No abstract

PurposeType 1 diabetes mellitus (T1DM) is a disorder of insulin deficiency but with a wide range of hormones simultaneously disturbed. The study was performed to explore relation of free triiodothyronine (FT3) with metabolic control and occurrence of microangiopathic complications.MethodsA total of 266 adult T1DM participants [56% men; 32 (interquartile range, IQR: 25–39) years and disease duration 13 (IQR: 8–19) years] in euthyroid state with negative history for hypothyroidism were included to the study. Participants were screened for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and FT3. Moreover, microangiopathic complications (retinopathy, diabetic kidney disease, peripheral and autonomic neuropathy), markers of metabolic control such as glycated hemoglobin (HbA1c) were evaluated.ResultsA total of 114 (42.9%) people had diagnosed at least one microangiopathic complication. In multivariable linear regression higher HbA1c was statistically significant independent predictor of lower FT3 (β = −0.25; p < 0.0001) after adjustment for sex, T1DM duration, HbA1c, waist-to-hip ratio (WHR) (R2 = 0.15, p < 0.0001). Higher FT3 was simultaneously a predictor of lower prevalence of microangiopathy in multivariate logistic regression analysis (odds ratio, 0.51; 95% confidence interval, 0.27–0.98; p = 0.04) after an adjustment for: age, hypertension, HbA1c, WHR and total cholesterol (TC).ConclusionsFT3 as tissue active hormone plays a clinically important role in T1DM people. The higher FT3 concentration is related to the lower prevalence of microangiopathy and better metabolic control of the disease in adult euthyroid people with T1DM.

The aim of this study was to assess the blood vessel density and maturity in the skin of adults with type 1 diabetes in relation to the presence of late neurovascular complications. We included 148 patients (87 men) with a median (interquartile range) age of 41 (31–49) and median diabetes duration of 21 (17–30) years. Microvessel (CD133, CD34, CD31 and von Willebrand factor) markers were evaluated by indirect immunohistochemistry assay in material from a skin biopsy. Diabetic retinopathy was diagnosed using direct ophthalmoscopy, and diabetic kidney disease was estimated in people with increased albuminuria and a 10-year duration of diabetes or evidence of diabetic retinopathy . Diabetic peripheral neuropathy diagnosis was based on Toronto definition, cardiac autonomic neuropathy on validated ProSciCard III program. Microvessel density, assessed by CD34 and CD133, was significantly higher in patients with cardiac autonomic neuropathy [160 (125–175) vs 121 (100–154)/1 mm2, p = 0.001 and 92 (83–104) vs 79 (63–92)/1 mm2, p = 0.007, respectively] and CD34 in patients with diabetic peripheral neuropathy [135 (106–168) vs 121 (95–145)/1 mm2, p = 0.018], as compared with subjects without complications. In multivariate logistic regression, density of CD34 and CD133 positive vessels was associated with presence of cardiac autonomic neuropathy [odds ratio 1.016 (95% confidence interval: 1.002–1.029), p = 0.019 and odds ratio 1.037 (95% confidence interval: 1.008–1.067), p = 0.011, respectively]. It was independent from age, sex, diabetes duration, smoking status, body mass index and HbA1c value. Density of CD34 positive vessels was also associated with diabetic peripheral neuropathy, independently from sex and diabetes duration [odds ratio 1.009 (95% confidence interval: 1.001–1.020), p = 0.037]. Skin microvessel density is increased in adults with clinical evidence of neurovascular complications of type 1 diabetes. This is associated with predominance of the vessels of low maturity.

No abstract

No abstract

No abstract

RESEARCH LETTER HDL cholesterol and insulin treatment in type 1 diabetes 69 diagnosed T1D (28 women and 50 men; mean age, 25.7 years [range, 21.6-30.0 years]), who participated in the Insulin Therapy and Lipoproteins Profile in Type 1 Diabetes Study (InLipoDiab1, NCT02 306 005). All patients were treated with intensive insulin therapy from the onset of the disease. The inclusion criteria for the study were as follows: age between 18 and 35 years, newly diagnosed T1D and initiation of insulin therapy, as well as consent for participation in the study. Patients were assessed at the time of diagnosis (the samples collected before administration of insulin) and then at a follow -up visit in an outpatient clinic after 3 months of insulin treatment. The diagnosis of T1D was confirmed by the measurement of disease -specific autoantibodies.Measurements Anthropometric data including body mass index and body weight were assessed. The daily dose of insulin (DDI) was defined as the requirement for insulin per kilogram body weight per day. This amount of insulin was calculated as the sum of units of long-and short--acting insulin. The final DDI at the time of diagnosis (baseline DDI) was established on the last day of hospitalization when glucose levels reached the treatment target and the patient could be discharged home. The DDI after 3 months was calculated at the follow -up visit based on data derived from patients' self -monitoring logs from the last month. The average dose of insulin that has been used by patients over the last 30 days was calculated. The lipid profile including the levels of total cholesterol, HDL-C, and triglycerides was measured with a Cobas 6000 biochemistry analyzer

Background. Type 1 diabetes (DM 1) is frequently associated with autoimmune thyroid diseases (AITD). Screening for AITD in adults is rarely performed. The aim of this study was to evaluate the prevalence of anti-thyroid peroxidase (anti-TPO) and thyroid function and their association with metabolic control in adults participating in Poznan Prospective Study (PoProStu). Material and Methods. The analysis included 74 patients (26 women and 48 men) aged 38.5 (IQR: 34.5-42.5), who have had diabetes for 15.0 (14-16) years. All patients have been treated with intensive functional insulin therapy (IFIT) from the onset of the disease. Anti-TPO and thyroid-stimulating hormone (TSH) were determined. The concentration of anti-TPO ≥ 5.61 IU/mL was considered positive. Based on the levels of anti-TPO the patients were divided into two groups: anti-TPO positive and anti-TPO negative. Metabolic control was assessed by the level of glycated hemoglobin (HbA 1c ). Results. Anti-TPO was positive in 32 (43.2%) patients. Prevalence of autoantibodies was significantly higher in women (53% vs 21%; p = 0.009). There was no significant difference in HbA 1c levels [median (IQR): 7.6% (7.1-8.6) vs 7.6% (7.1-8.8); p = 0.82] and TSH levels [median (IQR): 2.05 µIU/mL (1.23-3.15) vs 1.62 µIU/mL (1.00-2.10); p = 0.06] between anti-TPO positive and negative patients. After excluding patients with a thyroid dysfunction, a significant difference in TSH levels between anti-TPO positive and negative group was found [median (IQR): 2.11 µIU/mL (1.29-3.31) vs 1.66 µIU/mL (1.29-3.31); p = 0.04]. Conclusions. High anti-TPO prevalence is found in adult patients with long-standing DM 1, and autoantibodies occur more often in women. Therefore, screening for asymptomatic thyroid dysfunction should be performed in this group, as already recommended by the joint statement of Polish Society of Endocrinology and Diabetes Poland (Adv Clin Exp Med 2015, 24, 1, 79-84).