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The aim of the study was to investigate the relation between thyroid autoimmunity (TAI), reflected as the presence of thyroid peroxidase antibodies (TPOAb), and parameters of ovarian reserve in women with type 1 diabetes (T1DM) and polycystic ovary syndrome (PCOS). We studied 83 euthyroid women with T1DM (age – 26 ± 5 years, BMI – 24 ± 3 kg/m2) – 12 with PCOS and positive TPOAb (PCOS + TPOAb), 29 with PCOS with negative TPOAb (PCOS + noTPOAb), 18 without PCOS with positive TPOAb (noPCOS + TPOAb), 24 without PCOS with negative TPOAb (noPCOS + noTPOAb). Serum concentrations of anti-Müllerian hormone (AMH), sex hormones, TSH, thyroid hormones and TPOAb were assessed. The prevalence of TAI was comparable between PCOS and noPCOS. We did not observe differences in hormonal profile or AMH concentration between two PCOS groups—PCOS + TPOAb and PCOS + noTPOAb (p > 0.05). Women with PCOS + TPOAb had lower FSH concentration and higher LH/FSH index than noPCOS + noTPOAb (p = 0.027; p = 0.019, respectively). Moreover, PCOS + TPOAb had lower oestradiol level than noPCOS + TPOAb (p = 0.041). AMH concentration was higher in both groups with PCOS, independent of TPOAb presence, than in noPCOS + noTPOAb (both p < 0.001). The presence of positive TPOAb titre was not related to the studied parameters of ovarian reserve – AMH and ovarian follicle number. In multiple linear regression analysis, the only significant predictor of AMH in the whole studied group with T1DM was total daily insulin dose U/kg (β = − 0.264; p = 0.022). The presence of TAI did not affect the hormonal profile or ovarian reserve in women with T1DM with and without PCOS. [ABSTRACT FROM AUTHOR]

Introduction: An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VO2max) is an objective measure of the body's aerobic capacity. To assess VO2max, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up. Methods: The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VO2max was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test). Results: The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VO2max level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, P =.009. Univariate and multivariate regression confirmed a significant association between VO2max and presence of pCR [AOR 1.26 (1.05-1.52), P =.015]. Duration of remission was longer among group with higher VO2max results [15 (9-24) vs 9 (0-12) months, P =.043]. The positive relationship was observed between diabetes duration and VO2max (rs = 0.484, P =.005). Multivariate linear regression confirms a significant association between remission duration and VO2max (ml/min/kg) (β = 0.595, P =.002). Conclusion: The higher VO2max, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission. Plain Language Summary: Better cardiorespiratory fitness increases the chance of partial clinical remission and prolongs remission duration in people with newly diagnosed type 1 diabetes. Introduction An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VO2max) is an objective measure of the body's aerobic capacity. To assess VO2max, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up. Methods The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VO2max was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test). Results The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VO2max level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, P =.009. Univariate and multivariate regression confirmed a significant association between VO2max and presence of pCR [AOR 1.26 (1.05-1.52), P =.015]. Duration of remission was longer among group with higher VO2max results [15 (9-24) vs 9 (0-12) months, P =.043]. The positive relationship was observed between diabetes duration and VO2max (rs = 0.484, P =.005). Multivariate linear regression confirms a significant association between remission duration and VO2max (ml/min/kg) (β = 0.595, P =.002). Conclusions The higher VO2max, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission. [ABSTRACT FROM AUTHOR]

Introduction: Cancer, diabetes, and heart diseases are frequent causes of depression and anxiety. The study explored the metacognitive beliefs manifested by chronically ill patients and the presence of depressive or anxiety symptoms and the predictive role of metacognition in both. Methods: A total of 254 chronically ill patients participated in the study. The Metacognitive Questionnaire was used to measure the patients' metacognitive beliefs, whereas the Hospital Anxiety and Depression Scale was applied to evaluate their psychopathological symptoms. A correlation analysis was performed to explore the relationships between metacognition and psychopathological symptoms. Regression analyses were conducted to examine the predictive role of metacognition in anxiety and depression. Results: The Negative Beliefs about Uncontrollability and Danger scale correlated with both anxiety and depression scales, and the Cognitive Confidence scale correlated with the depression scale. Linear regression analyses indicated that metacognitive beliefs were responsible for 32.2% of the variance of anxiety symptoms among all the chronically ill. Metacognitive beliefs accounted for 48.8% of the variance in anxiety symptoms and 36.6% in depressive symptoms among diabetes patients. Conclusions: There are specific correlations between psychopathological symptoms and metacognition among chronically ill patients. Metacognitions have a moderate role in developing and sustaining anxiety and depressive symptoms. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the relationship between physical activity and sexual function in women with type 1 diabetes mellitus (T1DM). The study group consisted of 171 women with T1DM. All the participants voluntarily filled out anonymous questionnaires. Women who were sexually inactive or had some psychological, psychiatric, or endocrine diseases were excluded from the analysis. The scores about sexual function were obtained using a Female Sexual Function Index (FSFI) questionnaire. Results equal to or below 26 points indicate clinically significant sexual dysfunction. Physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Participants were divided into two groups depending on the Metabolic Equivalent of Task (MET-min/week) score with a cutoff point 3000 MET-min/week. Results above 3000 points indicate higher physical activity in woman. There were statistically significant differences in lubrication, orgasm, pain, satisfaction, and total score of FSFI. A positive correlation was revealed between results in total FSFI score and MET-min/week score (Rs = 0.18, p = 0.016). Univariate logistic regression does not show significant associations, but the multivariate logistic regression model shows an association between the MET-min/week and the total FSFI score. The higher the MET-min/week score, the higher the FSI score, and thus better sexual function. [ABSTRACT FROM AUTHOR]

Background. Helicobacter pylori infection (HPI) is more frequently diagnosed in patients with diabetes. Insulin resistance in patients with type 1 diabetes (DMT1) is associated with the accumulation of advanced glycation end products (AGEs) in the skin and progression of chronic complications. Objectives. Assessment of the relationship between the incidence of HPI and skin AGEs in patients with DMT1. Materials and methods. The study included 103 Caucasian patients with a DMT1 duration >5 years. A fast qualitative test was performed to detect the HP antigen in fecal samples (Hedrex). The content of AGEs in the skin was estimated using an AGE Reader device (DiagnOptics). Results. The HP-positive (n = 31) and HP-negative (n = 72) groups did not differ in terms of age, gender, duration of diabetes, fat content, body mass index (BMI) and lipid profile, metabolic control, and inflammatory response markers. The studied groups differed in the amount of AGEs in the skin. The relationship between HPI and increased AGEs in the skin was confirmed in a multifactor regression model taking into account age, gender, DMT1 duration, glycated hemoglobin A1c (HbA1c), BMI, low-density lipoprotein cholesterol (LDL-C) and the presence of hypertension, and tobacco use. The studied groups also differed in serum levels of vitamin D. Conclusions. Increased accumulation of AGEs in the skin of patients with DMT1 with coexisting HPI suggests that eradication of HP may significantly improve DMT1 outcomes. [ABSTRACT FROM AUTHOR]

Copyright of General Practitioner / Lekarz POZ is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To assess glycemic control and safety of children and adolescents with type 1 diabetes participating in a 2-day football tournament. Methods: In total, 189 children with type 1 diabetes from 11 diabetes care centers, in Poland, participated in a football tournament in 3 age categories: 7–9 (21.2%), 10–13 (42.9%), and 14–17 (36%) years. Participants were qualified and organized in 23 football teams, played 4 to 6 matches of 30 minutes, and were supervised by a medical team. Data on insulin dose and glycemia were downloaded from personal pumps, glucose meters, continuous glucose monitoring, and flash glucose monitoring systems. Results: The median level of blood glucose before the matches was 6.78 (4.89–9.39) mmol/L, and after the matches, it was 7.39 (5.5–9.87) mmol/L (P =.001). There were no episodes of severe hypoglycemia or ketoacidosis. The number of episodes of low glucose value (blood glucose ≤3.9 mmol/L) was higher during the tournament versus 30 days before: 1.2 (0–1.5) versus 0.7 (0.3–1.1) event/person/day, P <.001. Lactate levels increased during the matches (2.2 [1.6–4.0] mmol/L to 4.4 [2.6–8.5] mmol/L after the matches, P <.001). Conclusions: Large football tournaments can be organized safely for children with type 1 diabetes. For the majority of children, moderate mixed aerobic–anaerobic effort did not adversely affect glycemic results and metabolic safety. [ABSTRACT FROM AUTHOR]

Introduction: All epidemiological studies suggest that vitamin D deficiency is prevalent among the Polish general population. Since vitamin D deficiency was shown to be among the risk factors for many diseases and for all-cause mortality, concern about this problem led us to update the previous Polish recommendations. Methods: After reviewing the epidemiological evidence, case-control studies and randomized control trials (RCTs), a Polish multidisciplinary group formulated questions on the recommendations for prophylaxis and treatment of vitamin D deficiency both for the general population and for the risk groups of patients. The scientific evidence of pleiotropic effects of vitamin D as well as the results of panelists' voting were reviewed and discussed. Thirty-four authors representing different areas of expertise prepared position statements. The consensus group, representing eight Polish/international medical societies and eight national specialist consultants, prepared the final Polish recommendations. Results: Based on networking discussions, the ranges of total serum 25-hydroxyvitamin D concentration indicating vitamin D deficiency [<20 ng/mL (<50 nmol/L)], suboptimal status [20–30 ng/mL (50–75 nmol/L)], and optimal concentration [30–50 ng/mL (75–125 nmol/L)] were confirmed. Practical guidelines for cholecalciferol (vitamin D3) as the first choice for prophylaxis and treatment of vitamin D deficiency were developed. Calcifediol dosing as the second choice for preventing and treating vitamin D deficiency was introduced. Conclusions: Improving the vitamin D status of the general population and treatment of risk groups of patients must be again announced as healthcare policy to reduce a risk of spectrum of diseases. This paper offers consensus statements on prophylaxis and treatment strategies for vitamin D deficiency in Poland. [ABSTRACT FROM AUTHOR]

Copyright of Family Medicine Forum / Forum Medycyny Rodzinnej is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Apolipoprotein complement is a critical determinant of lipoprotein function and metabolism. The relation between exogenous insulin and apolipoproteins (apos) in newly diagnosed type 1 diabetes mellitus (T1DM) has not yet been studied extensively. The aim of this study was to prospectively observe the changes in serum apos AI (apo AI) and AII (apo AII) in patients with newly diagnosed T1DM and their association with the daily insulin requirement.Material and methods: Thirty-four participants of the InLipoDiab1 study aged 26 (IQR: 22-32) were enrolled in this analysis. Apolipoprotein AI and AII concentrations were assessed at diagnosis and at follow-up after 3 weeks, 6 months, and 1 year of insulin treatment. The daily dose of insulin (DDI) was calculated as the amount of short- and long-acting insulin at discharge from the hospital and at follow-up visits.Results: The changes in apo AI concentration were observed after 3 weeks of insulin treatment (p = 0.04), with the largest increase between 3 weeks and 6 months of observation (p < 0.001). Apolipoprotein AII level did not change significantly after 3 weeks, while a significant increase was observed between 3 weeks and 6 months of treatment (p < 0.001). The correlations between DDI and apo concentration were not statistically significant.Conclusions: In the first year of T1DM, there is a significant increase in apos concentration. Due to the significant deviation of apos concentration from accepted norms, changes in the recommendations of lipid control criteria in T1DM may be considered. [ABSTRACT FROM AUTHOR]

Copyright of Heart & Vascular Diseases / Choroby Serca & Naczyn is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To investigate whether physical activity is associated with the occurrence of remission in adults with type 1 diabetes. Methods: Ninety nine adult participants with newly diagnosed type 1 diabetes were enroled into a prospective, observational study. The participants were advised to exercise 2–3 times a week with moderate intensity for a one‐year period. Physical activity was assessed by a self‐administrated questionnaire on every fourth visit. We counted the months in which participants fulfiled a partial‐remission criteria: HbA1c < 6.5%, C‐peptide > 0.5 ng/ml, and daily dose of insulin <0.3 U/kg/day. We assigned the participants to two groups: MORE EFFORT and LESS EFFORT, depending on the median value of physical activity in the studied population. Results: The occurrence of the remission achieved statistical significance at 6th month with a greater prevalence in MORE EFFORT group (55% vs. 35% p = 0.047). In multivariate logistic regression analysis for the occurrence of remission at 12th month, physical activity before the diagnosis was the only variable that influences the occurrence of the remission (adjusted odds ratios = 3.32 [95% confidence intervals 1.25–8.80]; p = 0.02). Conclusion: In adults with newly diagnosed type 1 diabetes physical activity before the diagnosis is associated with higher occurrence of remission. [ABSTRACT FROM AUTHOR]

Background: Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and need structured interventions. Those should be based on unbiased, national‐scale outcomes, which have not yet been successfully assessed in Poland. Objective: To evaluate the glycemic control in young patients with T1D in Poland. Method: All pediatric diabetes care centers and the nine largest centers for adults with T1D were invited to this cross‐sectional study, conducted in March 2018. Eligibility was defined as age ≤ 30 years and diabetes duration ≥1 year. Blinded samples of capillary blood and clinical questionnaires were sent to coordinating center, where HbA1c was measured by high‐pressure liquid chromatography. Results: Nine adult and 25/28 pediatric centers participated, providing data for 1255 patients (50.8% males), mean age 12.3 years (95%CI:12.1–12.6) for children and 23.2 years (22.9–23.6) for adults; mean diabetes duration 7.1 years (6.8–7.3). This covered ~8% of pediatric population and 2% of 18–30‐years‐olds with T1D. Mean HbA1c was comparable between children and adults (57 mmol/mol [7.4%], 95%CI:56‐57 mmol/mol [7.3–7.4%] vs. 57 mmol/mol [7.4%], 95%CI:56–60 mmol/mol [7.3–7.6%], p = 0.1870). Overall, 45.2% of patients achieved ISPAD target (<53 mmol/mol [<7.0%]). During the month preceding the study, 0.9% of patients experienced severe hypoglycemia and 0.4% suffered ketoacidosis. HbA1c was related to the method of insulin therapy, continuous glucose monitoring use and body weight (p < 0.0001). Conclusions: In Polish children and young adults with T1D glycemic control expressed as HbA1c is promising in the light of ISPAD guidelines. Our results confirm the known associations between better glycemic control and the use of new technologies and maintaining optimal body weight. [ABSTRACT FROM AUTHOR]

Context: Higher prevalence of polycystic ovary syndrome (PCOS) in women with type 1 diabetes (T1DM) is linked to exogenous insulin, especially when diabetes is diagnosed before puberty.Objective: The study evaluates the impact of prepubertal onset of T1DM and insulin therapy on PCOS diagnosis and phenotypic characteristics in women with T1DM.Design, Setting, and Patients: We studied 83 women with T1DM (age 26 ± 5 years, BMI 24 ± 3 kg/m2) 36 with premenarchal (PM) onset of T1DM [17 with PCOS diagnosed (PCOS+PM) and 19 without PCOS (noPCOS+PM)] and 47 women with postmenarchal onset of T1DM [24 with PCOS (PCOS-noPM) and 23 without PCOS (noPCOS-noPM)].Outcome Measurements: Clinical examination, assessment of serum sex hormones, glycated hemoglobin (HbA1c) and ultrasonographic evaluation of the ovaries were performed in all women.Results: Applying Rotterdam criteria, 49% of women with T1DM were diagnosed with PCOS. There were no differences in hormonal profile and ovarian parameters between PCOS+PM and PCOS-noPM. Women with T1DM+PM had higher insulin dose/24 h and U/kg bw/24 h than T1DM-noPM (P-values = 0.014 and 0.001, respectively). Both PCOS+PM and noPCOS+PM groups had higher insulin dose U/kg bw/24 h in comparison to PCOS-noPM (P-values = 0.004 and = 0.006, respectively). In multivariable logistic regression analysis, age of menarche [odds ratio (OR): 0.672; 95% confidence interval (CI): 0.465-0.971] and HbA1c (OR: 0.569; 95% CI: 0.383-0.846) were associated with the diagnosis of PCOS.Conclusions: There were no differences in the prevalence of PCOS between T1DM+PM and T1DM-noPM; however, earlier menarche might have an influence on PCOS diagnosis in women with T1DM. [ABSTRACT FROM AUTHOR]

Aim Type 1 diabetes mellitus (T1DM) is a disease characterized by an absolute deficiency of endogenous insulin secretion. Insulin resistance (IR) may develop among patients with T1DM. Vitamin D deficiency was reported to be a risk factor in the development of IR. The aim of the study was to assess the relationship between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and IR among patients with T1DM. Methods The test group consisted of 110 adult patients [males=65 (59%)] with T1DM. Participants were recruited in Poland between 1st October and 30th April in 2015/2016 and 2016/2017. VD serum level was assessed by ELISA array. IR was assessed by estimated Glucose Disposal Rate (eGDR). Results In the study group 21 (19%) patients were recognized as IR according to eGDR cut-offs (<7.5 mg/kg/min), 52 (47.3%) patients had VD deficiency (25(OH)D<20 ng/ml), 16 (14.5%) patients had 25(OH)D<10 ng/ml. Only 6 (5%) participants reported VD supplementation. Patients with IR, according to eGDR cut-off revealed significantly lower 25(OH)D serum level 15.7 (9.2–28.4) vs. 22.1 (13.0–38.4) ng/ml; p=0.04 as compared to patients without IR. R Spearman analysis found a positive relationship between VD and eGDR (Rs=0.27; p<0.01). Logistic regression analysis revealed significant relationship between the presence of IR and VD serum level/presence of 25(OH)D serum level below 10 ng/ml, both models adjusted to sex, age, BMI, LDL and triglycerides, accordingly (OR=0.95, CI: 0.90–0.99; p=0.04) and (OR=4.19, CI: 1.04–16.93; p=0.04). Conclusion The serum concentration of Vitamin D is negatively associated with insulin resistance in patients with T1DM and may have clinical implications. [ABSTRACT FROM AUTHOR]

Aim. The purpose of the conducted study was to explore the role of cognitive processes, such as habitual worry, with regard to depressive mood in patients with type 1 diabetes mellitus (T1DM), as well as the significance of illness acceptance in the form of personal asset and mediator in relation between worry and depression. Material and Methods. The study involved 229 participants diagnosed with T1DM, who completed a set of self-description questionnaires. Assessment methods included The Anxious Thoughts Inventory (AnTI), The Acceptance of Illness Scale (AIS) and The Center for Epidemiologic Studies Depression Scale (CES-D). Results. The results demonstrate that worry is positively correlated with depression. What is more, the relationship between habitual worry and depression was mediated through illness acceptance. Conclusions. The impact of habitual worry on mental health in T1DM cannot be ignored. Moreover, the observed dependence suggests that depressive mood present in individuals with T1DM may persist, since overly worried patients do not accept their own illness. Strengthening patients' acceptance of their condition and bringing up the topic of worry in the course of diabetes education, can be a powerful tool in depression prevention. Nevertheless, further research is necessary. [ABSTRACT FROM AUTHOR]

Background: Factory‐calibrated intermittently‐scanned Continuous Glucose Monitoring (isCGM) device FreeStyle Libre (FSL) has recently received improvements in its glucose tracking algorithm and calibration procedures, which are claimed to have improved its accuracy. Objective: To compare the accuracy of two generations of 14‐days FSL devices (A in 2016, B in 2019) to self‐monitored blood glucose measurements (SMBG) in children with type 1 diabetes in real‐life conditions during a summer camp. Materials and Methods: Two largely independent groups of youth with type 1 diabetes took part in summer camps. In 2016 they used FSL‐A, in 2019 FSL‐B. On scheduled days, participants performed supervised 8‐point glucose profiles with FSL and SMBG. The accuracy vs SMBG was assessed with mean absolute relative difference (MARD) and clinical surveillance error grid (SEG). Results: We collected 1655 FSL‐SMBG measurement pairs from 78 FSL‐A patients (age 13 ± 2.3 years old; HbA1c: 7.6 ± 0.8%) and 1796 from 58 in FSL‐B group (age 13.8 ± 2.3 years old, HbA1c: 7.5 ± 1.1%)—in total 3451 measurements. FSL‐B displayed lower MARD than FSL‐A (11.3 ± 3.1% vs 13.7 ± 4.6%, P =.0003), lower SD of errors (20.2 ± 6.7 mg/dL vs 24.1 ± 9.6 mg/dL, P =.0090) but similar bias (−7.6 ± 11.8 mg/dL vs −6.5 ± 8 mg/dL, P =.5240). Both FSL‐A and FSL‐B showed significantly higher MARD when glycaemia was decreasing >2 mg/dL/min (FSL‐A:22.3 ± 18.5%; FSL‐B:17.9 ± 15.8%, P <.0001) compared with stable conditions (FSL‐A: 11.4 ± 10.4%, FSL‐B:10.1 ± 9.1%) and when the system could not define the glycaemic trend (FSL‐A:16.5 ± 16.3%; FSL‐B:15.2 ± 14.9%, P <.0001). Both generations demonstrated high percentage of A‐class and B‐class results in SEG (FSL‐A: 96.4%, FSL‐B: 97.6%) with a significant shift from B (decrease by 3.7%) to A category (increase by 3.9%) between generations (FSL‐A: 16/80.4%; FSL‐B:12.3/85.3%, P =.0012). Conclusion: FSL‐B demonstrated higher accuracy when compared to FSL‐A However, when glycemia is decreasing or its trend is uncertain, the verification with a glucose meter is still advisable. [ABSTRACT FROM AUTHOR]

The aim of the article is to summarize the current knowledge on the phenomenon of fear of hypoglycaemia and its impact on the metabolic control and well-being of the population of diabetic patients. The article proposes a description of clinical criteria useful for the diagnosis of the fear of hypoglycaemia in a non-normative and harmful form. Therapeutic directions are presented that have been proven effective in the recent years in reducing the level of maladaptive fear of hypoglycaemia, while also protecting the mental health of the patients. Despite extensive knowledge and numerous clinical trials undertaken in other countries, further research on diabetes-related anxiety disorders in Polish patients is needed. It is also advisable to create a database of culturally adapted management protocols for specialists that could increase the quali ty and effectiveness of the assistance provided in the outpatient health care. [ABSTRACT FROM AUTHOR]

Background. The process of protein glycation described by Brownlee et al. is a crucial pathogenic mechanism in the development of chronic complications of diabetes. Objectives. To assess advanced glycation end products (AGEs) in the skin of patients with type 1 diabetes (DM1) and excess body fat (EBF) accumulation. Material and methods. The study group consisted of 227 DM1 patients (121 women and 106 men) whose mean age was 31 ±9.2 years; the mean duration of diabetes was 12 ±7.7 years; and the mean HbA1c was 8.9 ±1.8%. The inclusion criteria were as follows: age 18-65 years, DM1, and lack of acute inflammations and uncontrolled chronic diseases. The exclusion criteria were: anemia (hemoglobin (Hb) <11 g/dL), chronic kidney disease (CKD) (glomerular filtration rate (eGFR) <30 mL/min/1.73 m2) and elevated aminotransferase levels (more than twice the upper normal limits). Total adipose tissue content was assessed using the electrical bioimpedance method, with the Tanita BC-418 MA analyzer (Tanita Corp., Tokyo, Japan). The Tanita ViScan AB 140 (Tanita Corp.) was used to evaluate visceral fat tissue (VTF). The content of glycation end products in the skin was assessed using a DiagnOptics AGE Reader device (type 214D00102; DiagnOptics, Groningen, the Netherlands). Results. The group with normal body fat (NBF) consisted of 123 subjects, whereas 104 subjects had EBF. No significant statistical differences were found between the NBF and EBF groups with regard to age, duration of diabetes, current HbA1C value, and tobacco use. A significantly higher AGE score was observed in the EBF group. Conclusions. Increased body fat affects the amount of AGE in the skin, which correlates with a higher risk of developing chronic diabetes complications. [ABSTRACT FROM AUTHOR]

In this study, the aim was to provide observational data from an ascent to the summit of Mount Damavand (5670 meters above sea level (m.a.s.l), Iran) by a group of people with type 1 diabetes (T1DM), with a focus on their physiological characteristics. After a 3-day expedition, 18 T1DM patients, all treated with personal insulin pumps, successfully climbed Mount Damavand. Information was collected on their physiological and dietary behaviors, as well as medical parameters, such as carbohydrate consumption, glucose patterns, insulin dosing, and the number of hypo- and hyperglycemic episodes during this time frame. The participants consumed significantly less carbohydrates on day 3 compared to day 1 (16.4 vs. 23.1 carbohydrate units; p = 0.037). Despite this, a gradual rise in the mean daily glucose concentration as measured with a glucometer was observed. Interestingly, the patients did not fully respond to higher insulin delivery as there was no significant difference in mean daily insulin dose during the expedition. There were more hyperglycemic episodes (≥180 mg/dL) per patient on day 3 vs. day 1 (p < 0.05) and more severe hyperglycemic episodes (>250 mg/dL) per patient on days 2 (p < 0.05) and 3 (p < 0.05) vs. day 1. In summary, high mountain trekking is feasible for T1DM patients with good glycemic control and no chronic complications. However, some changes in dietary preferences and an observable rise in glucose levels may occur. This requires an adequate therapeutic response. [ABSTRACT FROM AUTHOR]

The prevalence of diabetes mellitus is increasing worldwide, including the nation of Poland. The aim of this prospective and observational study was to determine risk factors and the predictors of diabetes incidence in elderly women, and to calculate the diabetes incidence ratio in this population. Two-hundred women, aged 65–74, who were non-diabetic at baseline in 2012 were followed for 6.5 years. All women were checked for incident diabetes. In non-diabetic subjects, diagnostic procedures for diabetes were performed according to Poland's Diabetes recommendations. Between April 2012 and September 2018, 25 women developed diabetes and the next 11 cases were diagnosed based on FPG or oral glucose tolerance test. Women with incident diabetes had significantly higher baseline FPG, triglycerides (TG), TG/HDL cholesterol ratio and visceral adiposity index (VAI) score, and lower abdominal aorta diameter (AAD), HDL cholesterol and eGFR. In the Cox proportional hazard regression analysis, only AAD < 18 mm and VAI score ≥ 3.8 were independently associated with diabetes risk, hazard ratio (HR) 2.47 (95% confidence interval 1.21–5.02), P = 0.013 and HR 2.83 (1.35–5.94), P = 0.006 respectively. In the backward stepwise regression analysis including all variables, diabetes incidence could be predicted from a linear combination of the independent variables: AAD < 18 mm (P = 0.002), VAI score ≥ 3.8 (P < 0.001) and FPG ≥ 5.6 mmol/L (P = 0.011). The calculated incidence of diabetes was 2769.2 new cases/100,000 persons per year. AAD below 18 mm seem to be a novel, independent marker of diabetes risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful in identifying females at early elderliness with high risk of diabetes incidence. [ABSTRACT FROM AUTHOR]

The widespread use of personal insulin pumps in the treatment of type 1 diabetes has significantly improved the effects of therapy. Better metabolic control of diabetes, but also increased comfort of life and professional opportunities have been achieved. One of the functions that increased the effectiveness of insulin therapy using a personal insulin pump is the bolus calculator. The bolus calculator function allows the user to dose their insulin more accurately before meals and to correct hyperglycaemia. The bolus calculator algorithms in insulin pumps of individual manufacturers differ in the way they calculate the correction dose and the amount of so-called active insulin. Consequently, with the same treatment parameters, individual bolus calculators may offer a different dose of insulin. Understanding the principles of the bolus calculator by therapeutic team members and patients is very important for proper diabetes education and diabetes management. [ABSTRACT FROM AUTHOR]

Aims: To analyze physical performance and diabetes-related outcomes in adolescents with type 1 diabetes (T1DM) during two semi-competitive football matches utilising precise physical activity monitoring. Methods: The study was conducted during an annual summer camp for adolescents with T1DM. After physical examination and glycated hemoglobin measurement, 16 adolescent players completed Cooper's 12-min running test and, in the following days, took part in two football matches while wearing heart rate (HR) monitors coupled with global positioning system (GPS) tracking. Results: Both matches were comparable in terms of covered distances, number of sprints, achieved velocities and heart rate responses. During both games, capillary blood lactate increased significantly (Match 1: 1.75 ± 0.16–6.13 ± 1.73 mmol/l; Match 2: 1.77 ± 0.18–3.91 ± 0.63 mmol/l, p = 0.004). No significant differences in blood glucose were observed between the matches (p = 0.83) or over each match (p = 0.78). Clinically significant hypoglycemia (< 54 mg/dl) occurred in two children during the first match. None of the players experienced severe hypoglycemia. Despite similar workloads, players consumed significantly less carbohydrates during Match 2 [median difference: − 20 g (25–75%: − 40 to 0), p = 0.006]. Conclusions: HR monitoring and GPS-based tracking can effectively parameterize physical activity during a football match. In T1DM patients, exercise workload and glycemic changes during similar matches are comparable, which provides an opportunity to develop individual recommendations for players with T1DM. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of ZnT8-ab and its correlation to other autoimmune markers and diabetic ketoacidosis occurrence in children and adults with T1DM onset. Methods: The study included 367 patients (218 children; 149 adults) at the T1DM onset. Selected diabetes-related autoantibodies such as GAD-ab, IA2-ab, ZnT8-ab were tested before the initiation of insulin therapy. Diabetic ketoacidosis was defined as glucose concentration > 13.9 mmol/l, pH < 7.30, concentration of HCO3 < 15 mmol/l, presence of ketone bodies in the blood and urine.Results: The autoantibodies pattern differs in both study groups. Children were mostly positive for two (37.8%) and three (49.5%) autoantibodies, whereas adults for one (32.2%) and two (30.7%). The most frequently detected autoantibodies in youth were ZnT8-ab (81.1%) and IA2-ab (80.7%), while in adults GAD-ab (74.8%). ZnT8-ab (p < 0.0001) titers were significantly higher in children, but adults had higher titer of GAD-ab (p < 0.0001) and IA2-ab (p < 0.0001). Children developed more frequently diabetic ketoacidosis (28.4 vs. 10.7%, p = 0.0002). ZnT8-ab (p = 0.002) and IA2-ab (p = 0.008) were reported mostly in individuals with ketoacidosis. A correlation between the number of positive antibodies and the severity of ketoacidosis was observed (Rs − 0.129 p = 0.014). ZnT8-ab were associated with a greater risk of ketoacidosis independent of gender, age group and the autoantibodies number [OR = 2.44 (95% CI 1.0-5.94), p = 0.04]. Conclusions: Children are at greater risk of ketoacidosis at the diagnosis of diabetes. ZnT8-ab and IA2-ab are commonly detected in children, while adults have frequently higher titer of GAD-ab. ZnT8-ab are associated with more acute diabetes onset. [ABSTRACT FROM AUTHOR]

Background. Osteoprotegerin (OPG) is an arterial calcification marker which has been associated with vascular damage. Elevated OPG concentrations associated with low-grade inflammatory processes are found in diabetic subjects. Objectives. The aim of the study was to assess concentrations of OPG in relation to the presence of diabetic complications in patients with diabetes type 1 (DM 1) participating in the Poznań Prospective Study (PoProStu). Material and methods. The study included 74 patients with DM1 (48 men) with a median age of 39 years (interquartile range [IQR]: 34-43) and a median 15-year history (IQR: 14-16) of diabetes, who were participants in the PoProStu. Serum OPG concentration was measured using the ELISA method, and serum concentration of C-reactive protein was measured with a high sensitivity test (hsCRP). The visceral adipose index (VAI) was used to determine indirect markers of insulin resistance (IR). The prevalence of microangiopathic diabetes complications was assessed. Results. Retinopathy was diagnosed in 28 patients (38%), diabetic kidney disease (DKD) in 28 (38%) patients, and neuropathy in 17 (23%) patients. The median OPG level was 43.8 (28.0-74.0) pg/mL. Patients with retinopathy had higher levels of OPG than those without retinopathy: 47.5 (35.0-88.0) vs 35.4 (24.7-69.4) pg/mL (p = 0.04). Positive correlations were observed between OPG concentration and hsCRP (Rs = 0.53; p < 0.001), HbA1c level (Rs = 0.36; p = 0.002), VAI (Rs = 0.23; p = 0.04) and waist circumference (Rs = 0.24; p = 0.04). Conclusions. Higher concentrations of osteoprotegerin in DM1 patients are related to the presence of retinopathy. The study results indicate that OPG might play a role in the pathogenesis of vascular complications in association with hyperglycemia and low-grade inflammatory processes. [ABSTRACT FROM AUTHOR]

6 Goldenberg RM, Gilbert JD, Hramiak IM, Woo VC, Zinman B. Sodium-glucose co-transporter inhibitors, their role in type 1 diabetes treatment and a risk mitigation strategy for preventing diabetic ketoacidosis: The STOP DKA Protocol. International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) inhibitors. Today, even more so than in March 2019, it is evident that SGLT-2 inhibitor treatment in type 1 diabetes represents an effective and safe oral adjunct therapy in selected patients who are not reaching their glycaemic goals via insulin therapy alone. [Extracted from the article]

The article discusses the study on the factors of early beginning of partial remission phase in newly diagnosed type 1 diabetes patients. The study reportedly involved more than a hundred patients with a mean hospitalization time of one week. The study revealed that degree and duration of metabolic disorders are associated with early onset of partial remission in young adults.

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current review presents up-to-date knowledge on tuberculosis (TB) in diabetic patients. On the basis of available literature, there is little doubt about the close relationship between these two conditions. Diabetes mellitus in this association may still contribute substantially to the burden of TB and negatively affect control of the latter. Chronic hyperglycemia at least to some extent may alter the clinical manifestation, radiological appearance, treatment outcome and prognosis of TB. Although the pathogenesis is not clear, diabetes may impair both innate and adaptive immune responses to Mycobacterium tuberculosis. Eventually, effective screening and dual management of the diseases have to be addressed both in low- and high-income countries in order to limit the negative effects of the forthcoming global diabetes epidemic. [ABSTRACT FROM AUTHOR]

Background. The aim of study was to evaluate clinical features in adults with metabolic syndrome at diagnosis of diabetes, depending on the exponents of absolute insulin deficiency. Material and methods. The study included 122 adults consecutively hospitalized in the Department of Internal Medicine and Diabetology in 2007-2010 who met the inclusion criteria: age under 50 years, newly diagnosed diabetes, the presence of metabolic syndrome. The study group was divided into two subgroups depending on the presence diabetic ketoacidosis. Results. Adults with the metabolic syndrome, with newly diagnosed diabetes and markers of absolute insulin deficiency, had at diagnosis significantly higher glycaemia (p = 0.009) and HbA1c (p = 0.001), and significantly lower C-peptide levels (p = 0.007) than that observed in the group without diabetic ketoacidosis. People with newly diagnosed diabetes with metabolic syndrome were generally classified as type 2 disease. The diagnosis that was significantly more often placed in the group without ketones (p = 0.002). However, regardless of the presence ketoacidosis, some patients were classified as type 2 diabetes or without specifying the type of diabetes. Study groups differed in the prevalence of ICA antibodies characteristic of type 1 diabetes (p = 0.005). Conclusions. Occurrence of ketoacidosis in adults with newly diagnosed diabetes and metabolic syndrome is not a prerequisite for the diagnosis of type 1 diabetes, nor the need for further treatment with insulin. In patients with newly diagnosed diabetes with ketoacidosis and a phenotype characteristic of type 2 diabetes to assess β cell function and autoantibodies may be useful when deciding how to treat. [ABSTRACT FROM AUTHOR]

Copyright of Experimental & Clinical Diabetology / Diabetologia Doswiadczalna i Kliniczna is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)