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This review provides an overview of the evidence which concerns the parental stress of children with type 1 diabetes mellitus. Articles for this review were collected using the Science Direct, CINAHL, PsycINFO, Medline, Scopus, EBSCO, Springer, Ovid, PubMed, Google Scholar, and Cochrane Library. In total, 38 articles were relevant to this review. The findings of the reviewed studies provide an exciting opportunity to advance our knowledge for a different aspect of parental stress which is related to the disease and predictor's factor contributes to parental stress. This review sheds new light on developing the educational programs to reduce the level of parental stress and to help them to cope positively with this disease. [ABSTRACT FROM AUTHOR]

Background: Type 1 Diabetes mellitus (T1DM)is one of the most widely seen chronic disease in child hood and its prevalence rate till age of 18 is approximately one in every 300 and its late complications responsible for reduced life expectancy and major health coasts. Aims: To assess the quality of life (QOL) among children and teenagers with T1DM and its determinants and to compare their QOL to that of healthy peers. Subjects and Method: A case-control study was carried out in Al Imam Hussain Medical City in Holy Kerbala / Iraq. The sample size included 164 diabetic child as case group and 330 healthy child as a control group. The participants were selected by consecutive convenience sampling technique; the information were collected by using specific questionnaire through direct interview with the participants. The study was performed during the period from 1st of December 2018 to 31th of August 2019. Results: There were a significant difference in each domain and in all quality of life between the study groups; In addition to that there was a significant association between QOL of diabetic children and certain variables like gender, birth order, number of siblings and paternal education. The study also concluded a negative correlation between the age of the child and QOL there is no significant association between QOL and residence or economic state. Conclusion: Iraqi children and teenagers with T1DM who live in Kerbala governorate and aged between 5-18 year had poorer QOL than healthy peers. The QOL is associated in all or some domains with certain factors and not associated with others. [ABSTRACT FROM AUTHOR]

Type1Dibetes Mellitus (T1DM) is a heterogeneous disorder that develops usually during adolescence and childhood. The main target in management of type 1Diabetes mellitus is achievement of good metabolic control to get normal growth & development plus delay or prevent the complications. Nowadays there is a rising interest in measuring quality of life to assess pediatric health outcomes in addition to biomedical indicators. Although a cause and effect relation between QOL & and glycemic control cannot be determined, it is so consistent that it is now justified to consider both of them are equally important in the management of T1DM. The aim is to evaluate the quality of life among children and teenager with type1 Diabetes mellitus and to determine the glycemic control in that age group and also to assess the association between quality of life and glycemic control. A case control study was performed during the period from1st of December 2018to30th of August2019 in Al Imam Al Hussain Medical City in Holy Karbala / Iraq. The estimated number for case group is 164 diabetic child and for control group is 330 healthy one. Both case and control groups are convenient samples. Using specific questionnaire through direct interview with the participants the information for this study were collected. There were significant differences in each domain and in overall quality of life between the study groups. Also, a significant difference was found between glycemic controlled and glycemic uncontrolled children in physical, social domains and also overall quality of life. In addition to that a significant association between the physical domain of quality of life of diabetic children and female gender. While this study found a negative correlation between the age and both emotional and physical domains of quality of life, there was positive correlation between the disease duration and glycemic control. The Iraqi children and teenagers with Type1Diabetes mellitus who live in Karbala governorate and aged between 5-18 years had less quality of life than healthy peers. Also, metabolic control was inappropriate in most of our diabetic children, and glycemic controlled patient tolerate diabetes more than glycemic uncontrolled one. [ABSTRACT FROM AUTHOR]

The purpose of this article writing was to go through the prominent changes and associated safety in diabetic patients during the Islamic month of fasting. Various researches have been conducted upon physiological changes in a diabetic patient during the period of Islamic fasting, but still there is no variation perceived pathologically influencing the body weight, blood glucose, HbA1c, insulin, fructose amine, C-peptide, cholesterol or triglycerides ranges. In the suggestive portion of the following articles, the diabetic patients were advised to carry on with their regular routine. The pre-eminent point noted was that the patients adjusted their drug regimen especially by those with type I diabetes mellitus. Adjusting of drug regimen along with control over the diet and daily activities composed a Ramadan 3D Triangle through which a proper supervision and education came in to being concluding that few of the type I and most of the type II diabetes mellitus patients who wanted to fast could carefully manage it. [ABSTRACT FROM AUTHOR]

Introduction: the use of standardized questionnaires for assessment of patients’ life quality after organ transplantation has not been widely used in our country.Purpose: The assessment of patients’ quality of life after the simultaneous pancreas & kidney transplantation using the SF-36 questionnaire.Material and methods: 35 patients with type I diabetes mellitus (DM1) complicated by end-stage chronic renal failure were investigated. There were 16 women (45.7%) and 19 men (54.3%). The median age was 36 [33; 45] years. The patients were divided into 2 groups depending on the transplantation type: group I included the patients who underwent isolated kidney transplantation, group II included those after combined kidney and pancreas transplantation. Patients’ life quality was estimated using the SF-36 questionnaire.Results: Patients in group II had significantly better physical functions, general health status, and vital activity.Conclusion: Simultaneous pancreas & kidney transplantation considerably improves the life quality of patients with DM1.

TLRs in Epithelium of the oral cavity can be effected as due to the dental as general somatic pathology. TLR availability in the external membrane of neutrophils, macrophages, keratocytes was found to be a starting point in triggering inflammation in the periodontal tissues ensuring molecular reception of a pathogen with further involvement of important components in the inherited immunity. These effectors possess phagocytic and killer activities, ensure a number of signals activating and directing antigen-specific response by the cells of the adaptive immune system. The aim of the study was to study mRNA TLR-2, TLR-4 in the epithelium of the oral cavity in children with chronic catarrhal gingivitis and diabetes mellitus taking to account revealed metabolic disorders. Materials and methods. 30 children with chronic catarrhal gingivitis and diabetes mellitus type I were included into Іst group, 30 children with chronic catarrhal gingivitis were included into the ІInd group and 30 absolutely healthy children -ІII group. Polymerase chain reaction with reverse transcription in the regime in real time (RT-RRT) was used to analyze gene expression. Buccal epithelium was used as an object for molecular-genetic study. Results. Content of mRNA TLR-2 (90.0755) in diabetes mellitus patients was in 5.5 times higher as compared to children with CCG – 15.1505. Expression of mRNA TLR-4 in children of I group increased in 6 times as compared to the children from II group. Conclusion. Relative quantity of mRNA TLR-2 and TLR-4 in the epithelium of the oral cavity in children with diabetes mellitus was considerably higher than in patients without chronic inflammatory disease.

Hala Ahmadieh,1 Nisrine Ghazal,2 Sami T Azar3 1Faculty of Medicine, Clinical Sciences Department, Beirut Arab University, 2Department of Endocrinology and Metabolism, American University of Beirut, Beirut, Lebanon; 3Department of Internal Medicine, Division of Endocrinology, American University of Beirut, New York, NY, USA Abstract: The burden of diabetes mellitus (DM) in general has been extensively increasing over the past few years. Selective sodium glucose cotransporter-2 (SGLT2) inhibitors were extensively studied in type 2 DM and found to have sustained urinary glucose loss, improvement of glycemic control, in addition to their proven metabolic effects on weight, blood pressure, and cardiovascular benefits. Type 1 DM (T1D) patients clearly depend on insulin therapy, which till today fails to achieve the optimal glycemic control and metabolic targets that are needed to prevent risk of complications. New therapies are obviously needed as an adjunct to insulin therapy in order to try to achieve optimal control in T1D. Many oral diabetic medications have been tried in T1D patients as an adjunct to insulin treatment and have shown conflicting results. Adjunctive use of SGLT2 inhibitors in addition to insulin therapies in T1D was found to have the potential to improve glycemic control along with decrease in the insulin doses, as has been shown in certain animal and short-term human studies. Furthermore, larger well-randomized studies are needed to better evaluate their efficacy and safety in patients with T1D. Euglycemic diabetic ketoacidosis incidences were found to be increased among users of SGLT2 inhibitors, although the incidence remains very low. Recent beneficial effects of ketone body production and this shift in fuel energetics have been suggested based on the findings of protective cardiovascular benefits associated with one of the SGLT2 inhibitors. Keywords: glycemic control, glycosylated hemoglobin, euglucemic diabetic ketoacidosis, oral antidiabetics

Background: Epidemiologic studies show that the prevalence of type I diabetes mellitus is different in several areas in Iran. The aim of this study was comparison of the risk factors of type I diabetes between the children with and without this disease in Isfahan Province, Iran. Methods: In a case-control study during 2013-2014, 175 patients with type I diabetes as case group and 350 healthy children as control group were selected from Imam Hossein hospital and Isfahan Endocrine and Metabolism Research Center. Risk factors of type I diabetes mellitus were compared between the two groups using SPSS software. Findings: Season of birth, number of children, duration of using infant formula, using vitamin D supplement during pregnancy, using vitamin A and D supplement during infancy, family history of types I and II diabetes mellitus, age of attending kindergarten, duration of breast feeding and age of starting supplementary feeding were statistically different between the two groups. Conclusion: According to the result of our study, in addition to genetic factors, several environmental factors have positive roles in the incidence of type I diabetes. Health providers must plan for reducing these risk factors.

Maple Syrup Urine disease (MSUD) is caused by the deficiency of the branched chain 2-ketoacid dehydrogenase complex. Type I diabetes mellitus (TIDM) is a chronic illness characterized by the body’s inability to produce insulin due to the autoimmune destruction of the beta cells in the pancreas. A case with both MSUD and TIDM has not been reported previously. In this study, we presented a patient with both MSUD and TIDM, dietary management and the follow up period. Dietary management could be difficult in the presence of two disorders affecting more than one macronutrient component such as both carbohydrate and protein. Our patient had good metabolic control in the follow-up period. Treatment was successful with intensive insulin, frequent feeding and a leucine restricted diet.

Sickle cell anaemia (SCA) and type 1 diabetes mellitus (type 1 DM) are chronic medical conditions whose co-existence is uncommon in childhood. Furthermore, complications of SCA such as mesenteric crisis typically present with abdominal pain, which is also common in children with diabetic ketoacidosis (DKA) and this may possess diagnostic challenge. Herewith in, we report a rare case of a nine-year-old child with homozygous sickle cell anaemia, who presented with features of mesenteric crisis and diabetic ketoacidosis. The DKA was diagnosed based on the presence of hyperglycaemia (32.2 mmol/L), ketonaemia (4.6 mmol/L) and acidosis (11.6 mmol/L). The fluids deficit was corrected over 24 hours, with improvement in the vaso-occlusive crises (VOC) without precipitating cerebral oedema.

Background: Diabetes mellitus is a common disease in most parts of the world, the metabolic abnormalities of diabetes potentially affect bone metabolism, structure, mineral density, and bone resorption, as part of physiological bone turnover. Aim: This study aimed to estimate urinary total deoxypyridinoline as a biomarker of mature bone collagen degradation and bone resorption in type I diabetes mellitus patients and evaluate its relationship with fasting blood sugar, serum bone minerals profile and the duration of disease and also to investigate the degree of severity of bone resorption and the probability of fracture risk. Patients and methods:165patients with type I diabetes mellitus from Diabetes mellitus and Endocrine Disease Centre at AL -Nasiriyah city in Thi-Qar province, Iraq were studied.100 (60.6%) were female and 65(39.4%) were male, age was between(25-65) year, mean44.27

Background and objective Diabetes mellitus (DM) is a chronic debilitating metabolic disease caused by insulin deficiency. Diabetic ketoacidosis (DKA) is a potentially fatal complication characterized by acute hyperglycemia and metabolic acidosis. In light of the high prevalence of DM in Saudi Arabia, we sought to investigate the knowledge, attitudes, and practices of the Saudi general population about DKA. Methods An online self-administered questionnaire was distributed through popular social media platforms among diabetics in the Saudi population. The survey questions involved demographic data; diabetes status including the time of diagnosis, current medications, and the latest HbA1c level; and an assessment of the knowledge about DKA through queries related to diagnostic criteria, definition, risk factors, symptoms, and preventive measures. Results Our study involved 400 participants, and 42.5% of them were able to correctly identify DKA as an emergency requiring immediate medical attention. Regarding the awareness of DKA's symptoms among the participants, 33.8% correctly identified excessive thirst as a key indicator, followed closely by frequent urination (31.8%), and the characteristic fruity breath odor (31.3%). As for the awareness of the participants of the causes of DKA, 33.8% correctly linked forgetting insulin injections to DKA development. Encouragingly, 39.8% of participants identified regular blood sugar monitoring as the most effective way to prevent DKA. Conclusions Most patients in our study demonstrated limited knowledge of DKA. However, a significant portion of them was able to identify it as an emergency. To prevent such events, raising awareness about DM and its complications may serve as the first step toward better outcomes in diabetic patients. We believe our findings can be used to devise quality-improving interventions in this field., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Hassan et al.)

Diabetes mellitus (DM) is a metabolic disorder with numerous symptoms categorized via serves hyperglycemia effect along with altered fat, protein and carbohydrate metabolism mainly resultant from defects in insulin action/secretion or both. The aim of the current experimental study was to comfort the neuroprotective effect of ganoderic acid against the streptozotocin (STZ)-induced type I diabetes mellitus in mice and explore the underlying mechanism. Differentiation of 3T3-L1 preadipocytes effect; hepatic and glucose consumption effect of ganoderic acid was estimated on HepG2 cell lines and peroxisome proliferator-activated receptor (PPAR). FFA content was estimated in adipose and hepatic tissues. Ganoderic acid induced the 3T3-L1 preadipocytes differentiation. The mRNA expression of PPAR was increased in the high glucose-treated group in HepG2 and ganoderic acid treatment down-regulated the mRNA expression of PPAR. Ganoderic acid exhibited the inhibitory effect of α-glucosidase and α-amylase. Ganoderic acid demonstrated the reduced blood glucose and increase insulin level and also reduced the free fatty in hepatic and adipose tissue. Histopathological study showed the enhancement of β-cells in ganoderic acid-treated mice. Finally, their prebiotic effects on gut microbiota were illustrated via enhancing the population of diabetes resistant bacteria and also reducing the quantity of diabetes sensitive bacteria. Ganoderic acid attenuated STZ induced T1DM in mice via inflammatory pathways. [ABSTRACT FROM AUTHOR]

Background: Type I Diabetes Mellitus (T1DM) is one of the most common endocrine diseases in the world. It is also the dominant type of diabetes mellitus among children and adolescents that, if left uncontrolled, becomes a major risk factor for cardiovascular disorders and may cause clinical and subclinical cardiac dysfunction. Objective: This study aimed to compare uncontrolled pediatric and adolescent patients and similar healthy people regarding cardiac function according to echocardiography and B-type Natriuretic Peptide (BNP). Methods: This case-control study was carried out in the Outpatient Department of Nemazi tertiary hospital in Shiraz, Iran between June and September 2016. The study included 29 consecutive outpatient cases aged 5 - 18 years who had been diagnosed with T1DM for more than three years and had normal ejection fraction in M-mode echocardiography. The control group consisted of 29 age- and gender-matched healthy non-diabetic volunteers. Both cases and controls were selected by simple random sampling. The participants underwent clinical evaluation, including BNP assay and echocardiographic examination composed of two-dimensional echocardiography, M-mode echocardiography, pulsed Doppler imaging, and Tissue Doppler Imaging (TDI). P-value ≤ 0.05 was considered to be statistically significant. Results: The results revealed a decline in cardiac function in TDI, which was related to the HbA1C level and duration of the disease. A significant difference was found between the cases and the controls regarding the left ventricular posterior wall, interventricular septal diameters in diastole, and E/A ratio of tricuspid valve (P = 0.047, P = 0.001, and P = 0.021, respectively). A significant difference was also observed between the two groups in terms of septal S' and E' parameters (P = 0.004 and P = 0.002, respectively). Moreover, diminished E/A ratio of tricuspid valve annulus was related to the increased duration of the disease. Even though left ventricular hypertrophy occurred in the patients, no significant increase was observed in BNP values. Conclusion: The results indicated that M-mode, two-dimensional, pulsed Doppler, and TDI echocardiography might efficiently evaluate cardiac function in patients with preserved ejection fraction. However, BNP measurement might not be useful for screening of cardiac function. [ABSTRACT FROM AUTHOR]

Sickle cell anaemia (SCA) and type 1 diabetes mellitus (type 1 DM) are chronic medical conditions whose co-existence is uncommon in childhood. Furthermore, complications of SCA such as mesenteric crisis typically present with abdominal pain, which is also common in children with diabetic ketoacidosis (DKA) and this may possess diagnostic challenge. Herewith in, we report a rare case of a nine-year-old child with homozygous sickle cell anaemia, who presented with features of mesenteric crisis and diabetic ketoacidosis. The DKA was diagnosed based on the presence of hyperglycaemia (32.2 mmol/L), ketonaemia (4.6 mmol/L) and acidosis (11.6 mmol/L). The fluids deficit was corrected over 24 hours, with improvement in the vaso-occlusive crises (VOC) without precipitating cerebral oedema. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Microencapsulation of pancreatic islets for the treatment of Type I Diabetes Mellitus (T1DM) generates a high quantity of empty microcapsules, resulting in high therapeutic graft volumes that can enhance the host's immune response. We report a 3D printed microfluidic magnetic sorting device for microcapsules purification with the objective to reduce the number of empty microcapsules prior transplantation. In this study, INS1E pseudoislets were microencapsulated within alginate (A) and alginate-poly-L-lysine-alginate (APA) microcapsules and purified through the microfluidic device. APA microcapsules demonstrated higher mechanical integrity and stability than A microcapsules, showing better pseudoislets viability and biological function. Importantly, we obtained a reduction of the graft volume of 77.5% for A microcapsules and 78.6% for APA microcapsules. After subcutaneous implantation of induced diabetic Wistar rats with magnetically purified APA microencapsulated pseudoislets, blood glucose levels were restored into normoglycemia (<200 mg/dL) for almost 17 weeks. In conclusion, our described microfluidic magnetic sorting device represents a great alternative approach for the graft volume reduction of microencapsulated pseudoislets and its application in T1DM disease. [ABSTRACT FROM AUTHOR]

Juvenile myasthenia gravis (JMG) is an autoimmune disease caused by antibodies affecting the postsynaptic membrane at the neuromuscular junction. The association of JMG with Type I diabetes mellitus (DM), another autoimmune disease, is very rare and the pathogenesis has not been fully explained. Our case is the youngest patient where this association has been reported in the literature and presented at the age of 4 years when diabetic ketoacidosis developed together with the emergence of ocular myasthenia findings. She is the only case diagnosed with JMG among the 510 Type I DM patients followed-up at our clinic. Although an autoimmune process may have triggered both autoimmune diseases at the same time in this case, we believe the diabetic ketoacidosis was a triggering factor for the JMG and discuss this association. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune systemic condition caused by sensitivity to gluten in genetically predisposed patients. The clinical signs of CD are extremely diverse, ranging from the typical intestinal malabsorption syndrome (characterized by chronic diarrhea, abdominal distension and malnutrition) to atypical symptoms that may involve any system or organ: chronic constipation, increased level of liver enzymes, iron deficiency anemia, recurrent abdominal pain, neurological conditions, tooth enamel erosion. The authors report four pediatric cases diagnosed with various atypical forms of celiac disease: the form associated with recurrent abdominal pain and increased level of liver enzymes, and the form associated with chronic constipation, all accompanied by failure to thrive and one case of type I diabetes mellitus associated with celiac disease. To conclude with, pediatricians, gastroenterologists and general practitioners should be familiar with all the clinical forms of coeliac disease in order to be able to diagnose this childhood disease and thus prevent long-term complications like osteoporosis, infertility and intestinal lymphoma.

Background: Eating disorder diagnoses and disordered eating behaviours are more prevalent in people living with Type 1 Diabetes Mellitus, in particular in adolescents. The role of the dietitian in this setting is not clearly outlined in the literature., Aim: This scoping review aims to outline the available information for the role of the dietitian in identifying and managing eating disorders in adolescents and adults with co-occurring Type 1 Diabetes Mellitus (T1DM) in a clinical setting., Methods: The Johanna Briggs Institute was utilised to guide this scoping review and to develop a search strategy for relevant databases. Relevant organisations and societies websites and professional magazines were reviewed as part of the grey literature search., Results: 38 peer reviewed journal articles, 5 professional articles, 5 book chapters and 11 clinical guidelines were included in this scoping review. Roles for the dietitian in identification, prevention and screening for eating disorders in Type 1 Diabetes Mellitus were identified and outlined in a visual workflow. The role of the dietitian in the management of eating disorder in both the outpatient/community and inpatient setting and as core member of the multidisciplinary team was detailed in the literature., Conclusion: This scoping review mapped the available information in the current literature on the role of the dietitian in the identification and management of eating disorders and disordered eating in adolescents and adults with a dual diagnosis of T1DM. The reviewed literature suggests there is a strong reliance on expert opinion and practice to inform the role of the dietitian. Further research is required in order to ensure more robust evidence-based practice in this area., Competing Interests: Declaration of competing interest No conflicts of interest to be declared by all authors., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Background: Type I diabetes mellitus is a chronic illness in which autoimmune destruction of pancreatic beta cells results in the body's inability to produce insulin. Vitamin D has several important roles regarding bone health however, recent studies suggest that Vitamin D3 (the active form of Vitamin D) has potent antiproliferative and immunomodulatory properties which has linked it to many autoimmune disease including Type I Diabetes Melltius. Vitamin D deficiency (serum levels less than 50 nmol/l) has a negative influence on insulin secretion in patients with Type I Diabetes Mellitus, thereby suggesting a role for vitamin D3 in the pathogenesis of Type I Diabetes Mellitus. Vitamin D deficiency is an increasingly recognized comorbidity in patients with Type I diabetes mellitus. We aim to determine the frequency of vitamin D deficiency in Type I Diabetes Mellitus in Pakistani population. Objectives: The objective of the study was to determine frequency of Vitamin D deficiency in patients having Type I Diabetes Mellitus in Pakistani Population. Study Design: Cross-sectional study. Setting: The study was conducted in Diabetes Management Center & Endocrinology Unit (DMC & EU) at Services Hospital Lahore. Period: From 20th May to 19th November (6 months). Materials and Methods: 200 patients having Type I Diabetes Mellitus presenting to Diabetic Management Center were recruited by non-probability purposive sampling. Informed consent was taken. Pro forma was filled by a skilled interviewer and blood sample for vitamin D levels was drawn. Data was entered in the pro forma given at the end and was analyzed in SPSS. Results: Of the 200 subjects 125 were males and 75 were females. Of the males 85.6% and females 88% were vitamin D deficient. The frequency of vitamin D deficiency in newly diagnosed Type I Diabetics is 86.5%. In this study it was seen that higher HbA1c levels are significantly associated with Vitamin D deficiency. Conclusions: These results conclude that vitamin D deficiency is significantly frequent at the onset of Type I Diabetes Mellitus. So vitamin D levels should be measured in all Type I diabetics on their first presentation to the hospital especially those with higher HbA1c levels and vitamin D should be replaced in deficient patients. Further prospective studies should be done to evaluate Vitamin D3 as a factor in managing glycemic control. [ABSTRACT FROM AUTHOR]

Background: Offspring exposed to gestational diabetes mellitus (GDM) are at a high risk for metabolic diseases. The mechanisms behind the association between offspring exposed to GDM in utero and an increased risk of health consequences later in life remain unclear. The aim of this study was to clarify the changes in methylation levels in the foetuses of women with GDM and to explore the possible mechanisms linking maternal GDM with a high risk of metabolic diseases in offspring later in life.Methods: A genome-wide comparative methylome analysis on the umbilical cord blood of infants born to 30 women with GDM and 33 women with normal pregnancy was performed using Infinium HumanMethylation 450 BeadChip assays. A quantitative methylation analysis of 18 CpG dinucleotides was verified in the validation umbilical cord blood samples from 102 newborns exposed to GDM and 103 newborns who experienced normal pregnancy by MassARRAY EpiTYPER.Results: A total of 4485 differentially methylated sites (DMSs), including 2150 hypermethylated sites and 2335 hypomethylated sites, with a mean β-value difference of >0.05, were identified by the 450k array. Good agreement was observed between the massarray validation data and the 450k array data (R2 > 0.99; P < 0.0001). Thirty-seven CpGs (representing 20 genes) with a β-value difference of > 0.15 between the GDM and healthy groups were identified and showed potential as clinical biomarkers for GDM. "hsa04940: Type I diabetes mellitus" was the most significant Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, with a P-value = 3.20E-07 and 1.36E-02 in the hypermethylated and hypomethylated genepathway enrichment analyses, respectively. In the Gene Ontology (GO) pathway analyses, immune MHC (major histocompatibility complex)-related pathways and neuron development-related pathways were significantly enriched.Conclusions: Our results suggest that GDM has epigenetic effects on genes that are preferentially involved in the Type I diabetes mellitus pathway, immune MHC-related pathways and neuron development-related pathways, with consequences on fetal growth and development, and provide supportive evidence that DNA methylation is involved in fetal metabolic programming. [ABSTRACT FROM AUTHOR]

To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis. Anti-GAD-Ab titers in T1DM decreased over time, whereas they remained high in neurologic disorders. Immunotherapy improved neurological disorders and anti-GAD-Ab titers and index provide clinically meaningful information about their diagnostic accuracy. [ABSTRACT FROM AUTHOR]

A genetic variant in the SAND domain of autoimmune regulator (AIRE), R247C, was identified in a patient with type I diabetes mellitus (T1DM) and his mother with rheumatoid arthritis. In vitro , the variant dominantly inhibited AIRE; however, typical features of Autoimmune Polyendocrinopathy Candidiasis and Ectodermal Dysplasia (APECED) were not seen in the subjects. Rather, early manifestation of autoimmunity appeared to be dependent on additional genetic factors. On a population level, diverse variants were identified in this region. Surprisingly, many likely pathogenic variants were seen disproportionately in Africans when compared to Europeans, reinforcing the importance of these variants in altering the immune repertoire. In light of these findings, we propose that R247C and other variants within the SAND-domain alter protein function in a dominant fashion and hold potential as drivers of autoimmunity. [ABSTRACT FROM AUTHOR]

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Actuality. Developing countries spend from 2.5 to 15.0 percent of their annual health care budgets on the treatment of diabetes mellitus (DM), and families with diabetes spend from 15 to 25 percent of their income on treatment. The growing diabetes pandemic is unfolding with a rapid increase in the prevalence of type 2 diabetes. Objectives of research. Determine the prevalence of diabetes mellitus. Analyze the impact of diabetes in terms of the rehabilitation prognosis of patients after cholecystectomy (CC). To determine the main strategies of physical rehabilitation to improve the quality of life of people with diabetes after cholecystectomy. Results of research. The prevalence of gallstone disease (GD) is significantly higher among people with diabetes (24.8%) than in the general population (13.8%), the physical and social consequences of which can have a negative impact on quality of life. During the initial assessment of people after CC for the purpose of developing a physical rehabilitation program, it is necessary to establish the presence of signs of prediabetes or DM, taking into account glucose and insulin resistance, as well as signs, symptoms and factors that may further contribute to the development of DM. When developing a physical rehabilitation program, the complications that this disease leads to should be taken into account. Rehabilitation interventions for such individuals should be based on evidence-based practice in the field of health care. Conclusions. The physical rehabilitation (PR) program should last at least 3 to 6 months, aimed at increasing physical activity (PA) (at least 150 minutes and 3 sessions per week of combined aerobic and strength training), normalizing body weight; for older people, the PR program should include measures to prevent falls and sarcopenia. Anxiety and depression levels need to be monitored. Conduct special training to encourage a healthy lifestyle, nutrition, reduced calorie intake, regular physical activity, sleep management, and reduction of anxiety and depression.

Background: The aim of this study was to detect the prevalence of thyroid abnormalities among children and adolescents with type 1 diabetes mellitus (T1DM) in Upper Egypt and its relationship with disease-related variables. Design: Cross-sectional controlled study. Patients and Methods: The study included 94 children and adolescents with T1DM (Group 1) attending for regular follow-up in the diabetes clinic of Assiut Children University Hospital, Assiut, Egypt were enrolled in the study and 60 healthy subjects matching in age and sex were taken as a control (Group 2). History taking, clinical examination, measurement of thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine, anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies levels as well as HbA1c were measured Results: Mean TSH levels were significantly higher in (Group 1) when compared to control (P < 0.01). Six children (6.3%) were found to have subclinical hypothyroidism in Group 1 compared with two children (2.1%) in the control group (P < 0.001) two children (2.1%) were found to have clinical hypothyroidism in Group 1 compared with non in the control group. Positive levels of anti-TPOAb and anti-TgAb were found in 9 (9.5%) and 6 (6.3%) in Group 1 compared with 2 (3.3)% and 1 (1.6%) of controls respectively (P < 0.01). Cases with hypothyroidism were significantly older, had longer duration of DM, higher body mass index and higher HbA1c compared with those without hypothyroidism. TSH had significant positive correlations to age (r = 0.71, P < 0.001), diabetes duration (r = 0.770, P < 0.001), Anti-TPO level (r = 0.678, P < 0.01), HbAIc level (r = −0.644, P < 0.01) and significant negative correlation with FT4 (r = −0.576, P = 0.01). Conclusion: The present study reported high prevalence of thyroid abnormalities in children and in children and adolescents with type 1 diabetes in Upper Egypt. The study recommended yearly evaluation thyroid function tests and thyroid antibodies in all children and adolescents with type 1 diabetes commencing from the onset of diabetes.

Introduction: Type 1 diabetes mellitus (DM) is an endocrine disorder that occurs commonly in an age group, where the development of primary and permanent dentition takes place. As altered endocrine functions may affect the shape and size of teeth leading to dental anomalies, this study was conducted to look for the occurrence of any dental anomalies in type I DM patients. Materials and Methods: A diabetic camp was conducted at Alur Chandrashekharappa Memorial Hospital, Davangere, where 30 diabetic patients were examined and the impressions of their maxillary and mandibular arches were recorded. Age and sex matched controls were selected randomly, and similar recordings were done. Results: Type I diabetic patients showed statistically significant (P < 0.001) morphological alterations of total number of cusps, including presence of 6 th cusp in mandibular molars and extra cusps in mandibular premolars. Other alterations such as microdontia, flower shaped mandibular molars, prominent cusp of carabelli, and oblique ridge in maxillary molars were also noted. Severe attrition was found in 11 (36.6%) of the diabetic patients, whereas the control group showed attrition only in 2 (6.8%) patients. Conclusion: Remarkable morphological alterations do occur in the dentition of type I DM patients.

Objective This study aimed to investigate the susceptibility of mice with streptozotocin(STZ)-induced diabetes mellitus (TIDM) to the uptake of pentavalent inorganic arsenic (iAs V ) and the possible molecular mechanism. Methods TIDM was induced in mice by STZ. TIDM and normal mice were treated with 15.0 mg/kg Na 2 HAsO 4 ·12H 2 O by intragastric administration. Then, the concentrations of arsenic in various tissues were measured by atomic fluorescence spectrometry. The gene expression levels of Pit1 and Pit2 were quantified by real-time RT-PCR, and their protein levels were detected by Western blotting in mouse heart, kidney, and liver tissues. Results The concentrations of arsenic in STZ-induced TIDM mouse tissues were higher at 2 h after intragastric administration of Na 2 HAsO 4 ·12H 2 O. Compared with the levels in normal mice, PIT1 and PIT2, which play a role in the uptake of iAs V , were upregulated in the livers and hearts of TIDM mice. PIT1 but not PIT2 was higher in TIDM mouse kidneys. The upregulation of Pit1 and Pit2 expression could be reversed by insulin treatment. Conclusion The increased uptake of iAs V in TIDM mouse tissues may be associated with increased PIT1 and/or PIT2 expression. [ABSTRACT FROM AUTHOR]

ABSTRACT [ABSTRACT FROM AUTHOR]

Purpose: To investigate the clinical manifestations and surgical results after vitrectomy for proliferative diabetic retinopathy (PDR) in young patients. Methods: Clinical features of patients between 18 to 40 years old who received vitrectomy for PDR between January 2009 and January 2015 were retrospectively reviewed. Those older than 40 years who received vitrectomy for PDR during the same period were retrospectively enrolled and compared as the control group. Results: There were 68 eyes (52 patients) in the study group and 77 eyes (61 patients) in the control group. The average age at operation was 33.15 ± 4.92 years and 56.67 ± 7.52 years, respectively ( p < 0.001). At presentation, those in the study group had significantly higher proportions of active fibrovascular proliferation and traction retinal detachment, and with significantly higher-severity gradings than those in the control group. After operation, the recurrent detachment rates were 13.2% in the study group and 1.3% in the control group ( p = 0.006), and the final anatomical success rates were 91.2% in the study group and 100% in the control group ( p = 0.009). The most significant risk factor for poor visual outcome in the study group was neovascular glaucoma (NVG) ( p = 0.001). Patients with Type 1 and Type 2 diabetes mellitus subgroups shared similar clinical features and visual outcome. Conclusions: Younger patients who received vitrectomy for PDR presented with more severe anatomical features at the time of vitrectomy and had a higher rate of post-operative recurrent detachment. More than 90% achieved final anatomical success. NVG was associated with worse visual outcome. [ABSTRACT FROM AUTHOR]

Background: In the United States, racial disparities in health outcomes continue to be a major problem with far-reaching effects on equity in healthcare and public health. Children and teenagers with type 1 diabetes are a disadvantaged demographic that has particular difficulties in managing their condition and getting access to healthcare. Despite improvements in the treatment of diabetes, little study has examined how much racial disparities in in-hospital mortality affect this particular demographic. By examining racial differences in in-hospital mortality rates among children and adolescents with type 1 diabetes in the United States, this study seeks to close this gap., Methods: This cross-sectional study utilized data from the Healthcare Cost and Utilization Project's (HCUP) Kids' Inpatient Database (KID) for 2012. The KID is a nationally representative sample of pediatric discharges from US hospitals. A total of 20,107 patients who were admitted with type 1 diabetes were included in this study. The primary outcome was the patient's in-hospital mortality status. The primary predictor variable was the race of the patient. Six potential confounders were chosen based on previous literature: age, sex, hospital location, obesity, weight loss, electrolyte disorders status, and median household income. Descriptive statistics and bivariate analyses were done. Multivariate analysis was conducted while controlling for potential confounders. Odd ratios with a 95% confidence interval and probability value were reported. Statistical Analysis System (SAS) version 9.4 for Windows (SAS Institute Inc., Cary, NC, USA) was used for the statistical analysis., Results: A total of 20,107 patients were included in this study. Of the patients included, 78.6%, 5.3%, 5.9%, and 10.2% were of age groups <4, 5-9, 10-14, and 15-18, respectively. Among the patients, 64.3% were female. Whites stood at 54.3%, while Hispanic, Black, and other races accounted for 17.2%, 21.8%, and 6.7% respectively. After adjusting for all other variables, children, and young adults of Asian and Pacific Islanders (OR=1.948; 95% CI 1.015,3.738) had 94% higher odds of in-hospital mortality compared to their White counterparts. Children and young adults aged 5-9 (OR=0.29; 95% CI 0.13,0.649) had 71% lower odds of in-hospital mortality compared to those aged 4 or under. Those aged 10-14 (OR=0.155; 95% CI 0.077,0.313) had 85% lower odds of in-hospital mortality compared to those aged 4 or under, while those aged 15-19 (OR=0.172; 95% CI 0.100,0.296) had 83% lower odds of in-hospital mortality compared to those aged 4 or under. Children and young adults who had weight loss (OR=4.474; 95% CI 2.557,7.826) had almost five times higher odds of in-hospital mortality compared to those without weight loss, while children and young adults who had electrolyte disorders (OR=5.131; 95% CI 3.429,7.679) had five times higher odds of in-hospital mortality compared to those without electrolyte disorders., Conclusion: The results show young adults of Asian and Pacific Islanders have higher odds of in-hospital mortality compared to their White counterparts and this study highlights the urgent need for focused measures designed to lessen these inequalities and enhance health equity. The implementation of culturally sensitive healthcare practices, addressing social determinants of health, and enhancing access to high-quality diabetes care should all be priorities., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Omenuko et al.)

Glycogenic hepatopathy (GH) is an uncommon cause of serum transaminase elevation in type I diabetes mellitus (DM). The clinical signs and symptoms of GH are nonspecific, and include abdominal discomfort, mild hepatomegaly, and transaminase elevation. In this report we describe three cases of patients presenting serum transaminase elevation and hepatomegaly with a history of poorly controlled type I DM. All of the cases showed sudden elevation of transaminase to more than 30 times the upper normal range (like in acute hepatitis) followed by sustained fluctuation (like in relapsing hepatitis). However, the patients did not show any symptom or sign of acute hepatitis. We therefore performed a liver biopsy to confirm the cause of liver enzyme elevation, which revealed GH. Clinicians should be aware of GH so as to prevent diagnostic delay and misdiagnosis, and have sufficient insight into GH; this will be aided by the present report of three cases along with a literature review.