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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The study was undertaken to determine whether overnight insulin requirements were being met during conventional insulin therapy in adolescents with IDDM. Overnight glucose and insulin profiles were compared when the subjects were on their usual insulin regime (baseline) and when the blood glucose was clamped using a variable rate insulin infusion (clamp). Thirteen adolescents (5 boys and 8 girls, median age 12.2 yr; range 10.5-15.4 yr; Median HBA1 11.4%; range 8.4-15.6) took part in the study. Three were on twice daily, two on multiple injection therapy and two on once daily insulin therapy. During the baseline studies, blood glucose concentrations fell to a nadir at 0200-0400 hr and then rose during the early hours of the morning. The clamp studies confirmed that the insulin requirement for euglycaemia was higher between 0500 and 0800 hr (15.4 +/- 0.9 mU/kg/hr) than between 0100 and 0400 (12.1 +/- 1.1 mU/kg/hr; p = 0.002). Comparison of the free insulin concentrations between the baseline and clamp nights, indicated that during the baseline study subjects were relatively over-insulinized during the early part of the night and under-insulinized during the latter part of the night irrespective of what insulin regime they were receiving. We conclude that current insulin regimes do not provide appropriate insulin delivery for the control of blood glucose during puberty.
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PMID:Failure of current insulin regimes to meet the overnight requirements of adolescents with insulin-dependent diabetes. 213 2

The prevalence of overt diabetes mellitus and carbohydrate intolerance was studied in 448 patients with cystic fibrosis (CF). Insulin-dependent diabetes (IDDM) developed in 7.6% of patients (13 male and 21 female). Survival was significantly lower (P less than 0.01) in the IDDM-CF group, with fewer than 25% surviving to age 30 years, whereas nearly 60% of the nondiabetic CF population reached this age. A significant deterioration in CF clinical status, based on NIH score, became apparent 2 years before onset of overt IDDM (P less than 0.05 at 2 years prior, P less than 0.01 at IDDM diagnosis). Total glycosylated hemoglobin (HbA1) was significantly (P less than 0.001) higher for the total CF population (7.3% +/- 1.2%) than for the general non-CF population (6.5% +/- 0.7%), and in the IDDM-CF group (P less than 0.05) compared with normoglycemic CF control patients. Female patients had a higher mean HbA1 after 12 years of age than their male counterparts did (P less than 0.02). HBA1 did not predict the development of IDDM, but there was a weak inverse relationship between HbA1 and both NIH clinical score (r = -0.41, P less than 0.02) and standard pulmonary function tests (forced vital capacity, r = -0.25, P less than 0.01) in the general CF population. Therefore, impaired carbohydrate tolerance in CF is associated with progressive clinical deterioration.
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PMID:Diabetes mellitus associated with cystic fibrosis. 334 74