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Background: Celiac disease (CD) affects the small intestine and can hinder nutrient absorption. It is found worldwide and common in certain groups of people including individuals with Type 1 Diabetes Mellitus (T1DM). However, the prevalence of CD in the West African region is not documented. This study aimed to investigate the prevalence and pattern of CD autoimmunity in Nigerian children and adolescents diagnosed with T1DM. Methods: This was a cross-sectional descriptive study of children and adolescents with T1DM at the Paediatric Endocrinology Clinic of seven selected tertiary health facilities in Nigeria. Information was collected on socio-demographics, clinical characteristics and anthropometrics. The subjects were screened for markers of CD autoimmunity using anti-tissue transglutaminase antibody (tTG) and anti-endomysial antibody (EMA). Endoscopy and duodenal biopsy were recommended for participants with elevated CD-specific antibodies. Results: The study recruited a total of 104 children and adolescents with TIDM, out of which six participants (5.8%) had CD autoimmunity. All six participants were females, aged between 3 and 12 years, with a mean age of 9.2 ± 3.7 years. Participants with CD autoimmunity were more likely to have DM diagnosed before the age of 10 years compared to those without CD autoimmunity (83.3% vs. 37.7%, p = 0.149). Except for two participants, all individuals with CD autoimmunity experienced gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and bloating. Conclusion: This study highlights the occurrence of CD autoimmunity in Nigerian children and adolescents with TIDM. Healthcare providers should consider screening for celiac disease in children and adolescents with T1DM, particularly in females and when gastrointestinal symptoms are present. Additionally, the findings from this study suggest that there is a high probability of a significant burden of CD, even within the general population in Nigeria. Therefore, it's important to maintain a high level of suspicion and to actively screen at-risk groups in clinical settings to ensure early diagnosis of CD. [ABSTRACT FROM AUTHOR]

Abstract Background Celiac disease (CD) affects the small intestine and can hinder nutrient absorption. It is found worldwide and common in certain groups of people including individuals with Type 1 Diabetes Mellitus (T1DM). However, the prevalence of CD in the West African region is not documented. This study aimed to investigate the prevalence and pattern of CD autoimmunity in Nigerian children and adolescents diagnosed with T1DM. Methods This was a cross-sectional descriptive study of children and adolescents with T1DM at the Paediatric Endocrinology Clinic of seven selected tertiary health facilities in Nigeria. Information was collected on socio-demographics, clinical characteristics and anthropometrics. The subjects were screened for markers of CD autoimmunity using anti-tissue transglutaminase antibody (tTG) and anti-endomysial antibody (EMA). Endoscopy and duodenal biopsy were recommended for participants with elevated CD-specific antibodies. Results The study recruited a total of 104 children and adolescents with TIDM, out of which six participants (5.8%) had CD autoimmunity. All six participants were females, aged between 3 and 12 years, with a mean age of 9.2 ± 3.7 years. Participants with CD autoimmunity were more likely to have DM diagnosed before the age of 10 years compared to those without CD autoimmunity (83.3% vs. 37.7%, p = 0.149). Except for two participants, all individuals with CD autoimmunity experienced gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and bloating. Conclusion This study highlights the occurrence of CD autoimmunity in Nigerian children and adolescents with TIDM. Healthcare providers should consider screening for celiac disease in children and adolescents with T1DM, particularly in females and when gastrointestinal symptoms are present. Additionally, the findings from this study suggest that there is a high probability of a significant burden of CD, even within the general population in Nigeria. Therefore, it’s important to maintain a high level of suspicion and to actively screen at-risk groups in clinical settings to ensure early diagnosis of CD.

The creation of a cell-engineered pancreatic construct (CEPC) from islets of Langerhans and biocompatible matrix carrier (framework/scaffold), which imitates the native microenvironment of pancreatic tissue, is an approach to the treatment of type I diabetes mellitus (T1D).The objective of this work is to conduct a comparative analysis of the functional efficacy of CEPC and isolated rat islets of Langerhans after intraperitoneal administration into rats with experimental T1D.Materials and method. T1D was induced in rats by injecting low-dose (15 mg/ kg) streptozotocin (STZ) for 5 days. CEPC samples were created using viable and functional allogeneic isolated islets of Langerhans and tissue-specific scaffold obtained by decellularization of human pancreatic fragments. The rats received intraperitoneal injection of allogeneic islets of Langerhans (experimental group 1, n = 4) and CEPC (experimental group 2, n = 4). Control group rats received no treatment (n = 4). Blood glucose levels in the rats were measured, and the pancreas and kidneys of the experimental animals were examined histologically. The follow-up period for all animals continued for 10 weeks. Results. In experimental group 1, on day 7 after injection of Langerhans islets, glycemia decreased significantly from 28.2 ± 4.2 mmol/L to 13.4 ± 2.6 mmol/L. This fall persisted for 7 weeks, following which blood sugar increased to nearly their initial levels (prior to islets administration). In experimental group 2, on day 7 after CEPC administration, there was a more noticeable drop in blood sugar levels from 25.8 ± 5.1 mmol/L to 6.3 ± 2.7 mmol/L compared to experimental group 1. By the 10th week of the experiment, the average glucose level was two times lower than it was at the beginning. Blood glucose levels dropped more sharply in the CEPC group than in the islet group (by 75.6% and 52.5%, respectively).Conclusion. In T1D rats, CEPC has a more potent antidiabetic effect than islets of Langerhans. Thus, it has been shown that a tissue-specific scaffold may be used to create bioartificial pancreas in order to increase the functional efficiency of islets.

Type I diabetes mellitus (type I DM) is a serious disease, also known as insulin-dependent diabetes. There are two main approaches to treating type I DM patients: treatment with insulin pens and two types of insulin (ultrashort/short and prolonged/basal/long insulin), and treatment with insulin pump therapy and ultrashort insulin. It is still a challenge to develop a system for calculating insulin doses for treating type I DM using insulin pens. This work addresses the problem of determining the correctness of insulin doses based on historical data. Various means of artificial intelligence (decision trees, gradient boosting, support vectors, and different neural network architectures) are proposed to solve the problem, and a comparative analysis is performed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the therapeutic effects of feeding quercetin on streptozocin-induced type 1 diabetic rats and the associated metabolic pathway changes. Methods: Type 1 diabetic rat models were established by intraperitoneal injection of streptozotocin at a dose of 60 mg/kg. Rats were randomly divided into the model (T1DM) group, quercetin low-dose treatment (T1DM+QUE(25)) group, and quercetin high-dose treatment (T1DM+QUE(50)) group. The treatment groups were given quercetin at the corresponding concentrations (mg/kg), while the normal control group (Normal) and the T1DM group were given an equivalent volume of blank solvent. After 8 weeks of continuous feeding, plasma samples were collected for the detection of acetoacetic acid, glycosylated hemoglobin, alanine aminotransferase, and blood lipids. Muscle tissue samples were collected to measure glycogen synthase levels. Plasma metabolomics analysis was performed using LC-MS/MS. Results: Compared with that in the T1DM group, acetoacetic acid, aspartate aminotransferase in plasma in the T1DM+QUE (50) group decrease (P<0.05), while total antioxidant capacity levels in lipoprotein lipase increased (P<0.05)，and their levels were closer to Normal group than T1DM group. The levels of glycosylated hemoglobin, alanine aminotransferase, low-density lipoprotein and total cholesterol were also improved, but not significantly. The expression of glycogen synthase protein in muscle was also significantly improved (P<0.05). Metabolomics analysis results showed that quercetin feeding mainly interfered with sphingolipid metabolism and synthesis, steroid hormone biosynthesis, retinol metabolism, arachidonic acid metabolism and other metabolic pathways. Conclusion: Feeding quercetin can improve lipid and cholesterol metabolism in type 1 diabetic rats, alleviate liver damage, and achieve certain therapeutic effects by influencing lipid metabolism and modulating inflammation-related pathways. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In recent years, an overwhelming association between Pediatric Type 1 Diabetes Mellitus (T1DM) and autoimmune diseases has been largely reported. The current study was designed to determine a possible association between autoimmune thyroiditis (AIT), celiac disease (CD) - associated autoantibodies, and Parvovirus B19 infection among pediatric T1DM cases in the southwestern region of Saudi Arabia. PATIENTS AND METHODS: Blood samples from age groups 1-18 years attending the Diabetic Clinic were collected over a period of 12 months. Serum anti-thyroid peroxidase (TPO), anti-thyroglobulin (TG), anti-tissue transglutaminase immunoglobulin A (TG-IgA), endomysial IgA (EMA-IgA), Parvovirus B19-IgG and IgM antibodies were detected by standard methods. RESULTS: The results showed the prevalence of autoantibodies against thyroid and CD among pediatric T1DM patients to be 44 (25%) and 25 (14.4%), respectively. The prevalence of antibodies against B19 was 70 (40%). Further determination of the prevalence of Parvovirus B19-IgG antibodies and thyroid antibodies among T1DM pediatric patients revealed that there was a signifi- cant association between them with a p<0.0491. CONCLUSIONS: The prevalence of autoantibodies against the thyroid was higher among the seropositive Parvovirus B19 children with T1DM. A positive association between the prevalence of autoantibodies against thyroid disease and the increase in the duration of diabetes was also noted. Hence, periodic screening of T1DM patients for B19 antibodies and autoantibodies for thyroid is crucial. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is frequently associated with type I diabetes mellitus (T1D), where its diagnosis may be a challenging task. This study aims to test the usefulness of the double staining immunofluorescence (dsIF) technique for the detection of intestinal anti-tissue transglutaminase specific IgA antibody (tTG-IgA) deposits in CD and T1D children with coexisting CD. Methods: A total of 46 patients (30 cases of CD and 16 cases of T1D with CD) and 16 non-diabetic, non-celiac children were recruited. Endoscopic biopsies were taken and analyzed by light microscopy, quantitative histology (QH), and a dsIF technique. Results: Histologically, villous atrophy was most severe in CD, followed by T1D with CD, while all control biopsies except 1 were normal. QH showed a statistically significant difference in villous height (Vh), crypt depth (CrD), and Vh:CrD ratio between diabetic and non-diabetic patients with CD. dsIF technique could detect tTG-IgA deposits in 85.7% of cases of CD alone and 93.8% of biopsies from diabetic children. Surprisingly, deposits were more extensive in biopsies with minimal villous shortening. Also, all 5 biopsies from T1D patients with normal histology were dsIF positive. Conclusion: In-situ analysis of tTG-IgA immune deposits facilitates the detection of positive serology early-onset CD. Quantitative analysis may be used as an ancillary tool to increase the reliability of histological findings in these patients.

Purpose: To characterize patients with APS type 4 among those affected by APS diagnosed and monitored at our local Reference Center for Autoimmune Polyglandular Syndromes. Methods: Monocentric observational retrospective study enrolling patients affected by APS diagnosed and monitored in a Reference Center. Clinical records were retrieved and analyzed. Results: 111 subjects (51 males) were affected by APS type 4, mean age at the onset was 23.1 ± 15.1 years. In 15 patients the diagnosis of APS was performed during the first clinical evaluation, in the other 96 after a latency of 11 years (range 1-46). The most frequent diseases were type I diabetes mellitus and celiac disease, equally distributed among sexes. Conclusions: The prevalence of APS type 4 is 9:100,000 people. Type I diabetes mellitus was the leading indicator of APS type 4 in 78% subjects and in 9% permitted the diagnosis occurring as second manifestation of the syndrome. Our data, showing that 50% of patients developed APS type 4 within the first ten years, don’t suggest any particular follow-up time and, more importantly, don’t specify any particular disease. It is important to emphasize that 5% of women developed premature ovarian failure. [ABSTRACT FROM AUTHOR]

It is known that complexes based on natural polysaccharides are able to eliminate bone defects. Prolonged hyperglycemia leads to low bone regeneration and a chronic inflammatory response. The purpose of this study was to increase the efficiency of early bone formation in a cavity of critical size in diabetes mellitus in the experiment. The polyelectrolyte complex contains high-molecular ascorbate of chitosan, chondroitin sulfate, sodium hyaluronate, heparin, adgelon serum growth factor, sodium alginate and amorphous nanohydroxyapatite (CH–SA–HA). Studies were conducted on five groups of white female Wistar rats: group 1—regeneration of a bone defect in healthy animals under a blood clot; group 2—regeneration of a bone defect under a blood clot in animals with diabetes mellitus; group 3—bone regeneration in animals with diabetes mellitus after filling the bone cavity with a collagen sponge; group 4—filling of a bone defect with a CH–SA–HA construct in healthy animals; group 5—filling of a bone defect with a CH–SA–HA construct in animals with diabetes mellitus. Implantation of the CH–SA–HA construct into bone cavities in type I diabetic rats can accelerate the rate of bone tissue repair. The inclusion of modifying polysaccharides and apatite agents in the construction may be a prospect for further improvement of the properties of implants. [ABSTRACT FROM AUTHOR]

Pancreatic islet transplantation to restore insulin production in Type 1 Diabetes Mellitus patients is commonly performed by infusion of islets into the hepatic portal system. However, the risk of portal vein thrombosis or elevation of portal pressure after transplantation introduces challenges to this procedure. Thus, alternative sites have been investigated, among which the omentum represents an ideal candidate. The surgical site is easily accessible, and the tissue is highly vascularized with a large surface area for metabolic exchange. Furthermore, the ability of the omentum to host large volumes of islets represents an intriguing if not ideal site for encapsulated islet transplantation. Research on the safety and efficacy of the omentum as a transplant site focuses on the utilization of biologic scaffolds or encapsulation of islets in a biocompatible semi-permeable membrane. Currently, more clinical trials are required to better characterize the safety and efficacy of islet transplantation into the omentum.

PurposeTo characterize patients with APS type 4 among those affected by APS diagnosed and monitored at our local Reference Center for Autoimmune Polyglandular Syndromes.MethodsMonocentric observational retrospective study enrolling patients affected by APS diagnosed and monitored in a Reference Center. Clinical records were retrieved and analyzed.Results111 subjects (51 males) were affected by APS type 4, mean age at the onset was 23.1 ± 15.1 years. In 15 patients the diagnosis of APS was performed during the first clinical evaluation, in the other 96 after a latency of 11 years (range 1-46). The most frequent diseases were type I diabetes mellitus and celiac disease, equally distributed among sexes.ConclusionsThe prevalence of APS type 4 is 9:100,000 people. Type I diabetes mellitus was the leading indicator of APS type 4 in 78% subjects and in 9% permitted the diagnosis occurring as second manifestation of the syndrome. Our data, showing that 50% of patients developed APS type 4 within the first ten years, don’t suggest any particular follow-up time and, more importantly, don’t specify any particular disease. It is important to emphasize that 5% of women developed premature ovarian failure.

Type I diabetes mellitus is a serious autoimmune condition impacting a large population around the world that need a daily infusion of insulin substitutes to regulate blood glucose levels within healthy limits. The purpose of the study was to design a robust μ -controller based on an uncertain linear-time invariant (LTI) representation of the Hovorka model for glucose–insulin metabolism. The model set was obtained using linearization around an equilibrium point and adding parametric uncertainty to account for the time delay variation between plasma glucose concentration and its subcutaneous measurement. As a result, the robust stability and performance of the closed loop were proved using the structured singular value μ. The performance of the designed controller was also checked with a numerical simulation in connection with the nonlinear model. [ABSTRACT FROM AUTHOR]

Background: Type I diabetes mellitus can lead to the development of cognitive dysfunction and anxiety due to chronic hyperglycemia, recurrent hypoglycemia, and micro - and macrovascular complications. It is known that oxytocin and copeptin have effects on neuropsychiatric activities such as learning, memory, and social adaptation and have anxiolytic properties. In this study, we aimed to search the relationship between oxytocin and copeptin levels and cognition and anxiety in patients with type I diabetes mellitus. Methods: The study included 39 type I diabetes mellitus patients aged 18–50 years and 39 age- and sex-matched healthy controls. The Montreal cognitive assessment inventory for cognitive assessment and the State and Trait anxiety scales for anxiety assessment were administered to all participants by the same psychologist. Plasma oxytocin and copeptin levels were measured with ELISA kits and compared with the mentioned tests results. Results: There were significant differences in oxytocin and copeptin levels between the two groups (p = 0.001). There was no difference in Montreal cognitive assessment and state anxiety scales between the groups, but trait anxiety scales levels were higher in patients (p < 0.001). However, there was no correlation between the oxytocin and copeptin levels and the results of both tests. Conclusions: In conclusion, although there was no difference between the groups in terms of cognitive functions and state anxiety, trait anxiety scores were found to be significantly higher in type I diabetes mellitus patients. However, no correlation was found between oxytocin and copeptin levels and these cognition and anxiety scores in either group. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is frequently associated with type I diabetes mellitus (T1D), where its diagnosis may be a challenging task. This study aims to test the usefulness of the double staining immunofluorescence (dsIF) technique for the detection of intestinal anti-tissue transglutaminase specific IgA antibody (tTG-IgA) deposits in CD and T1D children with coexisting CD. A total of 46 patients (30 cases of CD and 16 cases of T1D with CD) and 16 non-diabetic, non-celiac children were recruited. Endoscopic biopsies were taken and analyzed by light microscopy, quantitative histology (QH), and a dsIF technique. Histologically, villous atrophy was most severe in CD, followed by T1D with CD, while all control biopsies except 1 were normal. QH showed a statistically significant difference in villous height (Vh), crypt depth (CrD), and Vh:CrD ratio between diabetic and non-diabetic patients with CD. dsIF technique could detect tTG-IgA deposits in 85.7% of cases of CD alone and 93.8% of biopsies from diabetic children. Surprisingly, deposits were more extensive in biopsies with minimal villous shortening. Also, all 5 biopsies from T1D patients with normal histology were dsIF positive. In-situ analysis of tTG-IgA immune deposits facilitates the detection of positive serology early-onset CD. Quantitative analysis may be used as an ancillary tool to increase the reliability of histological findings in these patients. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to investigate the influence of hyperbaric oxygen therapy on mandibular critical-sized defect regeneration in rats with experimentally induced type I diabetes mellitus. Restoration of large osseous defects in an impaired osteogenic condition such as diabetes mellitus is a challenging task in clinical practice. Therefore, investigating adjunctive therapies to accelerate the regeneration of such defects is crucial. Materials and methods Sixteen albino rats were divided into two groups (n = 8/group). To induce diabetes mellitus, a single streptozotocin dosage was injected. Critical-sized defects were created in the right posterior mandibles and filled with beta-tricalcium phosphate graft. The study group was subjected to 90-min sessions of hyperbaric oxygen at 2.4 ATA, for 5 consecutive days per week. Euthanasia was carried out after 3 weeks of therapy. Bone regeneration was examined histologically and histomorphometrically. Angiogenesis was assessed by immunohistochemistry against vascular endothelial progenitor cell marker (CD34) and the microvessel density was calculated. Results Exposure of diabetic animals to hyperbaric oxygen resulted in superior bone regeneration and increased endothelial cell proliferation, which were revealed histologically and immunohistochemically, respectively. These results were confirmed by histomorphometric analysis which disclosed a higher percentage of new bone surface area and microvessel density in the study group. Conclusions Hyperbaric oxygen has a beneficial effect on bone regenerative capacity, qualitatively and quantitively, as well as the ability to stimulate angiogenesis.

Background: Regular self-monitoring of blood glucose (SMBG) remains the mainstay method for diabetes monitoring. The major limitation of SMBG is poor compliance and it only provides a snapshot of glucose values at that point of time. Continuous glucose monitors (CGMs) are non-invasive devices which measure subcutaneous interstitial glucose for every five minutes and provide glucose variability throughout the day. Aim and Objective: To assess the effectiveness of intermittent continuous blood glucose monitoring in comparison with SMBG on the percentage reduction in HbA1c level in children with type 1 diabetes mellitus (DM). Methods: Children diagnosed with type 1 DM of age group 3–18 years were enlisted into the study. Participants were randomised to the study arm (CGMs+SMBG) or the control arm (SMBG alone). Subjects in the study group were given CGM along with regular SMBG for 14 days. The control group was asked to perform SMBG. HbA1c levels were measured in both groups after three months of intervention. Results: There were 62 children in each group. After three months, in the intervention group HbA1c level dropped from 11.23% ± 1.53% (Mean ± SD) to 10.14% ± 1.99%, in control group HbA1c level dropped from 11.62% ± 1.62% to 11.32% ± 1.57%. The fall in HbA1c level in intervention group is significant (p value –0.01). Conclusion: In a resource-limited setting, intermittent use of CGMs atleast once every two to three months will help in understanding the factors influencing glucose variation throughout the day and, with appropriate therapeutic modifications, will aid in achieving optimal glycaemic control.

Background: Regular self-monitoring of blood glucose (SMBG) remains the mainstay method for diabetes monitoring. The major limitation of SMBG is poor compliance and it only provides a snapshot of glucose values at that point of time. Continuous glucose monitors (CGMs) are non-invasive devices which measure subcutaneous interstitial glucose for every five minutes and provide glucose variability throughout the day. Aim and Objective: To assess the effectiveness of intermittent continuous blood glucose monitoring in comparison with SMBG on the percentage reduction in HbA1c level in children with type 1 diabetes mellitus (DM). Methods: Children diagnosed with type 1 DM of age group 3-18 years were enlisted into the study. Participants were randomised to the study arm (CGMs+SMBG) or the control arm (SMBG alone). Subjects in the study group were given CGM along with regular SMBG for 14 days. The control group was asked to perform SMBG. HbA1c levels were measured in both groups after three months of intervention. Results: There were 62 children in each group. After three months, in the intervention group HbA1c level dropped from 11.23% ± 1.53% (Mean ± SD) to 10.14% ± 1.99%, in control group HbA1c level dropped from 11.62% ± 1.62% to 11.32% ± 1.57%. The fall in HbA1c level in intervention group is significant (p value -0.01). Conclusion: In a resource-limited setting, intermittent use of CGMs atleast once every two to three months will help in understanding the factors influencing glucose variation throughout the day and, with appropriate therapeutic modifications, will aid in achieving optimal glycaemic control. [ABSTRACT FROM AUTHOR]

Introduction: Type I diabetes mellitus (T1DM) is an autoimmune disorder characterized by absolute insulin deficiency, which is caused by progressive destruction of the β -islet cells of the pancreas. Aminotransferases participate in the interconversion of amino acids and oxalic acids by transfer of amino groups. Organ damage leads to leakage of transaminases into the blood. IgA is the only immunoglobulin that is found in saliva and forms the first line of defense. Alteration in the levels of secretory IgA often indicates a local or systemic disease. The aim of this systematic review is to evaluate the role of salivary aspartate aminotransferase (AST), alanine aminotransferase (ALT), and IgA as biomarkers for T1DM patients. Materials and Methods: An electronic literature search was conducted by two independent reviewers using PubMed, Medline and Google scholar without any date filter. The inclusion criteria included case control and cross-sectional studies. Publications in languages other than English, review articles, letters to the editor, and studies done on animal models were excluded from the review. The difference in the levels of salivary AST, ALT, or IgA in T1DM patients and in healthy individuals were compared. Risk of bias assessment was done using the ROBINS-I tool. Results: A total of eight relevant articles were assessed, out of which three studies showed elevated salivary AST and ALT levels and five studies showed elevated salivary IgA levels in patients with T1DM. Conclusion: Our review reflected that salivary AST, ALT, and IgA were elevated in T1DM patients, and they can be used for monitoring these patients. Further studies are needed to establish the diagnostic accuracy of these parameters for clinical application. [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (DR) is one of the severe complications of diabetes mellitus (DM). Despite the multiyear research of DR pathogenesis, the role of the vitreous body in DR development has not been sufficiently studied. Purpose: to demonstrate the potentials of multispiral computer tomography for assessing the density of the vitreous body in patients with type I diabetes.Material and methods. 97 practically healthy individuals (the control group) and 137 patients with type I diabetes (the main group), aged 10 to 35, were tested by multispiral computer tomography to assess their vitreous density.Results. DM type I patients showed a higher vitreous body density in the central and preretinal areas than healthy individuals. The two observation groups showed a statistically significant difference in the level of glycemia only, whilst no reliable difference in lipid metabolism was revealed.Conclusion. Multispiral computer tomography is a sufficiently sensitive testing method which allows registering even minor differences in the density of the main components of the vitreous body between healthy people and patients with type I diabetes. The higher density of the vitreous body in type I DM patients is probably associated with a higher level of glycosylation.

Background: This study aimed to investigate the influence of hyperbaric oxygen therapy on mandibular critical-sized defect regeneration in rats with experimentally induced type I diabetes mellitus. Restoration of large osseous defects in an impaired osteogenic condition such as diabetes mellitus is a challenging task in clinical practice. Therefore, investigating adjunctive therapies to accelerate the regeneration of such defects is crucial. Materials and methods: Sixteen albino rats were divided into two groups (n = 8/group). To induce diabetes mellitus, a single streptozotocin dosage was injected. Critical-sized defects were created in the right posterior mandibles and filled with beta-tricalcium phosphate graft. The study group was subjected to 90-min sessions of hyperbaric oxygen at 2.4 ATA, for 5 consecutive days per week. Euthanasia was carried out after 3 weeks of therapy. Bone regeneration was examined histologically and histomorphometrically. Angiogenesis was assessed by immunohistochemistry against vascular endothelial progenitor cell marker (CD34) and the microvessel density was calculated. Results: Exposure of diabetic animals to hyperbaric oxygen resulted in superior bone regeneration and increased endothelial cell proliferation, which were revealed histologically and immunohistochemically, respectively. These results were confirmed by histomorphometric analysis which disclosed a higher percentage of new bone surface area and microvessel density in the study group. Conclusions: Hyperbaric oxygen has a beneficial effect on bone regenerative capacity, qualitatively and quantitively, as well as the ability to stimulate angiogenesis. [ABSTRACT FROM AUTHOR]

Hemşirelik mesleği, insan ve onun karmaşık süreci ile çalıştığı için insana yönelik yasaları formüle etmesi gerekmektedir. Bu durumda yapılabilecek en iyi yol insan davranışlarını teorilere başvurarak açıklamaya çalışmaktır. Bu amaçla çalışmamızda hemşireliğe öncülük etmiş hemşire kuramcılardan Virginia Henderson’ın Teorisini bir olgu çerçevesinde tartışmaya çalıştık. Bu makalede, Tip I Diabetes Mellitus olan bir hasta, Henderson Hemşirelik Teorisine göre incelenmiş ve bu teori bireylerin bütüncül olarak ele alınmasını sağlayarak, hemşirelere bir çerçeve sunup hasta verilerinin daha kolay toplanmasını dolayısıyla hastanın memnuniyetini ve güvenliğini de arttırmaktadır. Bu nedenle bu teori özellikle veri toplama konusunda etkin olabileceği düşünülmektedir.

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.

Stiff person spectrum disorder is a disease that involves a host of conditions that are associated with glutamic acid decarboxylase 65-kilodalton isoform autoantibodies. These conditions may include diabetes mellitus type 1, pernicious anemia, autoimmune leukoencephalopathy, cerebellar ataxia, and stiff-person syndrome. Clinical recognition and diagnosis of stiff person spectrum disorder are important early, as immunologic treatment options showing reliable efficacy in slowing disease progression are available. This case presents a wide constellation of symptoms in which we describe the pathophysiology, clinical diagnosis, and current as well as future treatment options that may be available. ., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mullins et al.)

Introduction The duration of diabetes mellitus (DM), blood pro-inflammatory markers, and dipeptidyl peptidase 4 (DPP4) activity are known predictors of diabetic kidney disease (DKD) progression in acute-onset type 1 DM (AT1DM) and type 2 DM. However, predictors of DKD progression in slowly progressive type 1 insulin-dependent DM (SPIDDM) have been less frequently studied. Patients and methods This retrospective cohort study included 60 patients with SPIDDM (definite) (26 men/34 women). We utilized Cox proportional hazard analyses to determine whether characteristics and laboratory findings at the time of the SPIDDM diagnosis were associated with subsequent DKD progression. The urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) at the last outpatient clinic visit served as indicators of renal function. Also, to compare blood markers in patients with SPIDDM, we included 21 patients diagnosed with AT1DM at the same department during the same period and 50 healthy adult volunteers. Results In patients with SPIDDM (definite), the multivariate Cox proportional hazard analysis revealed that the body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP) levels at diagnosis, and the duration of DM prior to SPIDDM diagnosis were associated with the new onset of albuminuria and systolic blood pressure (SBP) at diagnosis, and the duration of DM prior to SPIDDM diagnosis was associated with a decline in eGFR to less than 60 ml/min/1.73 m². Additionally, serum hs-CRP levels were significantly higher in the SPIDDM (definite) group compared to both the AT1DM patients and healthy controls, suggesting a higher inflammatory state in patients with SPIDDM at the time of diagnosis. In patients with SPIDDM (definite) who were not treated with a DPP4 inhibitor, plasma DPP4 activity was associated with the new onset of albuminuria. Conclusions BMI, SBP, hs-CRP levels, DPP4 activity at SPIDDM diagnosis, and the duration of DM prior to SPIDDM diagnosis are associated with subsequent progression of DKD in SPIDDM. Also, we found that the patients with SPIDDM are often already being treated as DM for a long period of time at the time of diagnosis, which may be linked to their already high inflammatory status at the time of SPIDDM diagnosis and contribute to DKD progression. These findings underscore the importance of early diagnosis and management in preventing DKD progression in this population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This work was supported by JSPS KAKENHI (Kiban kenkyu C), and research grants from the Japan Diabetes Society (Grants to Young Researchers 2021) and Yamanashi prefecture (Grants to Young Researchers 2022). Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Okuma et al.)

Objectives: Diabetes mellitus (DM) is among the four noncommunicable diseases. There are two types-type I and type II. The prevalence of type I DM in India is 0.26/1,000 population (1992). This study was carried out to assess dental caries status and gingival status. The study group was compared with the nondiabetic control group to find any association with metabolic control of the disease., Methodology: A total sample size of 200 subjects was selected out of 100 patients referred to treat their poorly controlled type I diabetes mellitus at the tertiary hospital. Another 100 nondiabetic subjects were selected as controls. An oral clinical examination used a mouth mirror, dental explorer, visible light source, and cotton gauze. Decayed, missing, and filled teeth (DMFT), gingival index, plaque index, and calculus index were evaluated., Results: Comparison of the gingival index between cases and control was found to be significant, where the p -value is <0.001. This points out that type I diabetic patients have more chance of gingival problems than others. The increased plaque index indicates the need to give more importance to oral health as it may lead to an increased calculus index in the future, leading to periodontal problems. It was found that glycosylated hemoglobin (HbA1c) is directly proportional to the gingival index., Conclusion: Maintaining good oral health through regular check-ups with dental experts and motivating and educating type I diabetic patients as they are more prone to dental issues., How to Cite This Article: Thankappan N, Chandran V, Venugopal M, et al. Assessment of Oral Health Status among Children with Type I Diabetes Mellitus: A Cross-sectional Study. Int J Clin Pediatr Dent 2024;17(10):1124-1128., Competing Interests: Source of support: Any grants or fellowships supporting the writing of the paper: ICMR short-term studentship (STS) 2022 Grant of 50,000 rupees. STS references ID: 2022–03896. Conflict of interest: NoneConflict of interest: None, (Copyright © 2024; The Author(s).)

Transplantation of microencapsulated pancreatic cells is emerging as a promising therapy to replenish β-cell mass lost from auto-immune nature of type I diabetes mellitus (T1DM). This strategy intends to use micrometer-sized microgels to provide immunoprotection to transplanted cells to avoid chronic application of immunosuppression. Clinical application of encapsulation has remained elusive due to often limited production throughputs and body's immunological reactions to implanted materials. This article presents a high-throughput fabrication of monodisperse, non-immunogenic, non-degradable, immunoprotective, semi-permeable, enzymatically-crosslinkable polyethylene glycol-tyramine (PEG-TA) microgels for β-cell microencapsulation. Monodisperse β-cell laden microgels of ≈120 µm, with a shell thickness of 20 µm are produced using an outside-in crosslinking strategy. Microencapsulated β-cells rapidly self-assemble into islet-sized spheroids. Immunoprotection of the microencapsulated is demonstrated by inability of FITC-IgG antibodies to diffuse into cell-laden microgels and NK-cell inability to kill microencapsulated β-cells. Multiplexed ELISA analysis on live blood immune reactivity confirms limited immunogenicity. Microencapsulated MIN6β1 spheroids remain glucose responsive for 28 days in vitro, and able to restore normoglycemia 5 days post-implantation in diabetic mice without notable amounts of cell death. In short, PEG-TA microgels effectively protect implanted cells from the host's immune system while being viable and functional, validating this strategy for the treatment of T1DM., (© 2023 The Authors. Advanced Healthcare Materials published by Wiley‐VCH GmbH.)

Type I diabetes mellitus is a serious autoimmune condition impacting a large population around the world that need a daily infusion of insulin substitutes to regulate blood glucose levels within healthy limits. The purpose of the study was to design a robust μ-controller based on an uncertain linear-time invariant (LTI) representation of the Hovorka model for glucose–insulin metabolism. The model set was obtained using linearization around an equilibrium point and adding parametric uncertainty to account for the time delay variation between plasma glucose concentration and its subcutaneous measurement. As a result, the robust stability and performance of the closed loop were proved using the structured singular value μ. The performance of the designed controller was also checked with a numerical simulation in connection with the nonlinear model.

Objective: The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. Methods: The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t-test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. Results: The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). Conclusion: The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of “critical” pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group.

Incidence of the ophthalmic complications in autoimmune diseases is stably increasing over recent years, as well as overall increase in the number of autoimmune pathologies around the world, along with novel diagnostic approaches. According to the WHO estimates, the number of patients with visual impairment is estimated at 285 million people for 2010, causing blindness in 39 million cases. Among autoimmune diseases, diabetes mellitus, sarcoidosis and Behcet’s disease are most often complicated by these conditions. Dry eye syndrome is the most common eye complication associated with these diseases. Our aim was to describe eye complications in type I diabetes, sarcoidosis, and Behcet’s disease, as well as show the importance of research in the area, and to develop common criteria for the care of patients with ophthalmic conditions. The review considers main pathogenetic links, ethnic and genetic factors of ocular pathologies in autoimmune disorders, the main issues of timely diagnosis and the use of various schemes of conservative therapy. The results obtained upon analysis of the literature contain demonstrate the possible autoimmune nature of such eye pathologies, as uveitis and dry eye syndrome in diseases such as type 1 diabetes mellitus, sarcoidosis, and Behcet’s disease. Despite the ongoing research, there are many unresolved issues in the study of pathogenesis, as well as in therapeutic strategy. Therefore, the treatment of autoimmune eye diseases is a difficult task today, including treatment of the underlying disease, and local therapy of the visual organ. Since the primary immunopathology in the mentioned autoimmune diseases requires further studies, it is not possible to accurately predict the course of eye disease, possible complications and outcomes at the present time. Currently, there is only scarce information for creating uniform criteria for the treatment of uveitis and dry eye syndrome in autoimmune diseases. Their further development can contribute to establishment of the principles of medical care, in order to improve efficiency of treatment and quality of life in the patients. Further research and accumulation of data in the field are needed.

Hormonal and immunological characteristics of have been studied in individuals with initial autoimmune thyroiditis who have first- and second-degree relatives with autoimmune diseases. The age of the studied group of patients was 31±14 years, 60 women and 7 men. All the patients were examined by clinical, laboratory and instrumental methods in accordance with examination standards for autoimmune thyroiditis and type 1 diabetes mellitus. In addition, A, M, and G serum immunoglobulins and autoantibodies to insulin, pancreatic cells were determined. In patients with autoimmune thyroiditis, regardless of the presence / absence of a family history of autoimmune diseases, we have found an increase (p < 0.01) in total cholesterol content (by 63.6-65.9%), basal hyperglycemia (by 20-25%), higher thyroid-stimulating hormone (by 79-104%) in presence with decreased thyroglobulin levels (by 8-17.8%; p < 0.01), in comparison with the control group. There was a significant increase in postprandial glucose and glycated hemoglobin (p < 0.01) in patients with autoimmune thyroiditis and type 1 diabetes, in cases of familial autoimmune diseases, as compared to the controls. In all patients of the study group, there was a significant (p < 0.001) increase in autoantibodies to thyroperoxidase, compared with controls, and within the subgroup with co-existence of type 1 diabetes and autoimmune diseases in the family (p < 0.005).At the same time, the patients with autoimmune thyroiditis and type 1 diabetes mellitus with aggravated family history for autoimmune diseases have shown a significant increase of insulin autoantibodies, and to own pancreatic components (p < 0.005) when comparing with subgroup of patients without type 1 diabetes and, compared with a subgroup of patients without family history of type 1 diabetes mellitus and other autoimmune disorders.Increased IgA and IgG in blood serum (p < 0.05-0.001) can be traced, regardless of the presence of type 1 diabetes and familial autoimmune anamnesis. Increase of humoral immunity indices was significant in the persons with autoimmune thyroiditis accomplished by the type 1 diabetes in families with autoimmune diseases, in comparison with patients without type 1 diabetes (p < 0.005) and without burdened family history (p < 0.01). Hence, we have registered more pronounced changes in thyroid hormones, the contents of autoantibodies to a number of surface and internal structures of endocrine organs, as well as serum immunoglobulins in the persons with autoimmune thyroiditis accomplished by type 1 diabetes in hypothyreosis with first- and second-degree relatives with autoimmune diseases, in comparison with patients without burdened family history. Therefore, the diagnosis of at least one autoimmune disorder in a family member increases the alertness of patients and doctors, thus contributing to the early detection of autoimmune diseases.

Recent advancements in the management of type 1 diabetes mellitus (T1DM) have significantly improved outcomes and quality of life for patients, particularly children. Technological innovations, such as continuous glucose monitoring (CGM) systems and insulin pump therapy, including hybrid closed-loop systems, have enhanced glycemic control by providing real-time data and automated insulin delivery. Ultrarapid-acting insulins and adjunctive pharmacotherapies, like sodium-glucose transport protein 2 (SGLT2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists, offer improved postprandial glucose management and reduced insulin requirements. Immunotherapy and beta-cell replacement therapies, including stem cell research and encapsulation devices, aim to preserve or restore endogenous insulin production. Digital health platforms and telemedicine have expanded access to education and support, fostering better self-management. Future directions in precision medicine, artificial intelligence, and microbiome research hold promise for personalized and potentially curative treatments. Collectively, these advances are transforming T1DM management, reducing disease burden, and enhancing the prospects for children with T1DM., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bahal et al.)

Patients with type 1 diabetes mellitus (T1DM) are vulnerable to developing diabetic retinopathy even under insulin therapy. Thus, this study was designed to evaluate the efficacy of hesperidin and insulin in rats with T1DM compared with insulin alone in improving diabetic retinal changes. Eighty rats were divided into four equal groups: group I, control rats without diabetes; group II, untreated rats with diabetes; group III, rats with diabetes treated daily with subcutaneous (SC) doses of long-acting insulin; and group IV, a rat with diabetes in which hesperidin was orally administered with SC insulin. The animals were assessed histologically, morphometrically, and biochemically. In group II, the thickness of all retinal layers decreased histologically. Ultrastructurally, degenerated retinal neurons and congested blood vessels were observed. Immunostaining detected elevated gene expression of advanced glycation end products. Gene expression of vascular endothelial growth factor, and glial fibrillary acidic protein were elevated. In this study, hesperidin supplementation with insulin significantly improved the retinal histological changes, supported by morphometric findings, compared with insulin alone. Moreover, treatment with hesperidin significantly reduced malondialdehyde and elevated serum antioxidant markers, including superoxide dismutase and catalase; furthermore, glutathione peroxidase decreased. Hesperidin might be an effective supplement for improving diabetic retinal complications occurring even with insulin treatment. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the prevalence of dental caries among groups of 6–12-year-old children with and without Type 1 diabetes mellitus (T1DM) in Riyadh, Saudi Arabia, taking into account oral health behaviour, diet, and salivary parameters. The study was designed as a comparable study of dental caries experience between T1DM and non-diabetic groups of children. The total sample size of 209 participants consisted of 69 diabetic and 140 non-diabetic children. Oral hygiene, diet and socio-economic status were collected using a pre-tested questionnaire. Caries was recorded in terms of decayed and filled permanent and primary teeth (DFT/dft). Salivary microbial counts and pH levels were recorded using Caries Risk Test (CRT) kit. Student's t -test, the chi-squared test, linear regression and one-way analysis of variance were performed P-value of 0.05 considered significant. The mean dft scores for the diabetic and non-diabetic groups were 3.32 ± 0.78 and 3.28 ± 0.71 (mean ± SD), respectively (p = 0.458). The mean DFT scores for the diabetic and non-diabetic groups were 1.62 ± 0.65 and 1.96 ± 0.65, respectively (p = 0.681). Diabetic children visited dentists more often than non-diabetic children did (p = 0.04), and had lower consumption of both sweets (p = 0.003) and flavoured milk (p = 0.002) than the non-diabetic group. Furthermore, analysis showed that the diabetic children had medium oral pH levels (pH = 4.5–5.5), whereas the non-diabetic children tended to have high (pH ≥ 6.0) oral pH; this difference was statistically significant (p = 0.01). In addition, the diabetic group had higher Lactobacillus levels than the non-diabetic group (p = 0.04). The difference in caries prevalence between the diabetic and non-diabetic children was not statistically significant. The CRT analysis revealed a higher frequency of "critical" pH values (pH = 4.5–5.5) and higher Lactobacillus counts in diabetic children than in non-diabetic children, which indicated a higher caries risk in the former group. [ABSTRACT FROM AUTHOR]

The most two common autoimmune disease in endocrinology was Diabetes mellitus (DM) and thyroid dysfunction (TD). This study aimed to investigate the prevalence of TD in DM patients of type 1. The current study is carried out in the National Center for Diabetes of Endocrine and Genetic (NCDEG), AL- Mustansiriyah University, Baghdad. This study comprised of (36) patients with hypothyroidism diagnosed clinically under supervision of specialist physician in endocrinology. Their ages ranged between (30-40) years, among them there were 17 males (48%) and 19 females (52%). In addition there were (36) healthy control their age ranged between (28-42) years, among them there were 21 males (58%) and 15 females (42%). Results showed highly significant increase in the rate of Chol, TSH, T3, and FBS in patient group when compared with healthy subject (p

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.

The development of continuous glucose monitoring (CGM) systems has allowed for identification of blood sugar variations and trends in real-time that is not feasible with conventional self-monitoring of blood glucose. However, there is inconsistent data to show that the use of CGM leads to better glycemic control as measured by Hemoglobin A1c (HbA1c) in pediatric patients with type 1 diabetes mellitus. Our study aimed to compare the average HbA1c level in the 1–2 years prior to starting a CGM to the average HbA1c level in the 1–2 years immediately following CGM initiation in a sample of 1–20 year olds with type 1 diabetes mellitus. Participants were 90 youth (ages 1–20) followed for type 1 diabetes care at our institution who used a CGM for at least a 6 month time period. We performed a retrospective chart review to obtain up to four HbA1c values pre and post-CGM initiation each. We evaluated pre- and post-CGM initiation changes in mean HbA1c via dependent samples t-tests using IBM SPSS 24.0. The mean HbA1c was 8.7% pre-CGM and decreased to 8.27% 9–12 months after CGM initiation in the overall sample. A statistically significant decrease in HbA1c was seen in patients who used multiple daily injections (p=0.02), those with a pre-CGM HbA1c greater than 9% (p=0.01), and those with a diabetes duration of 5–10 years (p=0.02). CGM use was associated with a decrease in HbA1c over time which was statistically significant in some subgroups. [ABSTRACT FROM AUTHOR]

COVID‐19 in the setting of SGLT2 inhibitor use may precipitate euglycemic DKA separate from known acute viral illness and dehydration precipitants. There should be consideration of proactive discontinuation of these medications in these patients. [ABSTRACT FROM AUTHOR]

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The incidence of insulin-induced amyloidosis distant from an injection site is unknown. Due to its rare nature, only a few case reports have been reported, with even fewer describing amyloidoma as distant from the insulin injection site. We present a case of a 52-year-old male with a left arm mass that was determined to be cutaneous amyloidosis and successfully treated with total excision of the mass. Histopathological examination with Congo red stain demonstrated classic characteristics of amyloidosis. We present this case report to increase awareness of this relatively rare occurrence., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Community Memorial Health System (CMHS) Institutional Review Board issued approval CMHS IRB 2023-CR307. After review, CMHS IRB has determined that the case report does not meet the Department of Health and Human Services (DHHS) definition of research. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Duong et al.)

Type 1 diabetes mellitus is an autoimmune condition characterized by insulin deficiency resulting from loss of function of beta cells in the pancreas, leading to hyperglycemia and associated long-term systemic complications and even death. Immunotherapy demonstrates beta cell function-preserving potential; however, its impact on C-peptide levels, a definitive biomarker of beta cell function, and endogenous insulin secretion remain unclear. A systematic review of various immunotherapeutic interventions is hence needed for a comprehensive assessment of their effectiveness as well as identifying research gaps and influencing future research and clinical decisions. An extensive literature search was done in PubMed, Scopus, and Cochrane Library databases using precise keywords and filters to identify relevant studies. Three independent reviewers assessed eligibility according to predetermined eligibility criteria, and data was extracted. The Cochrane risk of bias assessment tool (RoB 2.0) was used to evaluate the quality and validity of the included studies. A senior reviewer resolved discrepancies and differences of opinion between independent reviewers. A total of 11 studies were included, with 1464 study participants. Both Phase II and III trials were included. Within the included studies, four studies assessed the anti-CD3 monoclonal antibody otelixizumab as an intervention. Another anti-CD3 monoclonal antibody, teplizumab, was assessed as an intervention in four studies, whereas two studies assessed the anti-CD20 antibody rituximab and one study assessed abatacept as its interventional drug. Otelixizumab demonstrated benefits at higher doses but was associated with adverse effects like Ebstein-Barr virus reactivation and cytomegalovirus infection, while at lower doses it failed to show a significant difference in C-peptide levels or glycosylated hemoglobin (HbA1c). Teplizumab, on the other hand, showed promise in reducing C-peptide loss and exogenous insulin requirements and was associated with adverse events such as rash, lymphopenia, urinary tract infection, and cytokine release syndrome. However, these reactions were only associated with therapy initiation, and they subsided on their own. Rituximab improved C-peptide responses, and abatacept therapy demonstrated reduced loss of C-peptide, improved C-peptide levels, and lowered HbA1c. Teplizumab, rituximab, otelixizumab, and abatacept show potential for preserving beta cell function by reducing C-peptide loss in patients with type I diabetes mellitus. However, careful monitoring of adverse reactions, particularly viral infections and cytokine release syndrome, is necessary for the safe implementation of these therapies., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Roy et al.)

Aim:Type I diabetes mellitus (TIDM) is an oxidative stress condition in addition to being a chronic metabolic disease. In this study, our aim is to investigate the activity of antioxidative enzymes and the products of oxidative stress in children and adolescents with TIDM and compare the findings with those in healthy control subjects.Materials and Methods:The study enrolled 41 children and adolescents with TIDM (mean age 11.4±3.3 years; 21 female, 20 male) and 25 healthy subjects (mean age 11.3±3.1 years; 8 female, 17 male) with a similar age and gender distribution. Serum samples were obtained to detect the antioxidative enzymes of paraoxonase (PON), arylesterase (ARE), oxidation degradation products of malondialdehyde (MDA) and also zinc which acts as an antioxidant.Results:We found a significant decrease in PON activity and zinc levels in diabetics compared to the healthy controls (p=0.021; p

Objective: To determine the clinical and functional characteristics of kidney damage in diabetes mellitus (DM) type I in children to establish the criteria for the prediction and early diagnosis of diabetic nephropathy (DN). Patients and methods. A total of 125 patients 4–18 years with type 1 diabetes. Kidney function was assessed by determining serum cystatin C and calculation of glomerular filtration rate (GFR) using the formula Hawke. Results and discussion: the majority of patients with type 1 diabetes with the NAM, the median age was observed for 2.5 years more than in the comparison group (p

Diabetes mellitus (DM) is a metabolic disease with 2.8% incidence worldwide. Insulin dependent DM (IDDM) or type I DM, usually arising in early ages, in most cases is accompanied by complications on vital organs like, kidney and heart. Medemia argun (MA) is an Egyptian palm, rich in proanthocyanidins (PACs), which are beneficial against a wide variety of human ailments. Thirty male rats were classified into 5 equal groups (6 rats each). Type I DM was induced by a single intraperitoneal (IP) injection of alloxan (120mg/kg). Rats were then treated by insulin (30 U/kg, daily), MA seed ethanolic extract (100mg/kg, orally, once daily, dissolved in sterile saline) for one week. Random blood sugar (RBS), serum creatinine, urea, triglycerides, total cholesterol, both high and low density lipoprotein cholesterol (HDLC, LDLC) and pancreatic tissue morphology were studied. MA showed insulin-mimetic action by significant downregulation of RBS, more significantly when given with insulin. This action was accompanied by preserving the populations of pancreatic beta, alpha and delta cells, usually perturbed by DM induction. Similarly, MA protected kidney through maintaining creatinine and urea normal levels. The effect of MA on lipid profile members was conflicting, as showing increments in triglycerides, total cholesterol and LDLC, with decreased HDL-C, compared to diabetic animals. Oral administration of MA ameliorated DM through showing preservation of pancreatic tissue and improving kidney functions. It protected DM subjects against complications on both pancreatic and kidney tissues, although it hasn’t a promising value in the protection of cardiovascular system which showed disturbed lipid profile. [ABSTRACT FROM AUTHOR]

To investigate the effects of Polygonatum cyrtonema Hua polysaccharide on blood glucose, survival rate and liver protection in type 1 diabetic mice. A female mouse model of type 1 diabetes mellitus was established by continuous intraperitoneal injection of streptozotocin. The experiment was mainly divided into four groups: high-dose group, low-dose group, model group and blank control group. The injection dose of high-dose group was 900 mg/kg, and that of low-dose group was 450 mg/kg. The blood glucose, survival rate and body weight of mice in each group were closely monitored during the experiment. After the experiment, the liver of mice was separated and the pathological changes of the liver were evaluated by HE staining. The levels of insulin receptor substrate 1 mRNA, interleukin-1beta and interleukin-6 in liver were detected by quantitative PCR. Female mice were intraperitoneally injected with streptozotocin for 5 consecutive days, and their blood glucose levels were significantly increased after 7 days of treatment. Under the condition of hyperglycemia, the mortality of mice in the model group will be significantly increased, and the high-dose treatment of Polygonatum cyrtonema Hua polysaccharide can promote the survival rate of model mice significantly improved; Low and high doses of Polygonatum cyrtonema Hua polysaccharide can significantly increase the body weight of model mice, and high doses of Polygonatum cyrtonema Hua polysaccharide treatment can promote the reduction of blood glucose levels. By HE staining, the results showed that the liver of model mice had obvious lesions: there were many infiltration of mononuclear inflammatory cells, which significantly changed the nature of hepatocytes. At the same time, hepatocytes develop structural disorders. However, the high-dose treatment of Polygonatum cyrtonema Hua polysaccharide can significantly improve the liver structural disorders, hepatocyte degeneration and active hepatocyte infiltration in the model mice. Quantitative PCR showed that polysaccharide from Polygonatum cyrtonema Huacould decrease the levels of interleukin-1beta and interleukin-6 in diabetic liver, and increase the level of insulin receptor substrate 1 mRNA significantly. Polygonatum cyrtonema Hua polysaccharide can significantly reduce the mortality of type 1 diabetic mice. This may have a very close relationship with its related factors, such as liver protection, blood glucose reduction and improving the weight of mice. [ABSTRACT FROM AUTHOR]

Type I diabetes mellitus is an autoimmune disease, in which the immune system attacks the β-cells of the islets of Langerhans in the pancreas, which produce insulin. Some of the main complications of this disease are the micro- and the macrovascular damages with main consequence: cardiovascular diseases, which appear to be the leading cause of mortality in this widespread, socially significant disease. The development of type I diabetes is affected by non-genetic factors such as the development of the optimal microbiome in early life, which programs the immune system. Patients have different intestinal microflora in comparison to healthy individuals as well as alterations in the intestinal permeability, inflammation and insulin resistance. Prebiotics represent a selective fermentative ingredient of food, which allows specific changes in both the composition and in the activity of the intestinal microflora of the person and thus improves his health and well-being. Human milk oligosaccharides, present in breast milk, are modulators of the microbiota and are known for directly regulating the immune response. They are vital for the protection of children at risk of developing type I diabetes by assisting the development of the immune and intestinal microbiota in early life. Soybean oligosaccharides are potential prebiotics, which improve the immune function. After 22 days of administration of 4 g/kg weight soybean oligosaccharides, they significantly affect the proliferation of bifidobacteria and lactic acid bacteria compared to the control group. Probiotic microorganisms show favorable interrelations with their host by influencing the intestinal cell proliferation and differentiation and the immune system, and they counteract pathogenic microorganisms. The supposed direct effects of oligosaccharides on pathogenic flora infections include mimicry of receptors and influence on their virulence. The regulation of virulent genes through the presence of oligosaccharides and polysaccharides in the nutrient medium has been described for a number of pathogenic bacteria. The indirect effects of prebiotics on the immune system can result from the stimulation of the growth of probiotic bacteria and the stimulation of the production of short chain fatty acids. The increase of the number of probiotic bacteria stimulates the immune system and leads to protection against pathogenic invasion. Oxidative stress, which is an important component of a number of diseases, is characterized by an imbalance in the level of oxidants and antioxidants in favor of the oxidants. It can lead to irreversible impairment of lipids, nucleic acids and proteins. It has been proved that the administration of synbiotics has a positive effect on the parameters of the oxidative stress. The elevated level of serum cholesterol is recognized as a risk factor for the development of atherosclerosis, cardiovascular diseases and hypertension. It has been proved that there are significant changes in the lipid profile of patients, treated with galactooligosaccharides. Prebiotics are a cheap and a low risk supplement, which can be used to favorably influence type I diabetes mellitus. They can also improve the glycemic control through changes in the intestinal microflora, the permeability of the intestines and inflammation. The purpose of this review is for the influence of new prebiotics (galactooligosaccharides and xylooligosaccharides) on the lipid and antioxidant profile of patients with type I diabetes mellitus to be studied. [ABSTRACT FROM AUTHOR]