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In summary, the significant rise in types 1 and 2 diabetes mellitus is poised to impart grave consequences on health and lifespan of the world's population if left unchecked. Recent publications in ATVB highlight progress toward t...
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In summary, the significant rise in types 1 and 2 diabetes mellitus is poised to impart grave consequences on health and lifespan of the world's population if left unchecked. Recent publications in ATVB highlight progress toward the identification of the fundamental mechanisms, and their interplay, that contribute to derangements in endothelial function, oxidative and inflammatory stresses in diabetes mellitus to mediate complications. Studies reported from primary cells contribute to elucidation of the key signaling mechanisms underlying complications and are buttressed by hypothesis-driven research in animal models. Using genetic modulation strategies, modulators of miRs, pharmacological agents and siRNA knockdown strategies, observations and associations progress to causality in diabetes mellitus. In large animal models of diabetes mellitus and atherosclerosis, efforts to improve imaging and diagnostic capabilities with respect to atherosclerotic plaques hold promise for extrapolation to human subjects, given the similarity between the 2 species in vessel size and anatomic characteristics. The messages from these studies are brought home to the human subject in multiple papers that both suggest means to reduce diabetes mellitus risk and to mitigate the complications. Surely, we are getting closer to identifying fundamental causative pathways in complications-the challenge is to develop therapeutic strategies for rigorous testing in human subjects. ATVB will continue to track the promise of basic, translational, and clinical research in diabetes mellitus and its complications.
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A 30year-old Hispanic male who presented with transient neonatal diabetes mellitus at 4 months has been intensively studied with 12 islet-cell secretagogues from 4 months to 24 years. He was both ICA- and GAD-65-negative, but at 2...
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A 30year-old Hispanic male who presented with transient neonatal diabetes mellitus at 4 months has been intensively studied with 12 islet-cell secretagogues from 4 months to 24 years. He was both ICA- and GAD-65-negative, but at 28 years was diagnosed with hypothyroidism due to positive thyroperoxidase antibodies. The course of his disease(s) and the various presentations of hyperglycemia are documented and illustrated by the responses in islet cell hormone secretion, namely, insulin, glucagon, and C-peptide. Insulin secretion gradually fell over 24 years, glucagon secretion persisted from infancy to 24 years but was only minimal during i.v. glucose at 24 years, and C-peptide secretion remained normal, although modest, throughout the 24 years. These data suggest that, despite changing presentations of diabetes mellitus over time, the islets continued to process proinsulin, although the patient required insulin therapy.
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Background : Diabetes is a chronic and worldwide common disease. This disease has many physical chronic complications. The aim of this study was to evaluate chronic complications of type 2 diabetes in the patients hospitalized in ...
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Background : Diabetes is a chronic and worldwide common disease. This disease has many physical chronic complications. The aim of this study was to evaluate chronic complications of type 2 diabetes in the patients hospitalized in Shohada Ashayer hospital because of lack of control of plasma glucose with oral drugs. Materials and Methods: This retrospective cross sectional study was carried out on the patients hospitalized because of lack of control of plasma glucose by oral drugs in 2009-2010. The required data were gathered using a questionnaire. The collected data were analyzed by SPSS software and chi-square and Fisher's exact test. P value <0.05 was statistically regarded significant. Results: Studied subjects were 299 patients, of them 177 were female. The mean age of the patients was 58.6±14.7 years. Cardiovascular diseases (41.5%) and retinopathy (37.4%) were the most frequent complications. There was a significant relation between retinopathy and nephropathy, and the duration of the disease. Conclusion: Considering the high prevalence of cardiovascular complications in the patients and the lack of a routine method for evaluation of these complications in the diabetic patients, designing a plan for periodic evaluation of these patients is suggested.
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The present study was performed to evaluate pregnancy outcomes in women with type 1 and type 2 diabetes mellitus (DM) in Japan. This multi-institutional retrospective study was conducted in 40 general hospitals in Japan during 200...
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The present study was performed to evaluate pregnancy outcomes in women with type 1 and type 2 diabetes mellitus (DM) in Japan. This multi-institutional retrospective study was conducted in 40 general hospitals in Japan during 2003-2009. We evaluated 369 and 579 pregnant women with type 1 and type 2 DM, respectively, and compared pregnancy outcomes between the two groups. Glycosylated hemoglobin levels in the first trimester did not differ significantly between the studied groups. Gestational weight gain was lower in type 2 DM than in type 1 DM. Although there were no significant differences in perinatal outcomes between the groups, the primary cesarean section rate was higher in type 2 DM than in type 1 DM. Multiple logistic regression analysis revealed that primigravida status, pre-gestational body mass index (BMI), gestational weight gain, chronic hypertension, and microvascular disease including diabetic retinopathy or nephropathy were associated with onset of pregnancy-induced hypertension. Further, pre-gestational BMI was associated with the need for primary cesarean section. This study demonstrated that no differences were observed in the rates of perinatal mortality and congenital malformation between pregnant women with type 1 DM and type 2 DM; however, women with type 2 DM displayed a higher risk of primary cesarean section.
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Importance? Type 1 diabetes has been associated with cardiovascular disease and late complications such as retinopathy and nephropathy. However, it is unclear whether there is an association between type 1 diabetes and school perf...
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Importance? Type 1 diabetes has been associated with cardiovascular disease and late complications such as retinopathy and nephropathy. However, it is unclear whether there is an association between type 1 diabetes and school performance in children.Objective? To compare standardized reading and mathematics test scores of schoolchildren with type 1 diabetes vs those without diabetes.Design, Setting, and Participants? Population-based retrospective cohort study from January 1, 2011, to December 31, 2015 (end date of follow-up), including Danish public schoolchildren attending grades 2, 3, 4, 6, and 8. Test scores were obtained in math (n?=?524?764) and reading (n?=?1?037?006). Linear regression models compared outcomes with and without adjustment for socioeconomic characteristics.Exposures? Type 1 diabetes.Main Outcomes and Measures? Primary outcomes were pooled test scores in math and reading (range, 1-100).Results? Among 631?620 included public schoolchildren, the mean (SD) age was 10.31 (SD, 2.42) years, and 51% were male; 2031 had a confirmed diagnosis of type 1 diabetes. Overall, the mean combined score in math and reading was 56.11 (SD, 24.93). There were no significant differences in test scores found between children with type 1 diabetes (mean, 56.56) and children without diabetes (mean, 56.11; difference, 0.45 [95% CI, ?0.31 to 1.22]). The estimated difference in test scores between children with and without type 1 diabetes from a linear regression model with adjustment for grade, test topic, and year was 0.24 (95% CI, ?0.90 to 1.39) and 0.45 (95% CI, ?0.58 to 1.49) with additional adjustment for socioeconomic status.Conclusions and Relevance? Among Danish public schoolchildren, there was no significant difference in standardized reading and mathematics test scores of children with type 1 diabetes compared with test scores of children without diabetes.
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Background: Helicobacter pylori infects more than half of the world's population. The aim of this study was to quantify the association between H. pylori infection and the risk of diabetes mellitus and diabetic nephropathy, and to...
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Background: Helicobacter pylori infects more than half of the world's population. The aim of this study was to quantify the association between H. pylori infection and the risk of diabetes mellitus and diabetic nephropathy, and to detect at which stage the infection might have higher pathogenicity in the disease-free status-diabetes mellitus-diabetic nephropathy process. Methods: A literature search was performed to identify studies published between 1997 and 2012 for relative risk estimates. Fixed and random effects meta-analytical techniques were conducted for diabetes mellitus and diabetic nephropathy. Results: Thirty-seven case-control studies and 2 cohort studies were included. H. pylori was associated with an increased risk of each type of diabetes mellitus (odds ratio (OR) 2.00, 95% confidence interval (CI) 1.82-2.20, p for heterogeneity = 0.07). The infection was also associated with increased risks of type 1 and type 2 diabetes mellitus, separately ( OR 1.99, 95% CI 1.52-2.60, p for heterogeneity = 0.15, and OR 2.15, 95% CI 1.81-2.55, p for heterogeneity = 0.24, respectively). In addition, we found a significant association between H. pylori infection and diabetic nephropathy risk (OR 1.60, 95% CI 1.10-2.33, p for heterogeneity = 0.44). Conclusions: Our meta-analyses suggest a relationship between H. pylori infection and the risk of diabetes mellitus and diabetic nephropathy. The bacterium may be able to play its pathogenic role in the whole disease process, and this action may be stronger in type 2 diabetic patients than in type 1 diabetic patients.
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The brain of patients with Alzheimer disease (AD) showed the evidence of reduced expression of insulin and neuronal insulin receptors, as compared with those of age-matched controls. This event gradually and certainly leads to a b...
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The brain of patients with Alzheimer disease (AD) showed the evidence of reduced expression of insulin and neuronal insulin receptors, as compared with those of age-matched controls. This event gradually and certainly leads to a breakdown of the entire insulin-signaling pathway, which manifests insulin resistance. This in turn affects brain metabolism and cognitive functions, which are the bestdocumented abnormalities in AD. These observations led Dr. de la Monte and her colleagues to suggest that AD is actually a neuroendocrine disorder that resembles type 2 diabetes mellitus. The truth would be more complex with understanding the role of low-density lipoprotein receptor-related protein 1, A beta derived diffusible ligands, and advanced glycation end products. However, now it known as "brain diabetes" and is called type 3 diabetes mellitus (T3DM). This review provides an overview of "brain diabetes" focusing on the reason why the phenomenon is called T3DM.
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The term type 1.5 diabetes is used to describe a subset of patients with diabetes who share characteristics of type 1 and type 2 diabetes. The presence of islet cell autoantibodies in diabetes patients often with atypical presenta...
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The term type 1.5 diabetes is used to describe a subset of patients with diabetes who share characteristics of type 1 and type 2 diabetes. The presence of islet cell autoantibodies in diabetes patients often with atypical presentation or phenotype is used to classify individuals as having type 1.5 diabetes. Although type 1.5 diabetes patients are commonly described as being leaner, having a younger age at onset, and having a more rapidly progressing disease than classic type 2 diabetes patients, many are obese, middle to older aged, and have an indolent disease process. There are currently several studies underway attempting to find strategies that preserve < beta > cell function and prevent or delay the diabetes process in type 1 and type 2 diabetes patients. Because type 1.5 diabetes patients have components of type 1 and type 2 diabetes, any successful strategies will need to be tested in type 1.5 diabetes patients to ensure similar outcomes. The importance of identifying type 1.5 diabetes patients has yet to be determined, but the knowledge of a patient's autoantibody status may prove to be invaluable. In this review, the authors discuss the various aspects of type 1.5 diabetes as well as potential considerations regarding their clinical management.
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This review discusses a number of different issues relating to the development and evaluation of interventions for the diabetes care of older people. The review draws on the experience of a pilot study examining a new model of car...
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This review discusses a number of different issues relating to the development and evaluation of interventions for the diabetes care of older people. The review draws on the experience of a pilot study examining a new model of care for older frail people with type 2 diabetes, which comprised a specially developed clinical protocol to support district nurses in carrying out a diabetic annual review for the 'older housebound'. The review examines the difficulties encountered in conducting research with this vulnerable subset of the population of people with diabetes and suggests how they may be overcome. Particular attention is directed at clarifying the research population, the validity of the proposed intervention, alternative approaches to the care of the older population with diabetes, sample selection and recruitment, and outcome measures. Copyright < copyright > 2002 John Wiley & Sons, Ltd.
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