Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011854 (type 1 diabetes)
 20,749 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Individuals with type 1 diabetes mellitus (DM1) have an increased risk of developing autoimmune thyroid dysfunction (AITD). We measured the prevalence of AITD in a pediatric DM1 population in order to examine the best combination of markers for predicting the development of AITD. A database of 1,254 patients with DM1 under 21 years of age was retrospectively screened for abnormalities in antithyroglobulin antibody (ATA), thyroid peroxidase antibody (TPO) and thyroid stimulating hormone (TSH). Charts on all 134 who had any of these serologic abnormalities were reviewed. 4.2% of the DM1 population was clinically diagnosed with AITD. Thirty-nine percent of the AITD diagnoses came within 1 year of DM1 diagnosis. Based upon evidence-based medicine statistics, TPO and TSH measurements are the most efficient and cost-effective combination of screening tests for AITD prediction and detection. The positive predictive value (of TPO and TSH) is 90%, with a positive likelihood ratio of 131.
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PMID:Autoimmune thyroid dysfunction in children with type 1 diabetes mellitus: screening guidelines based on a retrospective analysis. 1459 71

The aim of this study was to determine whether infrared thermography before and after challenge of the lower leg in cold water may be a useful tool to detect abnormalities in skin blood flow in adolescent asymptomatic patients with type 1 diabetes mellitus (DM1) and to assess the optimal setting of skin temperature measurements. Twenty-five adolescents (10 female, 15 male, mean age 21.2 +/- 6.2 years, body mass index [BMI] 23.0 +/- 2.1 kg/m2) with a duration of DMI of 13.8 +/- 5.4 years and mean HbA1c levels 8.5 +/- 1.3% were compared to age- and sex-matched controls (BMI 22.9 +/- 2.2 kg/m2). Seven defined sites of the lower leg were assessed by infrared thermography before and for 10 min after exposure of the leg to 14 degrees C cold water. As skin temperature before exposure to cold water differs from individual to individual and basal temperature was significantly warmer in patients at the tip of the first (p < 0.05) and fifth (p < 0.05) toe, the rewarming index was calculated in order to compare data. Rewarming indexes of skin temperature during the whole measurement procedure (0-10 min) were significantly lower at the tip of the first (p < 0.05) and fifth (p < 0.01) toes and from minute 2-10 also at the inner ankle (p < 0.05) in patients compared to healthy controls. Rewarming indexes of the other four sites were not significantly different between patients and controls. Infrared thermography of the lower leg after cold water exposure is an easily applicable method and a useful tool to detect abnormalities of skin blood flow in adolescents with DM1 especially at the tips of the first and fifth toes and the inner ankle.
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PMID:Rewarming index of the lower leg assessed by infrared thermography in adolescents with type 1 diabetes mellitus. 1471 48

Type 1 diabetes mellitus (DM1) is caused by environmental factors acting on genetically susceptible individuals. HLA-DQA1 and -DQB1 are major genetic determinants of the disease. Greece and Albania represent the low DM1 incidence countries of South-Eastern Europe. The HLA-DQA1 and -DQB1 associations with DM1 were investigated in these two groups, as reference for comparisons to the high-risk populations of Northern Europe. One hundred and thirty Greeks and 64 Albanians with DM1 were studied; 1,842 Greeks and 186 Albanians were analysed as controls. The samples were typed for six HLA-DQB1 alleles, using time-resolved fluorometry to detect the hybridisation of lanthanide labelled oligonucleotides with PCR products. Individuals positive for DQB1*0201 were selectively typed for three DQA1 alleles. In both populations DQB1*0201 increased the risk for DM1 while DQB1*0301 was protective. DQB1*0302 was associated with lower risk than *0201, while *0602 and *0603 were protective in Greeks but not in Albanians. It was also shown that DQA1 has a modifying effect, altering the risk conferred by the susceptible DQB1*0201. The low incidence of DM1 in these two countries correlates with the high frequency of the protective allele DQB1*0301 and the low impact of the susceptible DQB1*0302.
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PMID:HLA alleles and type 1 diabetes mellitus in low disease incidence populations of Southern Europe: a comparison of Greeks and Albanians. 1505 51

Simultaneous pancreas-kidney transplantation (SPK) recipients have longer survival compared to type 1 diabetes mellitus (DM1) cadaveric kidney recipients. However, DM1 living-related kidney transplant (KTX-LR) recipients have the same mortality as SPK recipients. It is unknown whether cardiovascular (CVD) risk factors pretransplant are similar between the two groups, SPK and DM1 KTX-LR. We analyzed pretransplant characteristics of SPK recipients (n = 39) and DM1 KTX-LR/living unrelated (LUR) recipients (KTX-LR/LUR, n = 20). In individuals who had multiple transplants, only pretransplant data from the first transplant was used. As all characteristics of KTX-LR/LUR recipients were the same, they were grouped for comparison with SPK. Pretransplant blood pressure (BP), body mass index, (BMI), hemoglobin A1c (A1c), total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TG), serum creatinine, type and duration of dialysis, and duration of diabetes were compared between the two groups. Mean age at time of transplantation was 41 +/- 1 years (mean +/- SEM) for SPK versus 39 +/- 2 years for KTX-LR/LUR (P = NS). Pretransplant BP, BMI, duration of diabetes, TC, HDL, LDL, TG, and lipid agent use were not different between the groups. Pretransplant A1c was 7.8 +/- 0.3% for SPK recipients and 8.3 +/- 0.5% for KTX-LR/LUR recipients (P = NS). Pretransplant serum creatinine was higher in KTX-LR/LUR compared to SPK (7.9 +/- 0.6 mg/dL versus 5.4 +/- 0.5 mg/dL; P =.01). Except for serum creatinine, there were no significant differences in traditional CVD risk factors pretransplant. However, factors posttransplant in addition to better glucose control with SPK may still be different between SPK and KTX-LR/LUR groups.
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PMID:There are no differences in pretransplant characteristics of individuals receiving simultaneous pancreas-kidney transplant and individuals with type 1 diabetes mellitus receiving living-related kidney transplant. 1519 77

Recent studies have described linkage and association between cytotoxic T-lymphocyte antigen-4 (CTLA-4) gene polymorphism and type 1 diabetes mellitus (DM1) in some ethnic populations, but not others. This finding suggests that CTLA-4 gene association with DM1 may be influenced by the racial composition of the population. Thus, it is important to study the polymorphism of the CTLA-4 gene in different ethnic groups. In this case-control association study, the CTLA-4 gene exon 1 A/G polymorphism was analyzed in 48 children with DM1 and 80 healthy controls using polymerase chain reaction-restriction fragment length polymorphism analysis. The possible interaction of the CTLA-4 gene polymorphism with the presence of established genetic markers (HLA-DR genotyping) was also evaluated in 29 patients. The results of the present study do not suggest an association of the known polymorphism in exon 1 of the CTLA-4 gene with DM1 in this Turkish population, and G-allele containing CTLA-4 genotypes were not preferentially associated with age at clinical presentation or with presence of other genetic (HLA-DR3 or -DR4) markers of DM1.
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PMID:Analysis of cytotoxic T lymphocyte antigen-4 (CTLA-4) exon 1 polymorphism in patients with type 1 diabetes mellitus in a Turkish population. 1523 7

We analyzed glycemic control and insulin usage patterns of 14 preschoolers and 14 adolescents on continuous subcutaneous insulin infusion (CSII) matched for sex to determine how CSII therapy for type 1 diabetes mellitus (DM1) differs in preschoolers as compared to adolescents. Average hemoglobin A(1c) was lower in the adolescents. The percent of insulin delivered as the basal rate was the same in both groups; however, during the hours after midnight the preschoolers needed a much lower basal rate per kg body weight. There were also significant differences in insulin sensitivity and insulin/carbohydrate ratios. The number of basal rates, number of boluses, and percent of insulin administered as the basal rate were not different between groups. This is the first report of discrete differences in insulin usage patterns for preschoolers and adolescents on insulin pumps. Reasons for these dissimilarities include differences in hormone production, insulin absorption, frequency of food intake, and glycemic targets. Recognizing these variations is essential for safe and efficacious use of CSII in preschoolers with DM1.
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PMID:Preschoolers are not miniature adolescents: a comparison of insulin pump doses in two groups of children with type 1 diabetes mellitus. 1527 Apr 4

Patients with type 1 diabetes mellitus (DM1) are at high risk to develop further autoimmune disorders, which are mostly characterized by the presence of organ-specific antibodies in serum and a subclinical disease course. Diabetes-related (glutamic acid decarboxylase, tyrosine phosphatase, IA-2) and thyroid-specific (thyroperoxidase, thyroglobulin) as well as antibodies to 20S proteasome, and anti-nuclear antibodies, were measured at DM1 onset in 147 children and adolescents. Patients were followed prospectively for the development of autoimmune thyroiditis (TSH elevation and/or sonographic thyroid gland enlargement in the presence of thyroid antibodies) up to 12 years, median observation time 4.4 years. Eight of 147 (5.4%) patients developed autoimmune thyroiditis. The cumulative incidence (+/-SE) at 5 years was 0.08+/-0.03. The prevalence of thyroid antibodies was 16.7%, of DM-related 88.4%, 20S proteasome 21.9%, and anti-nuclear antibodies 20.0%. There was a positive correlation between thyroid and anti-nuclear antibodies (p <0.001). Clinical course of DM1 and remission duration were not influenced by the presence of autoantibodies. However, in contrast to patients without antibodies, those with positive antibodies had significantly (p <0.001) elevated cumulative incidence of autoimmune thyroiditis at 5 years: thyroperoxidase 0.40+/-0.13, thyroglobulin 0.38+/-0.15, and anti-nuclear antibodies 0.29+/-0.12, respectively. These data underline that autoimmunity in patients with DM1 is not only restricted to beta-cell antigens at the onset of disease. In particular, patients with positive thyroid and anti-nuclear antibodies are at high risk to develop autoimmune thyroiditis during the first 5 years of DM1.
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PMID:Prevalence of 20S proteasome, anti-nuclear and thyroid antibodies in young patients at onset of type 1 diabetes mellitus and the risk of autoimmune thyroiditis. 1530 Oct 45

In this prospective study we investigated the frequency of vulvovaginal candidiasis, the results of yeast cultures and detection of ketoconazole resistance in female children and adolescents with type 1 diabetes mellitus (DM1). The study consisted of 35 patients with DM1 (age 1.7-20 years) and 22 controls (age 1.5-18 years). Age, duration of DM1 and evidence of genital symptoms were recorded initially. After a pelvic examination, two separate swabs and samples for blood glucose and hemoglobin A1c (HbA1c) were taken. One of the swabs was used for direct examination and the second was placed on Sabouraud's dextrose agar and incubated. In vitro susceptibility of Candida species to ketoconazole was established by using Etest (AB B1ODISC). Candida species were isolated in 32 of 61 (52.5%) swabs of patients with DM1 and five of 22 (18.2%) of the control group. The predominant Candida species isolated from patients with DM1 were C. albicans (72.7%), C. glabrata (22.7%), C. tropicalis (2.3%), and C. parapsilosis (2.3%). The mean HbA1c in diabetic patients from whom Candida species were isolated was significantly higher than that of patients without Candida infection (p = 0.002). Most of the C. glabrata isolates were significantly resistant to ketoconazole. During the follow-up of patients with DM1, genital candidiasis is generally overlooked. It should not be forgotten that species other than C. albicans might cause genital candidiasis.
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PMID:Vulvovaginal candidiasis in children and adolescents with type 1 diabetes mellitus. 1557 Sep 92

To evaluate markers of inflammation, we studied 48 patients with type 1 diabetes [DM1, 23F:25M, 19.9+/-9.8 years and duration of DM of 5 (1-21) years& and 66 non-DM subjects, matched for sex, age, and stages of puberty according to Tanner. C-reactive protein (CRP), alpha1-acid glycoprotein (AGP) and fibrinogen were measured by turbidimetric immunoassay and urinary albumin excretion rate (AER) was determined in timed overnight urine samples by RIA. Microalbuminuria was defined when two out of three urine samples had AER ranging 20-200 microg/min. Retinopathy was evaluated by indirect ophthalmoscopic in DM patients. The CRP and AGP levels were higher in DM1 patients as compared to controls, respectively [0.23 (0.01-2.90) vs. 0.14 (0.01-2.41) mg/dl, p= 0.0172& and [53.5 (37-115) vs. 40 (19-78) mg/dl, p< 0.0001]. Fibrinogen levels were not different between both groups. Stepwise multiple regression analysis showed that HbA1c and plasma glucose were the independents predictive variables of AGP, respectively (r2= 0.26; p< 0.05 and r2= 0,29; p< 0,05); CRP and fibrinogen did not correlate significantly with the independents variables. PCR correlate with HbA1c (r= 0.18; p= 0.05) by Pearson's correlation. In conclusion, CRP and AGP were higher in DM1 patients, without microalbuminuria, retinopathy and clinical macrovascular disease. Prospective studies must be addressed to determine the influence of AGP and CRP in the development of chronic complications.
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PMID:[Markers of inflammation in type 1 diabetic patients]. 1564 Aug 80

Psychological aspects and patients' acceptance of type 1 diabetes (DM1) may exercise some influence in their glycemic control. In this project the influence of psychological aspects were evaluated on glycemic control of DM1 patients. A retrospective study of participants from Diabetes Weekend (DW), an educational project in DM1 was carried out in Minas Gerais. In a sample of 150 subjects (66M/84F, 21.6+/-13.5 years and duration of DM of 8.5+/-7.9 years) we analyzed: type of insulin, insulin delivery, insulin dose per day and insulin dose per day in DW, psychological profile, capillary glycemia and previous history of convulsion crisis, severe hypoglycemia or diabetic ketoacidosis (CAD). Glucose was monitored 4 times a day by a digital glucose monitor. 20.9% of the patients with DM1 felt very well (G1); 39.5% well (G2), 25.6% with difficult glycemic control (G3), 9.3% trying to accept (G4) and 4.7% reported to be very bad about their DM1. The average capillary glycemia (ACG, in mg/dl) was significantly lower in G1 than in the others (169.8; G2: 182.3; G3: 199.3; G4: 200.7). There were no significant association of this psychological aspects and previous history of CAD, hypoglycemia or convulsion crisis. DM1 duration over 5 years was associated to lower acceptance of the disease (p= 0.017) and age of patients (p= 0.000). 13.9% of patients reported to be ashamed of their disease; the ACG was significantly higher in this group as compared to others (246.2 vs. 178.1; p= 0.007). In 91 patients (60.4%) who mention to have apprehension of feeling sick in public the ACG was significantly higher (200.4 vs. 184.5; p= 0.014). The systematic glucose monitoring showed positive association between psychological aspects and worse glycemic control. The psychological and multidisciplinary approach of DM1 patients is very important to try to improve the metabolic control, to prevent future complications, which results in better quality of life for these patients.
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PMID:[Psychological aspects and blood glucose control of a type 1 diabetes mellitus group from Minas Gerais]. 1564 Aug 81


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