• Hvass Dixon posted an update 6 months ago

    Diabetic retinopathy (DR) is the most common microvascular complications seen in children and adolescents with type 1 diabetes. The aim of this study was to evaluate the prevalence of retinopathy and its association with other risk factors in young people with type 1 diabetes.

    This study was a cross-sectional study, which was done as part of the ongoing complication assessment in the paediatric diabetes clinic in BIRDEM (Bangladesh Institute of Research and Rehabilitation of Diabetes Endocrine and Metabolic Disorders), a tertiary care hospital. Children, adolescents and young adults with type 1 diabetes who were having diabetes duration >2years were included in this study. Retinopathy was detected using fundal photography, and grading was done by National Screening Committee of UK by trained ophthalmologists.

    Diabetic retinopathy was observed in 44 (6.6%) patients. Majority (95.4%) of them had early diabetic retinopathy in the form of mild NPDR (nonproliferative diabetic retinopathy) (R1). Patients with retinopathy had higher HbA1c 9.6 vs 9.1 (

    .013), longer duration of diabetes 7.6 vs 6.0 years (

    =.001) and were older 21.5 vs 18 years (

    =.0001) compared with those without retinopathy. On multivariate regression analysis, higher age and median HbA1c were significantly associated with DR.

    Higher HbA1c was the only modifiable risk factor for development of DR in our study population. Early detection of DR with improvement of glycaemic control may reduce the risk of progression of severe stages of the disease.

    Higher HbA1c was the only modifiable risk factor for development of DR in our study population. Early detection of DR with improvement of glycaemic control may reduce the risk of progression of severe stages of the disease.

    Fibrosis is characterized by dysregulation and accumulation of extracellular matrix. Peyronie’s disease and Dupuytren disease are fibroproliferative disorders of the tunica albuginea of the penis and fascia of the hand, respectively. Chronic hyperglycaemia due to diabetes mellitus can also lead to tissue injury and fibrosis. A meta-analysis has shown a relationship between Dupuytren disease and diabetes (overall odds ratio, 3.1; 95% confidence interval, 2.7-3.5). This review explores commonalities in the pathogenesis of Peyronie’s disease, Dupuytren disease and diabetes.

    A search of the PubMed database was conducted using the search terms “diabetes” AND “Peyronie’s disease”; and “diabetes” AND “Dupuytren.”

    Genome-wide association and gene expression studies conducted with tissue from people with Peyronie’s disease or Dupuytren disease identified signalling pathways associated with wingless-type mammary-tumour virus integration site signalling, extracellular matrix modulation and inflammation. Biochemical studies confirmed the importance of these pathways in the pathogenesis of fibrosis with Peyronie’s disease and Dupuytren disease. Dysregulation of matrix metalloproteinase activity associated with extracellular matrix breakdown was implicated in fibroproliferative complications of diabetes and in the aetiology of Peyronie’s disease and Dupuytren disease. A notable percentage of people with diabetes have comorbid Peyronie’s disease and/or Dupuytren disease.

    Studies have not been performed to identify fibroproliferative pathways that all 3 conditions might have in common, but data suggest that common pathways are involved in the fibroproliferative processes of Peyronie’s disease, Dupuytren disease, and diabetes.

    Studies have not been performed to identify fibroproliferative pathways that all 3 conditions might have in common, but data suggest that common pathways are involved in the fibroproliferative processes of Peyronie’s disease, Dupuytren disease, and diabetes.

    Type 2 diabetes (T2D) is driven by progressive dysfunction and loss of pancreatic β-cell mass. Imeglimin is a first-in-class novel drug candidate that improves glycaemia and glucose-stimulated insulin secretion in preclinical models and patients. Given evidence that imeglimin can attenuate β-cell dysfunction and protect β cells

    , we postulated that imeglimin could also exert longer term effects to prevent pancreatic β-cell death and preserve functional β-cell mass

    .

    Zucker diabetic fatty (ZDF) male rats were treated by oral gavage with imeglimin at a standard dose of 150 mg/kg or vehicle, twice daily for five weeks. At treatment completion, oral glucose tolerance tests were performed in fasted animals before a thorough histomorphometry and immunohistochemical analysis was conducted on pancreas tissue slices to assess cellular composition and disease status.

    Imeglimin treatment significantly improved glucose-stimulated insulin secretion (augmentation of the insulinogenic index) and improved glycaemiaa paramount component of type 2 diabetes progression progressive loss of functional β-cell mass. In addition, imeglimin may also moderate a-cell turnover to further ameliorate hyperglycaemia. Cumulatively, these cellular effects suggest that imeglimin may provide for disease modifying effects to preserve functional β-cell mass.

    Type 2 diabetes (T2DM) in children is considered rare before puberty.

    Describe the characteristics and outcomes of children with T2DM diagnosed at or before 10years of age.

    Retrospective electronic medical record review of children diagnosed with T2DM at a University Children’s Hospital over 12years was conducted. BIX02189 Patient characteristics at diagnosis, 2-3-year follow-up, and 4-5-year follow-up were analysed as a whole and by age groups, 5-8 and 9-10years.

    There were 42 children≤10years with T2DM (5-8-year age group, n=8 and 9-10-year age group, n=34). There were 88.1% African American, 11.9% Caucasian, and 88.1% females. Body mass index (BMI) was ≥95th percentile in 95.2%. Average BMI z score was 2.5±0.4 and higher in the 5-8-year age group (2.7±0.5 vs 2.4±0.4,

    =.02). Average haemoglobin A1C at diagnosis was 10.5±2.4%, and improvement was seen at 2-3years, but subsequent worsening was noted at 4-5years in both age groups. At 4-5years after diagnosis, 93.9% required insulin for management of their hyperglycaemia, 21.

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