469). Results There was a trend for lower HbA1c (adjusted p = .14) and higher rates of overweight/obesity, triglyceride/HDL > 2, log (triglyercide/HDL), and hypertension among parous women compared with nulliparous women. There were no significant differences in rates of advanced nephropathy, albuminuria or cardiovascular disease. Conclusions Four-5 years after delivery, parous women with T1D tended to have lower HbA1c levels despite higher body mass indices and more frequent adverse lipid profiles and hypertension compared with nulliparous women. Further studies based on these trends are warranted.

وصف الملف: application/pdf

العلاقة: The Journal of Maternal-Fetal & Neonatal Medicine; Polsky, S., Foster, N. C., DuBose, S. N., Agarwal, S., Lyons, S., Peters, A. L., Uwaifo, G. I., DiMeglio, L. A., Sherr, J. L., & Levy, C. J. (2020). Incident diabetes complications among women with type 1 diabetes based on parity. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 1–6. https://doi.org/10.1080/14767058.2020.1858278Test; https://hdl.handle.net/1805/27753Test

الإتاحة: https://hdl.handle.net/1805/27753Test

المؤلفون: Levy, Carol J., Foster, Nicole C., DuBose, Stephanie N., Agarwal, Shivani, Lyons, Sarah K., Peters, Anne L., Uwaifo, Gabriel I., DiMeglio, Linda A., Sherr, Jennifer L., Polsky, Sarit

المساهمون: Leona M. and Harry B. Helmsley Charitable Trust

المصدر: Journal of Diabetes Science and Technology ; volume 15, issue 6, page 1297-1302 ; ISSN 1932-2968 1932-2968

مصطلحات موضوعية: Biomedical Engineering, Bioengineering, Endocrinology, Diabetes and Metabolism, Internal Medicine

الوصف: Objectives: To examine changes in device use and glycemic outcomes for pregnant women from the T1D Exchange Clinic Registry between the years 2010-2013 and 2016-2018. Methods: Participant-reported device use and glycemic outcomes were compared for women aged 16-40 years who were pregnant at the time of survey completion, comparing 2010-2013 (cohort 1) and 2016-2018 (cohort 2). Hemoglobin A1c results within 30 days prior to survey completion were obtained from medical records. Results: There were 208 pregnant women out of 5,236 eligible participants completing the questionnaire in cohort 1 and 47 pregnant women out of 2,818 eligible participants completing the questionaire in cohort 2. Continuous glucose monitor (CGM) use while pregnant trended upward among cohort 2 (70% vs 37%, P = .02), while reported continuous subcutaneous insulin infusion (CSII) use while pregnant declined (76% vs 64%, P = .04). HbA1c levels trended downward (6.8% cohort 1 vs 6.5% cohort 2, P = .07). Conclusions: Self-reported CGM use while pregnant increased over the studied intervals whereas CSII use decreased. Additional evaluation of device use and the potential benefits for T1D pregnancies is needed.

الإتاحة: https://doi.org/10.1177/1932296820972123Test

المؤلفون: Alessi, Sheila M., Foster, Nicole C., Rash, Carla J., Van Name, Michelle A., Tamborlane, William V., Cengiz, Eda, Polsky, Sarit, Wagner, Julie

المساهمون: Leona M. and Harry B. Helmsley Charitable Trust

المصدر: Canadian Journal of Diabetes ; volume 44, issue 6, page 501-506 ; ISSN 1499-2671

مصطلحات موضوعية: Endocrinology, General Medicine, Endocrinology, Diabetes and Metabolism, Internal Medicine

الإتاحة: https://doi.org/10.1016/j.jcjd.2020.06.005Test
https://api.elsevier.com/content/article/PII:S1499267120301787?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1499267120301787?httpAccept=text/plainTest

المؤلفون: American Diabetes Association Professional Practice Committee, ElSayed, Nuha A., Aleppo, Grazia, Bannuru, Raveendhara R., Bruemmer, Dennis, Collins, Billy S., Ekhlaspour, Laya, Hilliard, Marisa E., Johnson, Eric L., Khunti, Kamlesh, Lingvay, Ildiko, Matfin, Glenn, McCoy, Rozalina G., Murdock, Lisa, Perry, Mary Lou, Pilla, Scott J., Polsky, Sarit, Prahalad, Priya, Pratley, Richard E., Segal, Alissa R.

المصدر: Diabetes Care; 2024 Supplement, Vol. 47, pS307-S308, 2p

مصطلحات موضوعية: DIABETES, PROFESSIONAL practice

الشركة/الكيان: AMERICAN Diabetes Association

مستخلص: The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetes Care is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Crandall, Jill P, Polsky, Sarit, Howard, Andrea A, Perreault, Leigh, Bray, George A, Barrett-Connor, Elizabeth, Brown-Friday, Janet, Whittington, Tracy, Foo, Sandra, Ma, Yong, Edelstein, Sharon L

المصدر: The American Journal of Clinical Nutrition ; volume 90, issue 3, page 595-601 ; ISSN 0002-9165

مصطلحات موضوعية: Nutrition and Dietetics, Medicine (miscellaneous)

الإتاحة: https://doi.org/10.3945/ajcn.2008.27382Test
https://api.elsevier.com/content/article/PII:S0002916523265624?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0002916523265624?httpAccept=text/plainTest
http://academic.oup.com/ajcn/article-pdf/90/3/595/23852647/595.pdfTest

المؤلفون: Foster, Nicole, Shah, Viral N, Bailey, Ryan, Wu, Mengdi, Pop-Busui, Rodica, Katz, Michelle, Crandall, Jill, Bacha, Fida, Nadeau, Kristen, Libman, Ingrid, Hiers, Paul, Mizokami-Stout, Kara, DiMeglio, Linda A, Sherr, Jennifer, Pratley, Richard, Agarwal, Shivani, Snell-Bergeon, Janet, Cengiz, Eda, Polsky, Sarit, Mehta, Sanjeev N

مصطلحات موضوعية: Diabetes management, Cardiovascular disease, adults, type 1 diabetes, CVD risk factors, Glycemic control, Endocrine disorders

الوصف: Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [IQR=21, 48], type 1 diabetes duration 16 years [IQR=9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) [IQR=6.9 (52), 8.6 (70)], 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, BMI, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era. ; Funding provided by: Leona M. and Harry B. Helmsley Charitable TrustCrossref Funder Registry ID: http://dx.doi.org/10.13039/100007028FundingTest provided by: National Institutes of HealthCrossref Funder Registry ID: http://dx.doi.org/10.13039/100000002Test

العلاقة: https://zenodo.org/communities/dryadTest; https://zenodo.org/record/5004588Test; https://doi.org/10.5061/dryad.msbcc2fv9Test; oai:zenodo.org:5004588

الإتاحة: https://doi.org/10.5061/dryad.msbcc2fv9Test
https://doi.org/10.1210/clinem/dgaa015Test
https://zenodo.org/record/5004588Test

المؤلفون: Afkarian, Maryam, Polsky, Sarit, Parsa, Afshin, Aronson, Ronnie, Caramori, Maria Luiza, Cherney, David Z, Crandall, Jill P, de Boer, Ian H, Elliott, Thomas G, Galecki, Andrzej T, Goldfine, Allison B, Haw, J Sonya, Hirsch, Irl B, Karger, Amy B, Lingvay, Ildiko, Maahs, David M, McGill, Janet B, Molitch, Mark E, Perkins, Bruce A, Pop-Busui, Rodica, Pragnell, Marlon, Rosas, Sylvia E, Rossing, Peter, Senior, Peter, Sigal, Ronald J, Spino, Catherine, Tuttle, Katherine, Umpierrez, Guillermo E, Wallia, Amisha, Weinstock, Ruth S, Wu, Chunyi, Mauer, Michael, Doria, Alessandro

المصدر: Articles, Abstracts, and Reports

مصطلحات موضوعية: Endocrinology, Diabetes, and Metabolism, Nephrology

الوصف: OBJECTIVE: Higher serum uric acid (SUA) is associated with diabetic kidney disease (DKD). Preventing Early Renal Loss in Diabetes (PERL) evaluates whether lowering SUA with allopurinol slows glomerular filtration rate (GFR) loss in people with type 1 diabetes (T1D) and mild to moderate DKD. We present the PERL rationale, design, and baseline characteristics. RESEARCH DESIGN AND METHODS: This double-blind, placebo-controlled, multicenter trial randomized 530 participants with T1D, estimated GFR (eGFR) of 40-99.9 mL/min/1.73 m RESULTS: Participants are 66% male and 84% white. At baseline, median age was 52 years and diabetes duration was 35 years, 93% of participants had hypertension, and 90% were treated with renin-angiotensin system inhibitors (median blood pressure 127/71 mmHg). Median HbA CONCLUSIONS: PERL will determine the effect of allopurinol on mild to moderate DKD in T1D, with or without albuminuria. Participants with normoalbuminuria and rapid GFR loss manifested many DKD risk factors of those with albuminuria, but with less severity.

العلاقة: https://digitalcommons.psjhealth.org/publications/1799Test; https://www.ncbi.nlm.nih.gov/pubmed/31186299Test

الإتاحة: https://digitalcommons.psjhealth.org/publications/1799Test
https://www.ncbi.nlm.nih.gov/pubmed/31186299Test

المؤلفون: Polsky, Sarit, Akturk, Halis K.

المصدر: Diabetes/Metabolism Research and Reviews ; volume 36, issue 3 ; ISSN 1520-7552 1520-7560

الوصف: Background Hybrid closed‐loop (HCL) therapy is rarely studied in pregnancy. We present three cases of women with type 1 diabetes who used the Medtronic 670G HCL system for most or all of gestation. Methods The Medtronic 670G system has a manual mode (no automated insulin delivery) and an auto mode (AM, HCL therapy). Women in this case series used AM off‐label in gestation. Results Case 1 started HCL therapy in the second trimester, her sensor glucose time spent <3.9 and >10 mmol/L improved thereafter. Case 1 had average sensor glucose (ASG) levels of 6.4 ± 2.4 mmol/L in the first trimester, 7.0 ± 2.7 mmol/L in the second trimester before HCL use, 7.1 ± 2.1 mmol/L in the second trimester after HCL use, and 6.8 ± 1.9 mmol/L in the third trimester. Case 1 continued AM during operative delivery and post‐partum. Cases 2 and 3 used HCL therapy throughout gestation but with inconsistent time in AM. When they increased time in AM their glycaemic indices improved. Case 2 had ASG of 9.5 ± 3.4, 8.6 ± 2.9, and 7.9 ± 2.5 mmol/L in the first through third trimesters, respectively. Case 3 had ASG of 11.1 ± 4.8 and 3.9 to 10 mmol/L in the first and second trimesters, respectively. Case 2 continued HCL therapy post‐partum, Case 3 did not. Conclusions CareLink® Clinical Software only reports the non‐pregnant time in range. Nonetheless, this represents the first report of HCL therapy in pregnancy with a system approved by the Food and Drug Administration in non‐pregnant populations.

الإتاحة: https://doi.org/10.1002/dmrr.3248Test