Definition, Classification, Diagnosis and Differential Diagnosis of Diabetes Mellitus: Update 2023

Experimental and Clinical Endocrinology & Diabetes, Год журнала: 2024, Номер 132(03), С. 112 - 124

Опубликована: Фев. 20, 2024

Notice Of Update The DDG clinical practice guidelines are updated regularly during the second half of calendar year. Please ensure that you read and cite respective current version.

Язык: Английский

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Insulitis in human type 1 diabetes: lessons from an enigmatic lesion

European Journal of Endocrinology, Год журнала: 2024, Номер 190(1), С. R1 - R9

Опубликована: Янв. 1, 2024

Type 1 diabetes is caused by a deficiency of insulin secretion which has been considered traditionally as the outcome precipitous decline in viability β-cells islets Langerhans, brought about autoimmune-mediated attack. Consistent with this, various classes lymphocyte, well cells innate immune system have found association during disease progression. However, analysis human pancreas from subjects type revealed that insulitis often less intense than equivalent animal models and can affect many fewer expected, at onset. This especially true developing in, or beyond, their teenage years. Such studies imply both phenotype number present within insulitic lesions vary among individuals an age-dependent manner. Additionally, influent lymphocytes are mainly arrayed peripherally around rather gaining direct access to endocrine cell core. Thus, remains enigmatic phenomenon this review seeks explore current understanding its likely role progression diabetes.

Язык: Английский

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Investigating the Interplay: Periodontal Disease and Type 1 Diabetes Mellitus—A Comprehensive Review of Clinical Studies

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(13), С. 7299 - 7299

Опубликована: Июль 2, 2024

Diabetes mellitus (DM) poses a significant challenge to global health, with its prevalence projected rise dramatically by 2045. This narrative review explores the bidirectional relationship between periodontitis (PD) and type 1 diabetes (T1DM), focusing on cellular molecular mechanisms derived from interplay oral microbiota host immune response. A comprehensive search of studies published 2008 2023 was conducted elucidate association these two diseases. Preclinical clinical evidence suggests relationship, individuals T1DM exhibiting heightened susceptibility periodontitis, vice versa. The includes recent findings human studies, revealing variations in composition patients, including increases certain pathogenic species such as

Язык: Английский

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Impact of School Nurse on Managing Pediatric Type 1 Diabetes with Technological Devices Support: A Systematic Review

Diseases, Год журнала: 2024, Номер 12(8), С. 173 - 173

Опубликована: Авг. 1, 2024

Introduction: Type 1 diabetes (T1D) is a disease that primarily occurs in pediatric populations. A school nurse (SN) can provide valuable support the setting for minors affected by this condition. Methods: The main objective of study was to evaluate impact nursing care provided adolescents and children with T1D using technological devices school. Qualitative quantitative outcomes considered included studies were collected discussed. systematic review conducted PubMed, CINAHL, Scopus databases reported thought PRISMA guidelines. Results: Eleven included. results showed SNs need enhance both their skills organization effectively manage young patients technology. response population caregivers management SN has been positive. Conclusions: chronic diseases one most urgent public health issues, especially Western healthcare systems. Proper at level definitely an aspect policymakers managers should consider improve quality life extremely vulnerable population, particularly those T1D.

Язык: Английский

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Predicting misdiagnosed adult-onset type 1 diabetes using machine learning

Diabetes Research and Clinical Practice, Год журнала: 2022, Номер 191, С. 110029 - 110029

Опубликована: Авг. 5, 2022

It is now understood that almost half of newly diagnosed cases type 1 diabetes are adult-onset. However, and 2 difficult to initially distinguish clinically in adults, potentially leading ineffective care. In this study a machine learning model was developed identify patients misdiagnosed as diabetes.In retrospective study, from population with prior diagnosis. Using Ambulatory Electronic Medical Records (AEMR), features capturing relevant information on age, demographics, risk factors, symptoms, treatments, procedures, vitals, or lab results were extracted patients' medical history.The identified BMI/weight, therapy history, HbA1c/blood glucose values among top predictors misdiagnosis. Model precision at low levels recall (10 %) 17 %, compared <1 % incidence rate misdiagnosis the time first encounter AEMR.This algorithm shows potential for being translated into screening guidelines clinical decision support tool embedded directly an EMR system reduce adult-onset implement effective care outset.

Язык: Английский

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Type 1 Diabetes and Aging

Endocrinology and Metabolism Clinics of North America, Год журнала: 2023, Номер 52(2), С. 389 - 403

Опубликована: Фев. 16, 2023

Язык: Английский

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Identifying type 1 and 2 diabetes in research datasets where classification biomarkers are unavailable: assessing the accuracy of published approaches

Journal of Clinical Epidemiology, Год журнала: 2022, Номер 153, С. 34 - 44

Опубликована: Ноя. 9, 2022

ObjectivesWe aimed to compare the performance of approaches for classifying insulin-treated diabetes within research datasets without measured classification biomarkers, evaluated against two independent biological definitions type.Study Design and SettingWe compared accuracy ten reported into type 1 (T1D) 2 (T2D) in cohorts: UK Biobank (UKBB) n = 26,399 Diabetes Alliance Research England (DARE) 1,296. The overall T1D T2D was assessed using: a genetic risk score stratification method (UKBB); C-peptide at >3 years duration (DARE).ResultsApproaches' ranged from 71% 88% 68% (DARE). When all participants, combining early insulin requirement with probability model (incorporating diagnosis age body image issue [BMI]), interview-reported (UKBB available only 15%) consistently achieved high 87% DARE 85% 88%, respectively). For identifying minimal misclassification, models thresholds or young (<20 years) had highest performance. Findings were incorporated an online tool optimum based on variable availability.ConclusionModels continuous features are most accurate methods biomarkers.

Язык: Английский

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Obstructive sleep apnoea and long-term risk of incident diabetes in the middle-aged and older general population

ERJ Open Research, Год журнала: 2023, Номер 9(2), С. 00401 - 2022

Опубликована: Фев. 23, 2023

Background Obstructive sleep apnoea (OSA) is associated with increased risk of type 2 diabetes. However, results from large population-based prospective cohort studies are rare. The main aim the present study was to investigate relative 8-year incident diabetes in relation OSA severity a middle-aged and older adults. Methods A total 2918 participants (mean age 59 years) Korean Genome Epidemiology Study (KoGES), who underwent home-based overnight polysomnography at baseline examination between 2011 2014, were followed up 4-yearly 2015–2018 2019–2021. 1697 both follow-ups. After excluding had (n=481), 1216 eligible for analyses. Results categorised by apnoea–hypopnoea index levels as non-OSA (0–4.9 events·h −1 ), mild (5.0–14.9 ) moderate–severe (≥15.0 ). Incident identified each follow-up. Compared non-OSA, 1.5 times higher developing end follow-up after adjusting potential covariates (relative 1.50, 95% CI 1.02–2.21). In same analytical models 4-year diabetes, none groups significantly compared group. Conclusion Moderate – severe OSA, modifiable factor, poses over an period general

Язык: Английский

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The T1D Index: Implications of Initial Results, Data Limitations, and Future Development

Current Diabetes Reports, Год журнала: 2023, Номер 23(10), С. 277 - 291

Опубликована: Авг. 23, 2023

Abstract Purpose of the Review Current global information on incidence, prevalence, and mortality type 1 diabetes (T1D) is limited, particularly in low- middle-income countries. To address this gap evidence, JDRF, Life for a Child, International Society Pediatric Adolescent Diabetes, Diabetes Federation have developed T1D Index, which uses Markov mathematical model, machine learning all available data to provide estimates burden T1D. This review assesses methodology, limitations, current findings, future directions Index. Recent Findings Global prevalence was estimated at 8.4 million 2021, with 1.5 <20 years (y). varied from 534 per 100,000, accounting <0.1–17.8% different A total 35,000 young people <25 y are died clinical onset non-diagnosis. An 435,000 were receiving “minimal care.” Health-adjusted life (HALYs) lost individuals diagnosed age 10 2021 ranged 14 55 y. Summary These results show that interventions reduce deaths non-diagnosis, improve access least an intermediate care level, needed projected lost. The significant uncertainties due incomplete across required inputs. Obtaining recent data, as well addressing quality issues, misdiagnoses, lack adult essential maintaining improving accuracy. index will be updated regularly new become available.

Язык: Английский

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Combination therapy with saxagliptin and vitamin D for the preservation of β-cell function in adult-onset type 1 diabetes: a multi-center, randomized, controlled trial

Signal Transduction and Targeted Therapy, Год журнала: 2023, Номер 8(1)

Опубликована: Апрель 20, 2023

Abstract Disease modifying therapies aiming to preserve β-cell function in patients with adult-onset autoimmune type 1 diabetes are lacking. Here, we conducted a multi-centre, randomized, controlled trial assess the preservation effects of saxagliptin alone and combined vitamin D as adjunctive diabetes. In this 3-arm trial, 301 participants were randomly assigned 24-month course conventional therapy (metformin or without insulin) plus therapy. The primary endpoint was change from baseline 24 months fasting C-peptide. secondary endpoints included area under concentration-time curve (AUC) for C-peptide level 2-h mixed-meal tolerance test, glycemic control, total daily insulin use safety, respectively. not achieved group ( P = 0.18) 0.26). However, compared therapy, AUC decreased less (-276 pmol/L vs. -419 pmol/L; 0.01), same degree (-314 0.14). Notably, higher glutamic acid decarboxylase antibody (GADA) levels, decline much lower than 0.001). Insulin dose significantly reduced both active treatment groups despite all having similar control. conclusion, combination preserves pancreatic diabetes, an effect especially efficacious individuals GADA levels. Our results provide evidence novel adjunct metformin potential initial (ClinicalTrials.gov identifier: NCT02407899).

Язык: Английский

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