scholarly journals Characterization of plasma lipidomics in adolescent subjects with increased risk for type 1 diabetes in the DiPiS cohort

Metabolomics ◽  
2020 ◽  
Vol 16 (10) ◽  
Author(s):  
Agnes Andersson Svärd ◽  
◽  
Simranjeet Kaur ◽  
Kajetan Trôst ◽  
Tommi Suvitaival ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
High Performance ◽  
Plasma Lipids ◽  
High Risk Population ◽  
Cross Sectional ◽  
Flight Mass Spectrometry ◽  
Insulin Autoantibody ◽  
Increased Risk

Abstract Introduction Type 1 diabetes (T1D) is caused by the destruction of pancreatic islet beta cells resulting in total loss of insulin production. Recent studies have suggested that the destruction may be interrelated to plasma lipids. Objectives Specific lipids have previously been shown to be decreased in children who develop T1D before four years of age. Disturbances of plasma lipids prior to clinical diagnosis of diabetes, if true, may provide a novel way to improve prediction, and monitor disease progression. Methods A lipidomic approach was utilized to analyze plasma from 67 healthy adolescent subjects (10–15 years of age) with or without islet autoantibodies but all with increased genetic risk for T1D. The study subjects were enrolled at birth in the Diabetes Prediction in Skåne (DiPiS) study and after 10–15 years of follow-up we performed the present cross-sectional analysis. HLA-DRB345, -DRB1, -DQA1, -DQB1, -DPA1 and -DPB1 genotypes were determined using next generation sequencing. Lipidomic profiles were determined using ultra-high-performance liquid chromatography quadrupole time-of-flight mass spectrometry. Lipidomics data were analyzed according to genotype. Results Variation in levels of several specific phospholipid species were related to level of autoimmunity but not development of T1D. Five glycosylated ceramides were increased in insulin autoantibody (IAA) positive adolescent subjects compared to adolescent subjects without this autoantibody. Additionally, HLA genotypes seemed to influence levels of long chain triacylglycerol (TG). Conclusion Lipidomic profiling of adolescent subjects in high risk of T1D may improve sub-phenotyping in this high risk population.

scholarly journals Low levels of soluble TWEAK, indicating on-going inflammation, were associated with depression in type 1 diabetes: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eva O. Melin ◽  
Jonatan Dereke ◽  
Magnus Hillman
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Goodness Of Fit ◽  
Hdl Cholesterol ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
Increased Risk ◽  
Galectin 3 ◽  
Low Levels

Abstract Background Low levels of the soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK) and depression are linked to cardiovascular disease. Galectin-3, inadequate glycemic control and low high-density lipoprotein (HDL)-cholesterol levels were previously linked to depression in these patients with type 1 diabetes mellitus (T1DM). The main aim was to explore whether sTWEAK was associated with depression. A secondary aim was to explore diabetes related variables associated with low sTWEAK. Methods Cross-sectional design. T1DM patients (n = 283, men 56%, age18–59 years) were consecutively recruited from one specialist diabetes clinic. Depression was defined as Hospital Anxiety and Depression Scale-Depression sub scale ≥8 points. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic health records. Enzyme linked immunosorbent assays were used to measure sTWEAK and galectin-3. Low sTWEAK was defined as < 7.2 ng/ml and high galectin-3 as ≥2.6 ng/ml. Multiple logistic regression analyses were performed, calibrated and validated for goodness of fit. We adjusted for age, sex, diabetes duration, galectin-3, metabolic variables, serum-creatinine, smoking, physical inactivity, medication, and cardiovascular complications. Results For 29 depressed versus 254 non-depressed patients the prevalence rates were for low sTWEAK: 93 and 68% (p = 0.003) and for high galectin-3: 34 and 13% (p = 0.005) respectively. HDL-cholesterol levels were lower for the depressed (p = 0.015). Patients with low sTWEAK versus high sTWEAK had lower usage of continuous subcutaneous insulin infusion (CSII) (6% versus 17%, p = 0.005). Low sTWEAK (adjusted odds ratio (AOR) 9.0, p = 0.006), high galectin-3 (AOR 6.3, p = 0.001), HDL-cholesterol (per mmol/l) (AOR 0.1, p = 0.006), use of antidepressants (AOR 8.4, p < 0.001), and age (per year) (AOR 1.05, p = 0.027) were associated with depression. CSII (AOR 0.3, p = 0.003) and depression (AOR 7.1, p = 0.009) were associated with low sTWEAK. Conclusions Lower levels of sTWEAK and HDL-cholesterol and higher levels of galectin-3 were independently associated with depression in T1DM. These factors might all contribute to the increased risk for cardiovascular disease and mortality previously demonstrated in patients with depression. CSII (inversely) and depression were independently associated with low sTWEAK levels.

scholarly journals Association of glycemic variability and hypoglycemia with distal symmetrical polyneuropathy in adults with type 1 diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ziyang Shen ◽  
Hemin Jiang ◽  
Rong Huang ◽  
Yunting Zhou ◽  
Qian Li ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
C Peptide ◽  
Nocturnal Hypoglycemia ◽  
Increased Risk ◽  
Distal Symmetrical Polyneuropathy

AbstractPrevious studies exploring the influence of glycemic variability (GV) on the pathogenesis of distal symmetrical polyneuropathy (DSPN) in type 1 diabetes (T1DM) produced conflicting results. The aim of this study was to assess the relationship between GV and DSPN in T1DM. Adults with T1DM were included in this cross-sectional study and asked to undergo 3-day CGM. GV quantified by coefficient of variation (CV) and mean amplitude of glucose excursions (MAGE) were obtained from CGM. Clinical characteristics and biochemical assessments were collected for analysis. The study comprised 152 T1DM patients (53.9% males) with mean age of 44.2 year. Higher levels of age and duration of diabetes and lower levels of total cholesterol, LDL, fasting C-peptide and postprandial C-peptide were observed in DSPN subjects. DSPN groups displayed a higher blood glucose between 00:00 and 12:59 according to the CGM profile. Higher MAGE and CV were associated with increased risk of DSPN in the fully adjusted model. Meanwhile, a significant association between measurements of hypoglycemia, especially nocturnal hypoglycemia, and DSPN was found after multiple tests. CGM parameters describing the glycemic variability and hypoglycemia were potential risk factors for DSPN in adults with T1DM.

scholarly journals Association of socioeconomic status and DKA readmission in adults with type 1 diabetes: analysis of the US National Readmission Database

2019 ◽  
Vol 7 (1) ◽  
pp. e000621 ◽  
Author(s):  
Estelle Everett ◽  
Nestoras Nicolas Mathioudakis
Keyword(s):  
Socioeconomic Status ◽  
Type 1 Diabetes ◽  
Private Insurance ◽  
National Level ◽  
Multivariable Logistic Regression Analysis ◽  
High Risk Population ◽  
Increased Risk ◽  
The Usa ◽  
National Readmission Database

ObjectiveTo identify patient and hospital predictors of recurrent diabetic ketoacidosis (DKA) admissions in adults in the USA with type 1 diabetes, focusing on socioeconomic indicators.Research design and methodsThis cross-sectional study used the National Readmission Database to identify adult patients with type 1 diabetes admitted for DKA between 2010 and 2015. The index DKA admission was defined as the first admission within the calendar year and the primary outcome was recurrent DKA admission(s) within the same calendar year. Multivariable logistic regression analysis was performed using covariates of patient and hospital factors at the index admission to determine the odds of DKA readmission(s).ResultsAmong 181 284 index DKA admissions, 39 693 (22%) had at least one readmission within the calendar year, of which 33 931 (86%) and 5762 (14%) had 1–3 and ≥4 DKA readmissions, respectively. When compared with the highest income quartile, patients in the first and second income quartiles had 46% (95% CI 30% to 64%) and 34% (95% CI 19% to 51%) higher odds of four or more DKA readmissions, respectively. Medicaid and Medicare insurance were both associated with a 3.3-fold adjusted risk (95% CI 3.0 to 3.7) for ≥4 readmissions compared with private insurance, respectively. Younger age, female sex, and discharge against medical advice were also predictive.ConclusionsLower socioeconomic status and Medicaid insurance are strong predictors of DKA readmissions in adults with type 1 diabetes in the USA. Further studies are needed to understand the mediators of this association to inform multilevel interventions for this high-risk population.Significance of the studyThe association of socioeconomic status (SES) and hospital admission for DKA has been studied in pediatrics with type 1 diabetes, but the data in adults are limited, and studies evaluating recurrent DKA admissions are scarcer. To our knowledge, this is the first study to describe predictors of recurrent DKA admissions in adults with type 1 diabetes on a national level in the USA. We found that those at highest risk of recurrent DKA are young women with low SES who had Medicaid or Medicare insurance. These findings should prompt further studies to explore the mediators of these disparities in patients with type 1 diabetes, as recurrent DKA results in high healthcare utilization and increased risk of long-term complications.

scholarly journals Depression in type 1 diabetes was associated with high levels of circulating galectin-3

2018 ◽  
Vol 7 (6) ◽  
pp. 819-828 ◽  
Author(s):  
Eva Olga Melin ◽  
Jonatan Dereke ◽  
Maria Thunander ◽  
Magnus Hillman
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Depression Scale ◽  
Cardiovascular Complications ◽  
Lipid Lowering ◽  
Cross Sectional ◽  
Diabetes Registry ◽  
Increased Risk ◽  
Galectin 3

Objective Neuroinflammatory responses are implicated in depression. The aim was to explore whether depression in patients with type 1 diabetes (T1D) was associated with high circulating galectin-3, controlling for metabolic variables, s-creatinine, life style factors, medication and cardiovascular complications. Design Cross-sectional. Methods Participants were T1D patients (n = 283, 56% men, age 18–59 years, diabetes duration ≥1 year). Depression was assessed by Hospital Anxiety and Depression Scale-depression subscale. Blood samples, anthropometrics and blood pressure were collected, and supplemented with data from medical records and the Swedish National Diabetes Registry. Galectin-3 ≥2.562 µg/l, corresponding to the 85th percentile, was defined as high galectin-3. Results Median (quartile1, quartile3) galectin-3 (µg/l) was 1.3 (0.8, 2.9) for the 30 depressed patients, and 0.9 (0.5, 1.6) for the 253 non-depressed, P = 0.009. Depression was associated with high galectin-3 in all the 283 patients (adjusted odds ratio (AOR) 3.5), in the 161 men (AOR 3.4), and in the 122 women (AOR 3.9). HbA1c, s-lipids, s-creatinine, blood pressure, obesity, smoking, physical inactivity, cardiovascular complications and drugs (antihypertensive, lipid lowering, oral antidiabetic drugs and antidepressants) were not associated with high galectin-3. Conclusions This is the first study to show an association between depression and galectin-3. Depression was the only explored parameter associated with high circulating galectin-3 levels in 283 T1D patients. High galectin-3 levels might contribute to the increased risk for Alzheimer’s disease, cardiovascular and all-cause mortality observed in persons with depression. Potentially, in the future, treatment targeting galactin-3 might improve the prognosis for patients with high galectin-3 levels.

scholarly journals High-risk alcohol use and anxiety and depression symptoms in adolescents and adults with type 1 diabetes mellitus: a cross-sectional study

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Maria Aparecida Knychala ◽  
Maria Luiza Mendonça Pereira Jorge ◽  
Cinara Knychala Muniz ◽  
Priscila Neves Faria ◽  
Paulo Tannús Jorge
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
High Risk ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adolescents And Adults

scholarly journals Healthcare professional awareness of eating disorders in people with type 1 diabetes: a staff survey

2020 ◽  
Vol 20 (2) ◽  
pp. 122-129
Author(s):  
Sarah Brewster ◽  
Helen Partridge ◽  
Caroline Cross ◽  
Hermione Price
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Healthcare Professional ◽  
Disordered Eating ◽  
Cross Sectional ◽  
Increased Risk ◽  
Study Support ◽  
Professional Confidence ◽  
Fear Of Weight Gain

Background: People with type 1 diabetes are at increased risk of eating disorders. ‘Diabulimia’, ‘Syndrome of Insulin Omission’ and ‘Type 1 diabetes and Disordered Eating’ (T1DE) are all terms used to describe the omission or restriction of insulin in type 1 diabetes for fear of weight gain. For consistency, Type 1 diabetes and Disordered Eating (T1DE) is used throughout this article. The condition is associated with a significant increase in morbidity and mortality but is not yet recognised as a unique entity.Aim: To determine healthcare professional awareness and knowledge of eating disorders in type 1 diabetes.Methods: A short, cross-sectional, online healthcare professional survey across primary, secondary and community settings.Results: Healthcare professional confidence is low when it comes to recognising and supporting people with T1DE, but there is an interest in learning more.Conclusion: The findings from this study support strategies to improve healthcare professional awareness of T1DE.

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