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Background: GLP-1 receptor agonists (GLP-1RA) are used in the management of type II diabetes mellitus or obesity, although its role in patients with type I diabetes mellitus (T1DM) has been debated. This study aimed to investigate the efficacy and safety of GLP-1RA in patients with T1DM using real-world data. Methods: This multicenter, retrospective study was conducted at three tertiary medical centers in Riyadh, Saudi Arabia. The study followed up patients (>16 years old) with T1DM treated with insulin followed by GLP-1RA add-on therapy. The efficacy outcomes included changes in HbA1c, body weight, and insulin requirements from baseline to each follow-up visit. The main safety outcomes assessed included hypoglycemic events and gastrointestinal (GI) adverse events. Results: The study included 144 patients with a mean age of 33.0 ± 10.1 years. Semaglutide was the most used GLP-1RA (63.9%) followed by liraglutide (34.0%). From baseline to 3-month follow-up, HbA1c (mean difference (MD) = −0.8%; p = 0.0053), weight (MD = −2.4 kg; p = 0.0253), and daily basal insulin dose (MD = −2.1 units; p = 0.0349) were significantly reduced. Likewise, HbA1c (MD = −0.5%; p = 0.0004), weight (MD = −3.6 kg; p < 0.0001), and daily basal insulin (MD = −2.4 units; p = 0.0282) were significantly reduced at the 4–6-month follow-up. The significant reductions in HbA1c, weight, and daily basal insulin levels were consistent for up to 18-month follow-up. Only one patient had a major hypoglycemic event, whereas 8.3% of the patients had GI adverse events. Conclusions: Overall, significant improvements in glycemic control, weight loss, and insulin requirements were observed with the use of GLP-1RA in patients with T1DM, with a limited number of GI adverse events. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionCaregivers are key stakeholders in management of children with Type 1 Diabetes (T1D), but their perspectives have remained understudied, especially in the developing countries. This study explores their perspectives on the barriers and facilitators of management of a child with T1D in a resource-constrained setting.This qualitative study, conducted in a tertiary level diabetes clinic in India, included parents of children with T1D, selected from subgroups varying in disease duration, education, habitat, and socioeconomic status, who participated in one of the five Focused Group Discussions (FGDs) of 60–90 min duration. The topic guide included questions like "What are the barriers you face related to diabetes care of your child at home or school?" and "What do you think helps you in managing a child with diabetes?" FGDs were audio-recorded, transcribed verbatim, and inductive coding was done independently by two authors.Twenty-eight parents (nineteen mothers and nine fathers, mean age: 35.1 years) of children aged between 2–13 years, were recruited till data saturation. Themes related to barriers of management were, ‘balancing nutrition and glycemic control is challenging’, ‘diabetes management involves psychological burden’ and ‘operational challenges’. Parents opined that family support, gaining decision-making and problem-solving attitude and optimal school-time management helped.Parents living in resource-constrained circumstances perceive unique challenges during management of T1D in their children like social stigma, illiteracy, financial and logistic issues like procuring and storing essential supplies. A better understanding of these factors can aid healthcare professionals in managing them. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes (T1D) is an organ-specific autoimmune disorder characterized by the destruction of pancreatic β cells, leading to absolute insulin deficiency. The genes NLRP3, ICAM-1, PTPN22, and INS are reportedly associated with T1D in other populations. However, the genetic pattern of T1D in the Pakistani population is not clear. This study aimed to find the association of polymorphisms in the PTPN22, INS, NLRP3, and ICAM-1 genes with T1D susceptibility in the Pakistani population. Methodology: This case-control study includes 100 T1D patients (3–14 years), recruited randomly from the pediatric endocrinology department of Fatima Memorial Hospital, Lahore, Pakistan and 100 age-matched healthy controls were selected from different localities of the same population. The polymorphisms in PTPN22 (rs601, rs33996649, rs2488457), INS (rs80356664), NLRP3 (rs10754558, rs35829419), and ICAM-1 (rs1799969, rs5498) genes were genotyped by Sanger sequencing. The genotypic and allelic frequencies, haplotypes, and linkage disequilibrium were computed using the genetic toolset PLINK to investigate their relationship to T1D. Results: The results indicate that the occurrence of the GT genotype of the rs33996649 variant is significantly higher in children with T1D compared to a control group of healthy individuals (P = 0.001, OR: 2.0, 95% CI = 0.15–0.45). Furthermore, the CT genotype of rs2488457 was notably associated with T1D patients (P = 0.007, OR: 2.8, 95% CI = 0.56–0.67). The CG genotype of rs80356664 showed a slight association with T1D (P = 0.03, OR: 1.9, 95% CI = 0.35–0.59). The prevalence of the AT genotype of rs10754558 showed a strong association with T1D (P = 0.005, OR: 3.4, 95% CI = 0.45–0.69). The TG genotype of rs5498 was also strongly associated with T1D (P = 0.009, OR: 2.8, 95% CI = 0.75–0.89). Conclusion: The present study provides evidence that SNPs in the PTPN22, INS, NLRP3, and ICAM-1 genes are associated with the development of T1D. Further research is needed to explore their potential use in genetic screening and personalized medication. Significance: That is already known on this topic?: The genes NLRP3, ICAM-1, PTPN22, and INS have been associated with Type 1 diabetes (T1D) in ‎various populations. However, there is limited knowledge about their specific genetic patterns in the ‎Pakistani population, necessitating this study to explore these associations. What this study hopes to add?: This study hopes to provide valuable data by identifying significant associations between ‎polymorphisms in the PTPN22, INS, NLRP3, and ICAM-1 genes and T1D susceptibility in Pakistani ‎children. How this study might affect research, practice, or policy?: The findings could enhance genetic screening protocols and personalized medicine in Pakistan by ‎identifying key genetic variants, assessing their impact on disease presentation, and discovering ‎novel disease pathways. This can lead to new drug development and inform policies on early ‎intervention programs and resource allocation for ASD services. [ABSTRACT FROM AUTHOR]

Purpose: Compared to the general stillbirth rate in Germany for term deliveries of 0.12% the risk in type 1 diabetes mellitus is reported to be up to ten times higher. The reasons for this excess risk of intrauterine demise are still not fully elucidated. Risk factors named in the literature include poor glycemic control before and during pregnancy and the occurrence of ketoacidosis. Additionally there might be a diabetes related type of placental dysfunction leading to organ failure in late pregnancy. Understanding the underlying causes is mandatory to develop strategies to reduce the incidences. The Purpose of this publication is to point out the difficulties in prediction of intrauterine death in pregnant type 1 diabetes patients and thus emphasizing the necessity of constant awareness to all caregivers. Methods: We present a case series of four cases of stillbirth that occurred in patients with type 1 diabetes mellitus at our tertiary care obstetric unit during a five-year period. Results: In all four presented cases the underlying cause of intrauterine demise was different and we could not find a common mechanism or risk profile. Furthermore, established monitoring tools did not become peculiar to raise awareness. We compared our cases to published data. Underlying causes of intrauterine death in type 1 diabetes are discussed in the light of the current literature. Conclusions: The main risk factors of stillbirth in diabetic pregnancies are high maternal blood glucose levels including pre-conceptional HbA1c and diabetic ketoacidosis. Late acute placental insufficiency are associated with intrauterine death in type 1 diabetes. Despite the elevated risk of near term intrauterine demise there are currently no guidelines on how to monitor pregnancies in type 1 diabetes for fetal distress during the third trimester. Established thresholds for fetal Doppler data indicating fetal distress in normal and growth restricted fetuses may not be applicable for overgrown fetuses. Future research on how to monitor the diabetic fetus needs to be initiated. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. Objectives: This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables in young people with type 1 diabetes. Methods: A systematic review of trials was conducted that involved a bibliographic search in electronic databases (Web of Science, MEDLINE, SciELO, Scopus, PsycINFO, and Cochrane Library) considering studies published between 2013 and 2024. Results: A total of 434 records were identified, of which 252 underwent selection according to title and abstract, leaving 32 that were evaluated for eligibility and 7 included in this review. From Google Scholar, six more studies were identified and evaluated, and two were selected. Finally, nine studies were subjected to full reading and a detailed analysis of the inclusion criteria. A total of 66.6% of the studies were evaluated as having a methodological quality of moderate or optimal, but the samples analysed tended to be small, and only two articles carried out short-term follow-up evaluations. Conclusions: Mindfulness-based interventions, upon reviewing the preliminary results, may be posited as a viable strategy to enhance psychological (anxiety, diabetes distress, perceived stress, depression, self-efficacy, psychological well-being, and quality of life) and biomedical outcomes (glycaemic control, blood glucose levels, and diastolic blood pressure) for type 1 diabetes in young people. Although promising, further research is required to improve the quality, methodology, and design of studies. [ABSTRACT FROM AUTHOR]

Objectives: Adiponectin (ADN) is related to insulin resistance and cardiovascular disorders risks. It is negatively controlled in obese cases among diabetes mellitus type 1 (DMT1) patients. The current study evaluates ADN levels in early-aged children 9–12 years old of obese and non-obese cases (DMT1). Methods: Across-sectional study among children aged 9–11 years old, was conducted during the year 2023 within two groups. First was a diabetic children DMT1 group excluding diabetic cases with complications. Second was a healthy children’s control group. Two groups were subdivided into two subgroups, obese and non-obese (n = 6 for each subgroup). ADN concentrations were measured in DMT1 cases related to weight and body mass index among treated and non-treated with insulin-therapy compared to in vitro diabetic rats. Adult albino male rats enrolled in a control group, non-treated diabetic, and insulin-treated diabetic rats. Statistical analysis-based measuring means and standard deviation for each group and comparing them with the student t-test. Results: Significantly increased plasma AND levels were detected in DMT1 patients compared to non-diabetic cases (P < 0.001). AND levels were decreased in obese rather than non-obese cases of control or diabetic cases (P < 0.001). Data shows significantly increased plasma AND levels in experimental rats, induced with diabetes (with or without insulin treatment) compared to the control group (P < 0.001). Conclusion: Plasma ADN levels were significantly reduced in obese subjects’ diabetics or non-diabetics. It may refer to insulin resistance or mechanisms that prevent further weight gain by decreasing insulin sensitivity and increasing energy expenditure. [ABSTRACT FROM AUTHOR]

Type 1 diabetes mellitus is characterized by absolute insulin deficiency, which requires life‐long insulin replacement. Exogenous multiple‐daily insulin injections are most commonly prescribed for patients with type 1 diabetes mellitus. However, exogenous insulin supply often fails to cope with real‐time changing life‐log variables, such as activity, diet and stress, which results in recurrent hypo‐ and hyperglycemia in patients with type 1 diabetes mellitus. Islet transplantation is an ideal method to treat patients with type 1 diabetes mellitus, as it can restore the endogenous capacity of glucose‐stimulated insulin secretion. However, due to donor scarcity and technical barriers, only a limited number of islet transplantations have been carried out in Asia, including South Korea. Since 2013, our center has carried out two allogenic islet transplantations, with one case leading to near total insulin independence after one‐to‐one islet transplantation. Although the other patient failed to restore endogenous insulin production, there was a remarkable improvement in hypoglycemia. We speculate that islet transplantation remains an important and ideal treatment option for patients with type 1 diabetes mellitus who suffer from recurrent severe hypoglycemia. [ABSTRACT FROM AUTHOR]

Adolescence remains a crucial age associated with diabetes distress in individuals living with type 1 diabetes (T1D). The Austrian organization "Diabär" regularly hosts a one-week adventure camp for adolescents (12–18 years) living with T1D. The camp focuses on "fun activities" without a structured educational protocol in order to minimize diabetes distress and increase diabetes management skills. In contrast to educational camps, training is kept to a minimum. However, attendees analyze the glycemic data of the previous day with their medical supervisor once daily during the camp. All subjects used a standardized real-time continuous glucose monitoring (CGM) system (DexcomG7) throughout the whole study. Glycemic metrics were prospectively analyzed during three periods: week 1 = home phase, week 2 = adventure camp, and week 3 = after the camp. Safety (time below range 1 [TBR1], 69–54 mg/dL, and time below range 2 [TBR2], <54 mg/dL) and efficacy (time in range [TIR], 70–180 mg/dL) were assessed by comparing the CGM data during weeks 1–3. The CGM data of 14 participants were analyzed. The TIR was higher during the camp week versus week 1 (70.4 ± 11.1% vs. 53.1 ± 20.2%; p = 0.001). The TBR1 significantly increased during camp compared to week 1 (2.5 ±1.7% vs. 1.3 ± 1.2%; p = 0.009), whereas the TBR2 did not differ. No serious adverse events occurred. This adventure camp without a main focus on education showed feasibility and safety in adolescents with T1D. [ABSTRACT FROM AUTHOR]

Despite significant progress in the treatment of T1DM in children, achieving target levels of carbohydrate metabolism in children remains one of the most difficult tasks. The influence of the psychosocial state of the family on the ability to achieve metabolic compensation is becoming increasingly clear. However, the study of social risk factors in families with children with T1DM and their impact on metabolic control remains clearly insufficient.The purpose of the study is to determine social risk factors (SR) that are most typical for families of children with type 1 diabetes mellitus (T1DM) in our country and to analyze their relationship with compensation for T1DM based on a survey of parents.MATERIALS AND METHODS: The study was conducted in endocrinology departments of children’s hospitals and departments of medical and social care of children’s clinics in 4 regions - Vologda, Tyumen, Chelyabinsk regions and Khanty-Mansi Autonomous Okrug.A total of 325 respondents took part in the study. 1 group — experience of T1DM in children >1 year and poor metabolic control (level of glycated hemoglobin ((HbA1c) >7.5%) — 195 hours; 2 gr. — experience of T1DM in children >1 year and good metabolic control (HbA1c

Type 1 diabetes mellitus is characterized by absolute insulin deficiency, which requires life‐long insulin replacement. Exogenous multiple‐daily insulin injections are most commonly prescribed for patients with type 1 diabetes mellitus. However, exogenous insulin supply often fails to cope with real‐time changing life‐log variables, such as activity, diet and stress, which results in recurrent hypo‐ and hyperglycemia in patients with type 1 diabetes mellitus. Islet transplantation is an ideal method to treat patients with type 1 diabetes mellitus, as it can restore the endogenous capacity of glucose‐stimulated insulin secretion. However, due to donor scarcity and technical barriers, only a limited number of islet transplantations have been carried out in Asia, including South Korea. Since 2013, our center has carried out two allogenic islet transplantations, with one case leading to near total insulin independence after one‐to‐one islet transplantation. Although the other patient failed to restore endogenous insulin production, there was a remarkable improvement in hypoglycemia. We speculate that islet transplantation remains an important and ideal treatment option for patients with type 1 diabetes mellitus who suffer from recurrent severe hypoglycemia.

Introduction: vitamin D is a steroid hormone that has important roles in the homeostasis of the human body, and one of them is the stimulation of insulin secretion from the pancreas. Therefore, the aim of this study is to examine the association between vitamin D deficiency and type 1 and type 2 diabetes mellitus. Materials and methods: 60 patients with diabetes mellitus type 1 (DMT1) and 60 patients with diabetes mellitus type 2 (DMT2) were included in the study and two control groups of 60 patients each. Gender, age, HbA1c and vitamin D concentration were compared between these two groups. The association between vitamin D deficiency and type 1 and type 2 diabetes mellitus was examined by comparing vitamin D values in patients with DMT1 and DMT2 and control groups. Results: the group of patients with DMT2 consisted of significantly older people and female patients (p<0.001). The concentration of HbA1c is significantly higher in patients with DMT2 (p<0.001). Vitamin D concentration was significantly higher in patients with DMT1 (p<0.001). An association between DMT1 and DMT2 and vitamin D deficiency was observed (p<0.001). Conclusion: the conducted study proved vitamin D deficiency in patients with DMT1 and DMT2 and serves as a valuable indicator in the further treatment of these patients. [ABSTRACT FROM AUTHOR]

To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0–17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control. [ABSTRACT FROM AUTHOR]

Co-occurrence of anorexia nervosa (AN) and diabetes mellitus type 1 (T1DM) is an uncommon disease combination in clinical practice. Treatment of T1DM may affect outcomes in AN patients due to self-modification of insulin dosage. In the presented case 14-year-old patient diagnosed with both T1DM and AN has been modifying her insulin-dependent treatment to prevent gaining weight. Undercontrolled glucose levels resulted in early-stage diabetic vascular complications in the central nervous system found in MRI. Due to higher T1DM morbidity of eating disorders patients, adjustments and special control of insulin treatment and blood glucose levels as well as HbA1c should be maintained in the prevention of diabetic complications, especially in individuals with lower treatment compliance. As AN may lead to structural changes and a decrease in cognitive functions, increased supervision of AN patients with T1DM can lower the risk of cumulative negative effects on the brain. [ABSTRACT FROM AUTHOR]

Introduction–Background: Data from experimental trials show that Crocus sativus L. (saffron) is considered to improve glycemia, lipid profile, and blood pressure and reduce oxidative stress. So far, clinical trials have been conducted in individuals with metabolic syndrome and Diabetes Mellitus type 2 (DMT-2). The purpose of this study is to assess the effectiveness of saffron in individuals with Diabetes Mellitus type 1 (DMT-1). Patients–Methods: 61 individuals with DMT-1, mean age 48 years old (48.3 ± 14.6), 26 females (42.6%) were randomized to receive a new oral supplement in sachets containing probiotics, prebiotics, magnesium, and Crocus sativus L. extract or placebo containing probiotics, prebiotics and magnesium daily for 6 months. Glycemic control was assessed with a continuous glucose monitoring system and laboratory measurement of HbA1c and lipid profile was also examined. Blood pressure at baseline and end of intervention was also measured. Individuals were either on a continuous subcutaneous insulin infusion with an insulin pump or in multiple daily injection regimens. Diabetes distress and satiety were assessed through a questionnaire and body composition was assessed with bioelectrical impedance. Results: At the end of the intervention, the two groups differed significantly only in serum triglycerides (p = 0.049). After 6 months of treatment, a significant reduction in the active group was observed in glycated hemoglobin (p = 0.046) and serum triglycerides (p = 0.021) compared to baseline. The other primary endpoints (glycemic control, lipid profile, blood pressure) did not differ within the groups from baseline to end of intervention, and there was no significant difference between the two groups. Diabetes distress score improved significantly only in the active group (p = 0.044), suggesting an overall improvement in diabetes disease burden in these individuals but that was not significant enough between the two groups. Conclusions: A probiotic supplement with saffron extract improves serum triglycerides in well-controlled people with DMT-1 and may potentially be a valuable adjunct for enhancing glycemic control. [ABSTRACT FROM AUTHOR]

Type 1 diabetes mellitus is a condition where the pancreas beta cells are destroyed due to autoimmune mechanisms or viral infections, resulting in the inability to produce insulin. The Korean government implements various support programs to aid in the health management of type 1 diabetes patients. To address some shortcomings and adapt to diverse needs arising from advancements in diabetes management device technology, related policies were revised starting on February 26, 2024. Key updates include application of the criteria for continuous glucose monitoring system sensors to users of sensoraugmented pumps and establishing consumable material subsidies for users of closed-loop insulin pumps who are younger than 19 years. Support amounts vary based on the type of insulin pump, which vary by application. Additionally, to enhance diabetes education for pediatric and adolescent patients and their families, insulin pump education is newly introduced, along with an expansion of educational counseling sessions. These policies may further aid in patients’ blood glucose management, with hopes for continued expansion of support in the future. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the major cause of mortality in type 1 diabetes (T1D). The objective of this study is to evaluate fibroblast growth factor 23 (FGF23) and calcium‐phosphate metabolism in relation to cardiovascular risk factors in adults with and without T1D. Methods: A case–control study was conducted using data from patients with T1D and age‐ and sex matched controls without T1D from the Lifelines Cohort Study. Results: We included 302 adults in the T1D group and 302 adults in the control group. Median age was 42 years. Median glycosylated hemoglobin (HbA1c) in the T1D group was 7.8%. FGF23 of all patients with T1D was not significantly different from controls. Females with T1D had significantly higher FGF23 than males with T1D (83.3 vs 69.3 U/mL, p = 0.002), this was not observed in controls. Serum phosphate, calcium, and alkaline phosphatase were higher and parathyroid hormone was lower in patients with T1D, compared to controls (all p <.001), all within normal range. In the T1D group, FGF23 was positively correlated with serum phosphate (p <.001), alkaline phosphatase (p =.01), and calcium (p =.030), these correlations were not observed in controls. Median FGF23 was significantly higher in current smokers than in nonsmokers with T1D (84.9 vs 73.5 U/mL, p <.05). Conclusions: Serum calcium, phosphate, and alkaline phosphatase were higher in patients with T1D than in controls and were positively correlated to FGF23 in patients with T1D. Current smokers with T1D had higher FGF23 than nonsmokers with T1D. These findings may contribute to the increased risk of CVD in patients with T1D. [ABSTRACT FROM AUTHOR]

Ayurveda, an age-old medical tradition originating from India, provides a comprehensive method for addressing diabetes mellitus. Diabetes, marked by increased blood sugar levels, is a persistent metabolic condition posing a widespread health challenge worldwide. Ayurveda, drawing upon principles of balance and individualised treatment, addresses diabetes through a multifaceted lens. In Ayurveda, diabetes is classified under the term "Madhumeha," where an imbalance in the body's doshas (Vata, Pitta, and Kapha) disrupts the normal functioning of the pancreas and impairs insulin production. The approach to diabetes management in Ayurveda involves a personalised assessment of an individual's constitution (Prakriti) and the identification of imbalances (Vikriti). Lifestyle modifications, dietary changes, herbal supplements, and therapeutic practices like yoga and meditation are integral components of Ayurvedic interventions. Plants like bitter melon (Momordica charantia), fenugreek (Trigonella foenum-graecum), and turmeric (Curcuma longa) are essential components in Ayurvedic remedies designed to address diabetes. These herbs are believed to have hypoglycaemic properties, helping regulate blood sugar levels. Additionally, practices like Panchakarma, a detoxification process, are employed to eliminate toxins and restore balance in the body. Ayurveda emphasises the importance of maintaining a sattvic (balanced) lifestyle, incorporating mindful eating habits, regular exercise, and stress management. While Ayurvedic interventions for diabetes have shown promise, it is essential to consult qualified practitioners to ensure personalised and safe approaches. As the global burden of diabetes continues to rise, exploring complementary strategies like Ayurveda provides a holistic perspective on diabetes management that aligns with the principles of balance and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes increases the prevalence of urinary incontinence and may be responsible for additional changes to those existing in a regular gestational period. This study aimed to describe the presence and symptoms of urinary incontinence in pregnant women with type 1 diabetes. Methods: In this Cross-sectional case control study, forty pregnant women in third gestational trimester were allocated in two equal groups - control group (CG) and type 1 diabetic group (1DMG). The patients answered the International Consultation on Incontinence Questionnaire Short Form and, to characterize the sample, they answered the Pregnancy Physical Activity Questionnaire, gynecological history and, after delivery, the newborn weight was registered. The groups were compared using the Student's T Test for parametric variables and the U-Mann Whitney Test for non-parametric variables, both at 5% probability. Results: The International Consultation on Incontinence Questionnaire Short Form score (p = 0.026) is higher in 1DMG (3.95 ± 4.70) compared to CG (1.05 ± 2.23). No correlations were found between time of diagnosis, HbA1c and newborn weight in relation to ICIQ-SF and other variables in CG and 1DMG with ICIQ-SF (p < 0.05). Conclusion: Type 1 diabetes mellitus, in the third trimester of gestation, seem to be associated with increase in the ICIQ-SF score. [ABSTRACT FROM AUTHOR]

Background and Purpose: The Acceptance and Action Diabetes Questionnaire (AADQ) is a tool for assessing the acceptance of thoughts and emotions related to diabetes in people living with the disease. This study aimed to examine the psychometric properties of the Swedish version of AADQ (Swe-AADQ) in a sample of adults with type 1 diabetes. Methods: To examine the psychometric properties of the Swe-AADQ, the Rasch model was used. Data for 120 individuals were included. Results: The Swe-AADQ showed an acceptable fit to the Rasch model. A sufficiently high value of the separation index indicated a capacity to distinguish between different levels of acceptance in the sample. The 7-point Likert scale was reduced to three categories suggesting an improvement in the ordering of the item thresholds. Conclusions: The Swe-AADQ possesses reasonable quality in terms of reliability and validity. However, there are some deficiencies regarding the categorization of the response rating that should be addressed. [ABSTRACT FROM AUTHOR]

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Introduction and Objective. In recent years, awareness of the problem of vitamin D deficiency in the human body has been steadily increasing. There is a growing emphasis on investigating the effects of vitamin D supplementation both in the prevention of autoimmune diseases and in the course of existing diseases. The aim of this study is to highlight and discuss the role of vitamin D supplementation in selected autoimmune diseases. Review methods. The publication is a narrative review. The PubMed electronic database was used to review the literature. To ensure the highest substantive value, the focus was mainly on studies from the last 8 years, with only 6 studies published before 2016, concerning autoimmune diseases. Results. There are still lots of unknowns when it comes to physiology and the role that vitamin D plays in our body and deepening the knowledge of its functions would definitely help prevent many diseases concerning various systems such as musculoskeletal, immune and nervous systems. Wide range of studies have already proven that appropriate supplementation of vitamin D prevents complications and exacerbations of disorders like rheumatoid arthritis, Hashimoto’s thyroiditis, ulcerative colitis, type 1 diabetes and multiple sclerosis. Unfortunately there is no unambiguous evidence of noticeable improvement in the patients suffering from psoriasis after taking vitamin D. There is a huge need for developing guidelines which would establish specific supplementation protocols considering various factors since it is inexplicably difficult to obtain an optimal level of vitamin D in our body. Summary. The increasing prevalence of autoimmune diseases in the population, their coexistence with vitamin D deficiency, and the scientifically proven impact of this vitamin on the body imply the need for an in-depth analysis of the relationship between its supplementation and the prevention and modification of the course of autoimmune diseases.

The article analyzes exercise patterns among individuals with type 1 diabetes (T1D) using the Hedia Diabetes Assistant app. Topics discussed include the comparison of physical activity (PA) between users who utilized the app's PA module and those who did not, glucose management during exercise, and the implications of exercise patterns on insulin dosing strategies.

Abstract Background Mesenchymal stem cell infusion and vitamin D supplementation may have immunomodulatory actions that could prolong the preservation of residual insulin secretion in patients with type 1 diabetes (T1D). Intervention with these agents after onset of T1D could favor the development of a remission phase, with potential clinical impact. We aimed to compare the presence of clinical remission (CR), glycemic control and daily insulin requirement at 6, 12, 18, 24 and 36 months after the diagnosis of T1D using IDAA1c in patients who received therapy with adipose tissue-derived mesenchymal stem cell (ASC) infusion and vitamin D supplementation and a control group. Methods: This retrospective cohort study analyzed data from the medical records of patients with T1D diagnosed between 15 and 40 years. Partial CR was defined as an IDAA1c index

Background: The COVID-19 pandemic has been a global health problem with high morbidity and mortality. In this study, it was aimed to compare the clinical and laboratory findings of patients diagnosed with type 1 diabetes(T1D) during the pandemic and after the pandemic. Method: This is a 30-month, single-center, cross-sectional study. Between October 2020 and December 2021 was defined as the pandemic period, and between January 2022 and March 2023 as the post-pandemic period. The clinical and laboratory parameters of the newly diagnosed T1D patients who applied in these two time periods were compared. Results: While 87 patients were diagnosed during the pandemic period, 86 patients were diagnosed during the post-pandemic period. The rate of male patients diagnosed during the pandemic period was significantly higher (56%, 36%, respectively, p=0.007). Anti-islet Cell antibody (ICA) positivity was statistically significantly higher in those diagnosed during the pandemic period. (52.6%, 18.6%, respectively, p0.05).C peptide levels were significantly lower in those diagnosed during the pandemic period (0.39±0.4, 0.63±0.6, respectively, p=0.021). Admissions with severe acidosis were more common during the pandemic than those admitted after the pandemic (29.9%, 16.3%, respectively, p=0.151). Conclusions: The numbers of children with T1D newly diagnosed in a secondary health center were similar during and after the pandemic. In the pandemic period, admissions with autoantibody positivity, low C-peptide and severe acidosis were more common.

Background and Objective: Type 1 diabetes is considered one of the most common chronic diseases during childhood. Diagnosis and presence of chronic disease in the child create tension, worry, and problems for parents, particularly for the mother who is responsible for taking care of the child. The present study was conducted to determine the effectiveness of resilience training on the self-esteem of mothers of children with type 1 diabetes. Methods: This clinical trial was carried out on 60 mothers of children with type 1 diabetes referring to diabetes clinics in the cities of Gonbad-e-Kavus and Gorgan, Golestan province, during 2022-23. Mothers were selected by the convenience sampling method and using a random number table and were assigned to two 30-people control and intervention groups. The resilience training program was implemented for the intervention group in 5-people groups for nine 90-minute sessions during 2 months. The data collection tool consisted of a demographic questionnaire and the Coopersmith Self-Esteem Inventory (SEI) filled out in two pre-test and post-test phases. Scoring of poor, moderate, and strong self-esteem was carried out by obtaining scores of 26 and below, 27-43, and over 44. Results: The mean and standard deviation of the overall self-esteem (22.73±3.26), social (7.32±0.79), occupational/social (7±1.46), and general self-esteem (44.73±5.03) dimensions had a statistically significant increase in the post-test in mothers of the intervention group compared to those in the control group (P

Background: Mesenchymal stem cell infusion and vitamin D supplementation may have immunomodulatory actions that could prolong the preservation of residual insulin secretion in patients with type 1 diabetes (T1D). Intervention with these agents after onset of T1D could favor the development of a remission phase, with potential clinical impact. We aimed to compare the presence of clinical remission (CR), glycemic control and daily insulin requirement at 6, 12, 18, 24 and 36 months after the diagnosis of T1D using IDAA1c in patients who received therapy with adipose tissue-derived mesenchymal stem cell (ASC) infusion and vitamin D supplementation and a control group. Methods: This retrospective cohort study analyzed data from the medical records of patients with T1D diagnosed between 15 and 40 years. Partial CR was defined as an IDAA1c index < 9. Patients in the intervention group received an infusion of adipose tissued-derived mesenchymal stem cells (ASCs) within 3 months after diagnosis and supplementation with 2000 IU of cholecalciferol for 1 year, started on the day following the infusion. Partial CR was also determined using the ISPAD criteria, to assess its agreement with IDAA1c. Results: A total of 28 patients were evaluated: 7 in the intervention group (group 1) and 21 in the control group (group 2). All patients in group 1 evolved with partial CR while only 46.7% of patients in group 2 had this outcome. Group 1 had a higher frequency of CR when evaluated with IDAA1c and ISPAD criteria. The mean duration of CR varied between the two criteria. Although HbA1c was similar between groups during follow-up, group 1 had a lower total daily insulin requirement (p < 0.005) at all time points. At 36 months, group 1 used 49% of the total daily insulin dose used by group 2 with similar glycemic control. Conclusion: The intervention with infusion of ASC + vitamin D supplementation was associated with partial CR at 6 months. Although there were no differences in CR established by the IDAA1c and ISPAD criteria after three years of follow-up, patients who underwent intervention had nearly the half insulin requirement of controls with conventional treatment, with similar glycemic control. Trial Registration: 37001514.0.0000.5257. [ABSTRACT FROM AUTHOR]

Aims: To find clinical and immunological signatures of the SARS‐CoV‐2 and the COVID‐19 pandemic on children newly diagnosed with type 1 diabetes (T1D). Methods: A single‐centre, retrospective, observational study comparing the clinical and immunological characteristics of children diagnosed with T1D the year before and during the first 2 years of the COVID‐19 pandemic. Data extracted from the medical records included clinical and demographic parameters, COVID‐19 PCR results and the presence of anti‐islet, thyroid and celiac‐related antibodies. Also obtained from the medical records was a family history of T1D, celiac disease and autoimmune thyroid disease in a first‐degree family member. Results: A total of 376 children were diagnosed with T1D during the study period. A total of 132 in the pre‐COVID era and 246 in the first 2 years of the pandemic. At diagnosis, the pH in children with DKA was lower, and HbA1c tended to be higher in the COVID‐19 group compared to the pre‐COVID‐19 group (7.30 [7.18, 7.35] vs 7.33 [7.19, 7.36], p = 0.046) and (110.9 [86.9, 129.5] vs 100 [80.3, 129.5], p = 0.067]) respectively. Multiple islet antibodies (IA) were significantly more common among patients in the pre‐COVID‐19 group compared to the COVID‐19 group (72% vs 61%, p = 0.032). Tissue transglutaminase antibodies were more common among children diagnosed in the COVID‐19 compared to the pre‐COVID group (16.6% vs 7.9%, p = 0.022). Conclusions: Our findings suggest that SARS‐CoV‐2 and the environmental alterations caused by the pandemic affected the clinical characteristics and the immunological profile of children diagnosed with T1D. It is, therefore, plausible that the virus plays a role in the autoimmune process causing T1D. [ABSTRACT FROM AUTHOR]

Type 1 diabetes influences adolescents' health status and therapeutic management. Adaptation for adolescents with type 1 diabetes is considered a significant issue for this cohort group and is based on many factors, including availability of resources, and family and community support. Thus, this study aimed to explore Palestinian adolescents' experiences of adaptation to type 1 diabetes in the West Bank. A qualitative grounded theory approach was adopted. The purposive sample consisted of fourteen adolescents aged from 12 to 18 years and diagnosed with type 1 diabetes. The data were collected using semi-structured and face-to-face individual interviews during the period from March to June 2023. A constant comparative method was used to analyze data. The core category had emerged with categories and subcategories. There were three categories and ten subcategories including difficulties in the management of type 1 diabetes, for example, "insulin injections, dietary management, and control of HbA1c levels", burdens of type1 diabetes, for example, "burden regarding follow-up treatment, the burden of interaction and communication, emotional burden, and economic burden", and fears and worries of unexpected future life, for example, "worries about disease complications, worries regarding social relationships, and worries about marriage and parenthood". Adolescents diagnosed with type 1 diabetes suffer from difficult experiences influencing their adaptation to this disease. Counseling programs concerning self-care management for those adolescents need to be developed in addition to support programs. Health education programs are needed to develop their adaptation and coping skills to these experiences. • The adolescents reported the experience of difficulties in the management of type 1 diabetes. • The adolescents stated the experience of burdens of type 1 diabetes (follow-up treatment, interaction and communication, emotional, and economic). • Fears and worries about the unexpected future life were another experience. • The adolescents had maladaptive experiences with type 1 diabetes. • Counseling and support programs should be developed to enhance adaptation. [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]

Aim: To exploit a relatively homogeneous national health care context and a national diabetes database to address the questions: Is there an optimal clinic/centre size in determining outcomes?; and Can improvement in median centre outcomes be driven by reducing variability in outcome? Methods: Using the Australasian Diabetes Database Network, data from seven tertiary hospital paediatric diabetes clinics for patients with type one diabetes from Australia were recorded from 6‐month uploads: September 2017, March 2018, September 2018 and March 2019. Data from 25 244 patient visits included demographic variables, HbA1C, number of patient visits and insulin regimens. Results: There was no association between centre size and median HbA1C. On the other hand, there was a significant association between or median absolute deviation of HbA1C outcomes and the median HbA1C result between centres. On average every two thirds of a median absolute deviation increase in clinic HbA1C was associated with a 1.0% (10.9 mmol/mol) increase in median clinic HbA1C. Conclusions: Our data have shown that it is likely difficult for centres to have a low median HbA1C if there is high variance of HbA1C's within centres or within centre treatment groups. This appears to be true regardless of centre size. These findings need to be carefully considered by teams who wish to lower their clinic median HbA1C. [ABSTRACT FROM AUTHOR]

Background and Objective: Type 1 diabetes is considered one of the most common chronic diseases during childhood. Diagnosis and presence of chronic disease in the child create tension, worry, and problems for parents, particularly for the mother who is responsible for taking care of the child. The present study was conducted to determine the effectiveness of resilience training on the self-esteem of mothers of children with type 1 diabetes. Methods: This clinical trial was carried out on 60 mothers of children with type 1 diabetes referring to diabetes clinics in the cities of Gonbad-e-Kavus and Gorgan, Golestan province, during 2022-23. Mothers were selected by the convenience sampling method and using a random number table and were assigned to two 30-people control and intervention groups. The resilience training program was implemented for the intervention group in 5-people groups for nine 90-minute sessions during 2 months. The data collection tool consisted of a demographic questionnaire and the Coopersmith Self-Esteem Inventory (SEI) filled out in two pre-test and post-test phases. Scoring of poor, moderate, and strong self-esteem was carried out by obtaining scores of 26 and below, 27-43, and over 44. Results: The mean and standard deviation of the overall self-esteem (22.73±3.26), social (7.32±0.79), occupational/social (7±1.46), and general self-esteem (44.73±5.03) dimensions had a statistically significant increase in the post-test in mothers of the intervention group compared to those in the control group (P<0.05). The mean and standard deviation of the selfesteem scores of mothers in the intervention group were evaluated as moderate at the onset of the study and strong at the post-test (P<0.05). Conclusion: Resilience training culminated in increasing the self-esteem of mothers of children with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been a global health problem with high morbidity and mortality. In this study, it was aimed to compare the clinical and laboratory findings of patients diagnosed with type 1 diabetes mellitus (T1D) during the pandemic and after the pandemic. Method: This is a 30-month-single-center, cross-sectional study. The time between October 2020 and December 2021 was defined as the pandemic period, and between January 2022 and March 2023 as the post-pandemic period. During these periods, clinical and laboratory parameters of pediatric patients diagnosed with T1D were compared at the time of admission. Results: While 87 patients were diagnosed during the pandemic period, 86 patients were diagnosed during the post-pandemic period. The rate of male patients diagnosed during the pandemic period was significantly higher (56%, 36%, respectively, p=0.007). Anti-islet Cell antibody (ICA) positivity was statistically significantly higher in those diagnosed during the pandemic period. (52.6%, 18.6%, respectively, p<0.001). There was no difference between the groups in terms of hemoglobin A1C, thyroid autoantibodies and tissue transglutaminase antibodies (p>0.05). C peptide levels were significantly lower in those diagnosed during the pandemic period (0.39±0.4, 0.63±0.6, respectively, p=0.021). Admissions with severe acidosis were more common during the pandemic than those admitted after the pandemic (29.9%, 16.3%, respectively, p=0.151). Conclusion: The numbers of children with T1D newly diagnosed in a secondary health center were similar during and after the pandemic. In the pandemic period, admissions with autoantibody positivity, low C-peptide and severe acidosis were more common. [ABSTRACT FROM AUTHOR]

Objective: To validate the Inventory of Teachers' Negative Attitudes towards the Care of Students with Diabetes Mellitus type 1 (INAPAD) and to study its reliability using Cronbach's Alpha and McDonald's Omega coefficients. Methods: This study describes the design and validation process of the INAPAD nursing scale in a sample of 382 teachers in the stages of Early Childhood Education, Primary Education, Compulsory Secondary Education, Baccalaureate and Vocational Training in a Spanish province. In order to validate the INAPAD, its reliability has been studied using Cronbach's Alpha and McDonald's Omega Coefficients. Hence, the construct validity has been evaluated through exploratory factor analysis by principal components and varimax rotation. Results and conclusion: The findings obtained inform the viability of the INAPAD to be used as an effective instrument for the diagnosis of prejudice or predisposition of educators towards the care of learners with type 1 DM and for the prediction of the success of psycho-pedagogical measures and of the care for children and adolescents with diabetes. [ABSTRACT FROM AUTHOR]

(1) Background. Diabetes mellitus (DM), called the first non-infectious epidemic of the modern era, has long-term health consequences leading to a reduced quality of life, long-term disabilities, and high mortality. Diabetic retinopathy (DR) is a neurovascular complication of diabetes and accounts for about 80% cases of vision loss in the diabetic population. The adaptive optics (AO) technique allows for a non-invasive in vivo assessment of retinal cones. Changes in number or morphology of retinal cones may be one of the first indicators of DR. (2) Methods. This study included 68 DM1 patients (17 women) aged 42.11 ± 9.69 years with a mean duration of diabetes of 22.07 ± 10.28 years, and 41 healthy volunteers (20 women) aged 41.02 ± 9.84 years. Blood pressure, BMI, waist circumference, and metabolic control measures were analysed. Cones' morphological parameters were examined with a retinal camera with Imagine Eyes adaptive optics (rtx1). Statistical analysis was carried out with IMB SPSS version 23 software. (3) Results. Neither study group differed significantly in age, BMI, blood pressure, or eyeball length. Intraocular pressure (IOP) was statistically significantly higher in DM1 patients but remained within physiological range in both groups. Analysis of cone parameters showed a statistically significant lower mean regularity of cones (Rmean) in the DM1 group compared to control group (p = 0.01), with the lowest value in the group with DM1 and hypertension (p = 0.014). In addition, DM1 patients tended to have fewer cones. (4) Conclusions. Our study revealed abnormalities in cone and vessel parameters and these abnormalities should be considered as risk factors for the development of DR. Complementing an eye examination with AO facilitates non-invasive in vivo cellular imaging of the retina. Lesions like those detected in the eye may occur in the brain and certainly require further investigation. [ABSTRACT FROM AUTHOR]

Background: Pregnant women with type 1 diabetes mellitus (T1DM) face an elevated risk of complications for both themselves and their newborns. Experts recommend strict glycemic control. The advanced hybrid closed-loop (AHCL) system, though not officially approved for pregnant T1DM patients, is promising for optimal glycemic control. Methods: We collected CGM metrics, HbA1c levels, insulin pump settings, and doses from a 33-year-old pregnant woman with 23-year history of T1DM from the 6th week of gestation to birth. She was initially on continuous insulin pump therapy with CGM and switched to the AHCL system (MiniMedTM 780G, Medtronic, Northridge, CA, USA) between weeks 13 and 14. Results: The AHCL system improved glycemic control from weeks 14 to 26, achieving international guidelines with TIR = 72%, TAR = 24%, TBR = 4%. At week 30, TIR was 66%, TAR 31%. By altering diet and adding 'fake carbohydrates', she maintained TIR ≥ 70%, TBR ≤ 4%, TAR ≤ 26% from week 34 to birth. A healthy 4 kg, 53 cm baby boy was born at week 38. Conclusions: The use of the AHCL system holds significant promise for improving glycemic control in pregnancy. Optimal glycemic control with MiniMedTM 780G in pregnancy requires accurate carbohydrate counting, specific timing of insulin doses in relation to meal consumption and dietary choices that reduce the glycemic load of meals continue to be crucial factors in achieving optimal glycemic control during pregnancy using the MiniMedTM 780G system. Further research and clinical studies are needed to explore the full potential of these advanced systems in managing T1DM during pregnancy and optimizing maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Aim: The metabolic and psychological management of paediatric type 1 diabetes mellitus (T1DM) can be challenging over time given that T1DM may cause a negative emotional burden and, consequently, result in poor metabolic control of the disease. The objectives of this study are to translate the Problem Area in Diabetes Survey–Pediatric version (PAID‐Peds) into Spanish, adapt it culturally and validate it. Design: Multicenter cross sectional study. Methods: 636 patients aged 8–17 years, diagnosed with T1DM, under treatment with insulin and follow‐up at the Miguel Servet University Hospital in Zaragoza (Aragón, Spain), the Ramón y Cajal University Clinical Hospital in Madrid (Spain) and at the Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain) between 1 January 2023 and 31 December 2024 will be included. This study will consist of two phases: (1) Translation and cultural adaptation of the original PAID‐Peds® survey into Spanish following eight steps; (2) Validation of the Spanish version of the PAIS‐Peds® survey. The statistical analysis will be performed using Jamovi® 2.1.23. The reliability or internal consistency will be calculated using Cronbach's alpha index (considering an index higher than 0.8 to be good) and the test–retest will be evaluated using the intraclass correlation coefficient. For validity, confirmatory factor analysis will be calculated. This study has been approved by the ethics and research committees at each centre. Results: The translation and validation into Spanish language of the Problem Area in Diabetes Survey‐Pediatric version will be feasible, valid and reliable to detecting the youth‐perceived burden of T1DM. Therapeutic education in diabetes—recommended by the WHO and the Diabetes Education Study Group—has shown encouraging results in glycaemia and psychosocial and behavioural factors in T1DM. [ABSTRACT FROM AUTHOR]

Background: The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2–5 years old. Methods: This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. Results: Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). Conclusions: A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2–5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives. [ABSTRACT FROM AUTHOR]

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition characterized by the destruction of insulin-producing beta cells in the pancreas, necessitating lifelong insulin therapy. This study explores the impact of physical activity on glycemic control and overall health in individuals with T1DM. Despite its proven benefits, including improved cardiovascular health, lower HbA1c levels, and reduced insulin requirements, over 60% of T1DM patients do not engage in regular exercise. Different types of physical activities—such as aerobic, anaerobic, and high-intensity interval training (HIIT)—affect metabolic responses differently. Aerobic exercises and HIIT have shown significant improvements in health-related quality of life (HRQoL) and reduced incidence of severe complications, such as diabetic ketoacidosis. However, exercise-induced hypoglycemia remains a significant risk, especially if exercise follows recent severe hypoglycemic episodes. Proper management strategies include adjusting insulin doses, monitoring glucose levels, and carbohydrate intake. The study highlights the importance of tailored exercise plans and preventive measures to mitigate risks such as nocturnal hypoglycemia and elevated ketones. Ultimately, effective integration of physical activity into diabetes management can lead to enhanced overall health and quality of life for individuals with T1DM.

Introduction and aim of the study: The growing awareness of gluten-related disorders has led to widespread misinformation about the gluten-free diet(GFD). The potential benefits of removing gluten are not well evaluated, yet it is often recommended or self-implemented by patients without robust supporting evidence. This paper aims to determine whether eliminating gluten from the diet provides proven benefits for individuals with specific diseases, including autoimmune thyroiditis (AIT), type 1 diabetes (T1D), psoriasis, and metabolic syndrome, who do not have a diagnosed gluten-related disorder. Description of the state of knowledge: Adhering to a gluten-free diet may benefit patients with AIT and T1D even without celiac disease, although there is no clear evidence that it alleviates AIT or T1D symptoms and the improvements are not significant enough to recommend it universally. Further research on humans is needed to explore the potential preventive effect of GFD on T1D risk and prolonging partial remission. For psoriasis, a GFD can be beneficial for patients with gluten-related antibodies, potentially reducing or clearing skin lesions, but it shows no benefit for those without these antibodies. The data on the GFD's impact on cardiovascular disease remains contradictory and unreliable. Conclusion: For psoriasis patients who test positive for gluten-related antibodies, a gluten-free diet can be recommended. Current studies do not substantiate the necessity for patients with AIT, T1D or metabolic syndrome to completely eliminate gluten from their diet.

Abstract Background Cardiovascular disease (CVD) is the major cause of mortality in type 1 diabetes (T1D). The objective of this study is to evaluate fibroblast growth factor 23 (FGF23) and calcium‐phosphate metabolism in relation to cardiovascular risk factors in adults with and without T1D. Methods A case–control study was conducted using data from patients with T1D and age‐ and sex matched controls without T1D from the Lifelines Cohort Study. Results We included 302 adults in the T1D group and 302 adults in the control group. Median age was 42 years. Median glycosylated hemoglobin (HbA1c) in the T1D group was 7.8%. FGF23 of all patients with T1D was not significantly different from controls. Females with T1D had significantly higher FGF23 than males with T1D (83.3 vs 69.3 U/mL, p = 0.002), this was not observed in controls. Serum phosphate, calcium, and alkaline phosphatase were higher and parathyroid hormone was lower in patients with T1D, compared to controls (all p

BackgroundType 1 diabetes mellitus (T1DM) is frequently associated with various infections, including mycoses; however, the direct link between T1DM and fungal infections remains under-researched. This study utilizes a Mendelian randomization (MR) approach to investigate the potential causal relationship between T1DM and mycoses.MethodsGenetic variants associated with T1DM were sourced from the European Bioinformatics Institute database, while those related to fungal infections such as candidiasis, pneumocystosis, and aspergillosis were obtained from the Finngen database, focusing on European populations. The primary analysis was conducted using the inverse variance weighted (IVW) method, with additional insight from Mendelian randomization Egger regression (MR-Egger). Extensive sensitivity analyses assessed the robustness, diversity, and potential horizontal pleiotropy of our findings. Multivariable Mendelian randomization (MVMR) was employed to adjust for confounders, using both MVMR-IVW and MVMR-Egger to evaluate heterogeneity and pleiotropy.ResultsGenetically, the odds of developing candidiasis increased by 5% in individuals with T1DM, as determined by the IVW method (OR = 1.05; 95% CI 1.02–1.07, p = 0.0001), with a Bonferroni-adjusted p-value of 0.008. Sensitivity analyses indicated no significant issues with heterogeneity or pleiotropy. Adjustments for confounders such as body mass index, glycated hemoglobin levels, and white blood cell counts further supported these findings (OR = 1.08; 95% CI:1.03–1.13, p = 0.0006). Additional adjustments for immune cell counts, including CD4 and CD8 T cells and natural killer cells, also demonstrated significant results (OR = 1.04; 95% CI: 1.02–1.06, p = 0.0002). No causal associations were found between T1DM and other fungal infections like aspergillosis or pneumocystosis.ConclusionThis MR study suggests a genetic predisposition for increased susceptibility to candidiasis in individuals with T1DM. However, no causal links were established between T1DM and other mycoses, including aspergillosis and pneumocystosis.

Ayurveda, an age-old medical tradition originating from India, provides a comprehensive method for addressing diabetes mellitus. Diabetes, marked by increased blood sugar levels, is a persistent metabolic condition posing a widespread health challenge worldwide. Ayurveda, drawing upon principles of balance and individualised treatment, addresses diabetes through a multifaceted lens. In Ayurveda, diabetes is classified under the term “Madhumeha,” where an imbalance in the body’s doshas (Vata, Pitta, and Kapha) disrupts the normal functioning of the pancreas and impairs insulin production. The approach to diabetes management in Ayurveda involves a personalised assessment of an individual’s constitution (Prakriti) and the identification of imbalances (Vikriti). Lifestyle modifications, dietary changes, herbal supplements, and therapeutic practices like yoga and meditation are integral components of Ayurvedic interventions. Plants like bitter melon (Momordica charantia), fenugreek (Trigonella foenum-graecum), and turmeric (Curcuma longa) are essential components in Ayurvedic remedies designed to address diabetes. These herbs are believed to have hypoglycaemic properties, helping regulate blood sugar levels. Additionally, practices like Panchakarma, a detoxification process, are employed to eliminate toxins and restore balance in the body. Ayurveda emphasises the importance of maintaining a sattvic (balanced) lifestyle, incorporating mindful eating habits, regular exercise, and stress management. While Ayurvedic interventions for diabetes have shown promise, it is essential to consult qualified practitioners to ensure personalised and safe approaches. As the global burden of diabetes continues to rise, exploring complementary strategies like Ayurveda provides a holistic perspective on diabetes management that aligns with the principles of balance and wellbeing.

The impact of diabetes on various organs failure including testis has been highlighted during the last decades. If on one hand diabetes-induced hyperglycemia has a key role in induced damages; on the other hand, glucose deprivation plays a key role in inducing male infertility. Indeed, glucose metabolism during spermatogenesis has been highlighted due to post-meiotic germ cells drastic dependence on glucose-derived metabolites, especially lactate. In fact, hyperglycemia-induced spermatogenesis arrest has been demonstrated in various studies. Moreover, various sperm maturation processes related to sperm function such as motility are directly depending on glucose metabolism in Sertoli cells. It has been demonstrated that diabetes-induced hyperglycemia adversely impacts sperm morphology, motility and DNA integrity, leading to infertility. However, fertility quality is another important factor to be considered. Diabetes-induced hyperglycemia is not only impacting sperm functions, but also affecting sperm epigenome. DNA packing process and epigenetics modifications occur during spermatogenesis process, determining next generation genetic quality transmitted through sperm. Critical damages may occur due to under- or downregulation of key proteins during spermatogenesis. Consequently, unpacked DNA is more exposed to oxidative stress, leading to intensive DNA damages. Moreover, epigenetic dysregulation occurred during spermatogenesis may impact embryo quality and be transmitted to next generations, increasing offspring genetic issues. Herein we discuss the mechanisms by which diabetes-induced hyperglycemia can affect epigenetic modifications and DNA packaging and methylation during spermatogenesis thus promoting long-lasting effects to the next generation.

Purpose: The psychosocial aspects of type 1 diabetes mellitus (T1DM) are still a neglected area, especially among children in India. This study was planned to evaluate and screen the children with T1DM for family support, symptoms of anxiety and depression, and to assess the role of these psychosocial aspects in glycemic control. Methods: This cross-sectional observational questionnaire-based study conducted over a year included 70 children aged 8–18 years diagnosed with T1DM for at least a year. The child and caregiver answered pre-validated standard questionnaires and the children underwent HbA1C testing once every 3 months. The methods used for inferential statistical analysis were reliability analysis, correlation analysis, χ2 test, and factor analysis. Results: Poorer glycemic control was noted by children raised by single parents (mean HbA1C 14.4, p < 0.001). It was also noted that children whose mothers had formal education beyond 10th standard had better glycemic control. 14 children (20%) had anxiety/depression of medium to high severity. The relationship between family conflict and glycemic control was not significant in either the parent or the child scoring. Conclusion: Children with T1DM experience considerable stress related to the diagnosis and management. Many families experience significant depression and anxiety which leads to increase in family conflicts which have a negative effect on parenting, the child’s quality of life, and their glycemic control.

INTRODUCTION: The aim of the present study was to investigate islet autoimmunity and susceptibility to type 1 diabetes (T1D) in children/ adolescents with autoimmune thyroid disease (AITD, and in family members of AITD patients with islet autoimmunity. METHODS: Islet-cell cytoplasmic, glutamic-acid decarboxylase, and tyrosine-phosphatase autoantibodies (AAbs) were measured in 161 AITD patients [127 with autoimmune thyroiditis (AT); 34 with Graves’ disease (GD)], 20 family members of AITD patients with islet autoimmunity, and 155 age-matched controls. RESULTS: Islet autoimmunity was found in 10.6% of AITD patients, significantly more frequent than in controls (1.9%; p=0.002). A higher prevalence of islet AAbs was found in females with AITD (p=0.011) but not in males (p=0.16) and in AT (p=0.013) but not in GD patients (p=0.19), compared to corresponding controls. Two or three islet AAbs were found concurrently in six AITD patients with islet autoimmunity. They all developed T1D and had significantly higher islet AAbs titers (p=0.01) than AITD patients with single islet AAbs but normal glucose metabolism. T1D was found in 3.7% of AITD patients compared to 0.2% of the age-matched, general Croatian population. Islet AAbs were found in 5/20 family members of AITD patients with islet autoimmunity, among whom two developed T1D. None of the controls was positive for more than one islet AAb or developed T1D. DISCUSSION AND CONCLUSION: Children/adolescents with AITD, particularly females and patients with AT, appear to represent a risk group for islet autoimmunity and T1D, as do family members of AITD patients with positive islet AAbs. However, these findings should be validated in larger studies.

Adolescence remains a crucial age associated with diabetes distress in individuals living with type 1 diabetes (T1D). The Austrian organization “Diabär” regularly hosts a one-week adventure camp for adolescents (12–18 years) living with T1D. The camp focuses on “fun activities” without a structured educational protocol in order to minimize diabetes distress and increase diabetes management skills. In contrast to educational camps, training is kept to a minimum. However, attendees analyze the glycemic data of the previous day with their medical supervisor once daily during the camp. All subjects used a standardized real-time continuous glucose monitoring (CGM) system (DexcomG7) throughout the whole study. Glycemic metrics were prospectively analyzed during three periods: week 1 = home phase, week 2 = adventure camp, and week 3 = after the camp. Safety (time below range 1 [TBR1], 69–54 mg/dL, and time below range 2 [TBR2], p = 0.001). The TBR1 significantly increased during camp compared to week 1 (2.5 ±1.7% vs. 1.3 ± 1.2%; p = 0.009), whereas the TBR2 did not differ. No serious adverse events occurred. This adventure camp without a main focus on education showed feasibility and safety in adolescents with T1D.

Aim To determine the influencing factors of health-related quality-of-life (HRQoL) perceived by North-African children/adolescents with type-1 diabetes-mellitus (T1DM) and their parents. Methods It was a cross sectional study conducted in Tunisia. A total of 116 patients ( ie ; 43 children and 73 adolescents) and their parents were included. The Arabic validated version of the Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) was used to evaluate the HRQoL of children/adolescents as perceived by patients and parents. The dependent data were the patients’ self-report and the parents’ proxy-report of the PedsQL4.0 total scores, and the independent data were the patients and parents characteristics. Results Patients’ PedsQL4.0 total score was influenced significantly by siblings in the family > 2; lipodystrophy, and glycosylated hemoglobin (HbA1C). The combination of these factors explained 34.84% of the PedsQL4.0 total score variability. Parents’ PedsQL4.0 total score was influenced significantly by lipodystrophy, siblings; body mass index (BMI), hypoglycemia episodes, and HbA1C. The combination of these factors explained 56.92% of the PedsQL4.0 total score variability. Conclusion T1DM patients self-reported HRQoL was influenced by siblings in the family > 2; lipodystrophy, and HbA1C. The parents’ proxy-report HRQoL was influenced by lipodystrophy, siblings, BMI, hypoglycemia episodes, and HbA1C.

Diabetes mellitus is a devastating chronic metabolic disease. Since the majority of type 2 diabetes mellitus patients are overweight or obese, a novel term—diabesity—has emerged. The gut–brain axis plays a critical function in maintaining glucose and energy homeostasis and involves a variety of peptides. Amylin is a neuroendocrine anorexigenic polypeptide hormone, which is co-secreted with insulin from β-cells of the pancreas in response to food consumption. Aside from its effect on glucose homeostasis, amylin inhibits homeostatic and hedonic feeding, induces satiety, and decreases body weight. In this narrative review, we summarized the current evidence and ongoing studies on the mechanism of action, clinical pharmacology, and applications of amylin and its analogs, pramlintide and cagrilintide, in the field of diabetology, endocrinology, and metabolism disorders, such as obesity. [ABSTRACT FROM AUTHOR]

The impact of diabetes on various organs failure including testis has been highlighted during the last decades. If on one hand diabetes-induced hyperglycemia has a key role in induced damages; on the other hand, glucose deprivation plays a key role in inducing male infertility. Indeed, glucose metabolism during spermatogenesis has been highlighted due to post-meiotic germ cells drastic dependence on glucose-derived metabolites, especially lactate. In fact, hyperglycemia-induced spermatogenesis arrest has been demonstrated in various studies. Moreover, various sperm maturation processes related to sperm function such as motility are directly depending on glucose metabolism in Sertoli cells. It has been demonstrated that diabetes-induced hyperglycemia adversely impacts sperm morphology, motility and DNA integrity, leading to infertility. However, fertility quality is another important factor to be considered. Diabetes-induced hyperglycemia is not only impacting sperm functions, but also affecting sperm epigenome. DNA packing process and epigenetics modifications occur during spermatogenesis process, determining next generation genetic quality transmitted through sperm. Critical damages may occur due to under- or downregulation of key proteins during spermatogenesis. Consequently, unpacked DNA is more exposed to oxidative stress, leading to intensive DNA damages. Moreover, epigenetic dysregulation occurred during spermatogenesis may impact embryo quality and be transmitted to next generations, increasing offspring genetic issues. Herein we discuss the mechanisms by which diabetes-induced hyperglycemia can affect epigenetic modifications and DNA packaging and methylation during spermatogenesis thus promoting longlasting effects to the next generation. [ABSTRACT FROM AUTHOR]