Type 1 diabetes mellitus is a disease involving changes to energy metabolism. Chronic hyperglycemia is a major cause of diabetes complications. Hyperglycemia induces mechanisms that generate the excessive production of reactive oxygen species, leading to the development of oxidative stress. Studies with animal models have indicated the involvement of mitochondrial dysfunction in the pathogenesis of diabetic cardiomyopathy. In the current review, we aimed to collect scientific reports linking disorders in mitochondrial functioning with the development of diabetic cardiomyopathy in type 1 diabetes mellitus. We also aimed to present therapeutic approaches counteracting the development of mitochondrial dysfunction and diabetic cardiomyopathy in type 1 diabetes mellitus.
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
Objective: The aim of the study was to evaluate NADH dehydrogenase [ubiquinone] iron–sulfur protein 8 (NDUFS8) serum concentration as a marker of Complex I, and the relationship with insulin resistance in type 1 diabetes mellitus (T1DM). Design and methods: Participants were adults with T1DM, recruited over the course of 1 year (2018–2019). NDUFS8 protein serum concentration was measured using the ELISA test. Insulin resistance was evaluated with indirect marker estimated glucose disposal rate (eGDR). The group was divided on the base of median value of eGDR (higher eGDR—better insulin sensitivity). Results: The study group consists of 12 women and 24 men. Medians of eGDR and NDUFS8 protein concentration are 7.6 (5.58–8.99) mg/kg/min and 2.25 (0.72–3.81) ng/mL, respectively. The group with higher insulin sensitivity has higher NDUFS8 protein serum concentration, lower waist to hip ratio (WHR), body mass index (BMI), and they are younger. A negative correlation is observed between NDUFS8 protein serum concentration and WHR (rs = −0.35, p = 0.03), whereas a positive correlation is observed between NDUFS8 protein serum concentration and eGDR (rs = 0.43, p = 0.008). Univariate logistic regression shows a significant association between insulin sensitivity and lower age, as well as a higher NDUFS8 serum level. A multivariate logistic regression model confirms the significance (AOR 2.38 (1.04–5.48). p = 0.042). Multivariate linear regression confirms a significant association between insulin sensitivity and better mitochondrial function (beta = 0.54, p = 0.003), independent of age, duration of diabetes, and smoking. Conclusions: Higher NDUFS8 protein serum concentration is associated with higher insulin sensitivity among adults with T1DM.
Aim To investigate whether physical activity is associated with the occurrence of remission in adults with type 1 diabetes. Methods Ninety nine adult participants with newly diagnosed type 1 diabetes were enroled into a prospective, observational study. The participants were advised to exercise 2–3 times a week with moderate intensity for a one‐year period. Physical activity was assessed by a self‐administrated questionnaire on every fourth visit. We counted the months in which participants fulfiled a partial‐remission criteria: HbA1c < 6.5%, C‐peptide > 0.5 ng/ml, and daily dose of insulin <0.3 U/kg/day. We assigned the participants to two groups: MORE EFFORT and LESS EFFORT, depending on the median value of physical activity in the studied population. Results The occurrence of the remission achieved statistical significance at 6th month with a greater prevalence in MORE EFFORT group (55% vs. 35% p = 0.047). In multivariate logistic regression analysis for the occurrence of remission at 12th month, physical activity before the diagnosis was the only variable that influences the occurrence of the remission (adjusted odds ratios = 3.32 [95% confidence intervals 1.25–8.80]; p = 0.02). Conclusion In adults with newly diagnosed type 1 diabetes physical activity before the diagnosis is associated with higher occurrence of remission.
Introduction Diabetic ketoacidosis is a life-threatening condition that requires prompt management. Objectives We aimed to assess the impact of adherence to potassium replacement protocol according to the guidelines of Diabetes Poland on the duration of diabetic ketoacidosis (DKA) treatment. Patients and methods This retrospective analysis included 242 adults (median age, 27 years; range, 21-38 years). Nonadherence to potassium replacement protocol was assessed, along with the relationship between nonadherence and duration of DKA management. Nonadherence to the protocol was defined as too low or too high doses of potassium compared with the recommended potassium replacement protocol. Results The median duration of DKA treatment was longer in the nonadherent group than in the adherent group: 37 hours (interquartile range [IQR], 27-48) and 30 hours (IQR, 17-43), respectively (P = 0.005). Treatment duration correlated positively with nonadherence to potassium replacement protocol (r = 0.18; P = 0.005) and severity of DKA (r = 0.52; P <0.0001). Stepwise multivariate linear regression analysis indicated nonadherence to the protocol (β = 0.14; P = 0.02) and severity of DKA (β = 0.43; P <0.0001) as predictors of treatment duration, after adjustment for body mass index and age (R2 = 0.28; P <0.0001). Conclusions Nonadherence to potassium replacement protocol leads to prolongation of DKA management. Medical staff should be educated about the benefits of potassium replacement and precision in potassium administration and dosing in patients with DKA.
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