An inexplicable upsurge: The rise in type 1 diabetes

Snouffer, Elizabeth

doi:10.1016/j.diabres.2018.02.022

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…Genome-wide association and linkage studies have identified several genetic loci associated with T1D susceptibility, however, the precise mechanisms which are perturbed by these mutations and how they initiate autoimmune reactions against islet cells have not yet been described 1,8–11 . Environmental factors such as virus infection, gut microbiota, and toxins may serve as additional exogenous triggers for initiation of T1D, and partially account for the alarming increase in global T1D incidence rate of children (<5 years) and young people (<20 years) during the last decades 12,13 .…”

Section: Introductionmentioning

confidence: 99%

Loss of MafA and MafB expression promotes islet inflammation

Singh

Colberg

Sarmiento

et al. 2019

Sci Rep

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Maf transcription factors are critical regulators of beta-cell function. We have previously shown that reduced MafA expression in human and mouse islets is associated with a pro-inflammatory gene signature. Here, we investigate if the loss of Maf transcription factors induced autoimmune processes in the pancreas. Transcriptomics analysis showed expression of pro-inflammatory as well as immune cell marker genes. However, clusters of CD4+ T and B220+ B cells were associated primarily with adult MafA −/− MafB +/− , but not MafA −/− islets. MafA expression was detected in the thymus, lymph nodes and bone marrow suggesting a novel role of MafA in regulating immune-cell function. Analysis of pancreatic lymph node cells showed activation of CD4+ T cells, but lack of CD8+ T cell activation which also coincided with an enrichment of naïve CD8+ T cells. Further analysis of T cell marker genes revealed a reduction of T cell receptor signaling gene expression in CD8, but not in CD4+ T cells, which was accompanied with a defect in early T cell receptor signaling in mutant CD8+ T cells. These results suggest that loss of MafA impairs both beta- and T cell function affecting the balance of peripheral immune responses against islet autoantigens, resulting in local inflammation in pancreatic islets.

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Section: Introductionmentioning

confidence: 99%

Loss of MafA and MafB expression promotes islet inflammation

Singh

Colberg

Sarmiento

et al. 2019

Sci Rep

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“…Interventions for alleviating DD need to address 2 issues: the first is helping the patient express his or her feelings about diabetes, and the second is to work with the patient to figure out what can be done to meet the patient’s needs [19]. Coaching techniques suitable for achieving the first objective include building a growth-promoting relationship with the client, establishing trust and rapport through the application of 3 core coaching skills, namely mindful listening, open-ended inquiry, and perceptive reflections [20], and helping clients handle negative emotions through an empathy protocol such as nonviolent communication [21].…”

Section: Methodsmentioning

confidence: 99%

Coaching and Education for Diabetes Distress (CEDD): Protocol for a Randomized Controlled Trial

Chima¹,

Salemi²,

Sidani³

et al. 2019

JMIR Res Protoc

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Background Diabetes distress (DD), a type of psychological distress specific to people with diabetes, is strongly associated with difficulties in performing self-care and inability to meet glycemic targets. Despite increased recognition of the need to manage DD, interventions that are both feasible and effective for reducing DD in routine care settings are not yet known. A pilot study showed that health coaching (HC) has some efficacy in addressing DD, but no adequately powered study has implemented a pragmatic research design capable of assessing the real-world effectiveness of HC in reducing DD. Objective The aim of this study is to describe the rationale and design of an ongoing clinical trial, Coaching and Education for Diabetes Distress trial, that seeks to assess whether HC effectively reduces DD among primary care patients with diabetes and whether HC is more effective than an educational program targeting DD. Methods The 2-arm randomized controlled trial is taking place at an academic family medicine practice in Houston, Texas. Both arms will receive usual care, which includes education about DD. In addition, the intervention arm will receive 8 HC sessions over a 5-month period. The primary outcome measure is reduction in DD over a 6-month period. Additional outcome measures include changes in hemoglobin A 1c and self-care practices (medication-taking, dietary, and physical activity behaviors). Results As of March 2019, screening and recruitment are ongoing, and the results are expected by July 2020. Conclusions HC is feasible in primary care and has been successfully applied to improving chronic disease self-management and outcomes. This study will provide evidence as to whether it has significant value in addressing important unmet psychological and behavioral needs of patients with diabetes. Trial Registration ClinicalTrials.gov NCT03617146; https://clinicaltrials.gov/ct2/show/NCT03617146 (Archived by WebCite at http://www.webcitation.org/76Va37dbO) International Registered Report Identifier (IRRID) DERR1-10.2196/12166

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“…Additionally, there is a lack of formally trained medical professionals in the field of pediatric endocrinology in several countries in Central and South America [14]. Some countries, such as Argentina, Brazil, and Mexico, have several trained medical professionals in pediatric endocrinology; however, other countries such as Nicaragua and Bolivia have a limited number of pediatric endocrinologists, available only in urban centers [15,16]. Previous conferences focused on pediatric endocrinology and diabetes were successfully held in Central America with the support of PES, as mentioned; however, participation was limited.…”

Section: Principal Findingsmentioning

confidence: 99%

Bringing the Pediatric Endocrine Spanish Speaking Community Together: First Virtual Pediatric Endocrine Meeting in Low- and Middle-Income Countries in Central and South America

Bogarin¹,

Elizondo²,

Kalaitzoglou³

et al. 2023

Interact J Med Res

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Background Pediatric endocrinology is a specialty that is struggling worldwide to maintain adequately trained professionals. Pediatric endocrine care in Central America and Caribbean countries is often performed by pediatricians or adult endocrinologists due to the limited number of pediatric endocrinologists. These health care providers are seldom members of endocrine societies and frequently lack formal training in the field. Objective In this study, we describe the scope of a virtual conference in pediatric endocrinology and diabetes targeted to low- and middle-income countries to provide equal opportunities for access to medical education for health care professionals. Methods The virtual conference was sponsored by the Pediatric Endocrine Society (North America), Asociación Costarricense de Endocrinología (previously, Asociación Nacional Pro Estudio de la Diabetes, Endocrinología y Metabolismo), and Asociacion Centroamericana y del Caribe de Endocrinologia Pediátrica. The conference was free to participants and comprised 23 sessions that were either synchronous with ability for real-time interactive sessions or asynchronous sessions, where content was available online to access at their convenience. Topics included idiopathic short stature, polycystic ovarian syndrome, diabetes mellitus, telemedicine, Turner syndrome, congenital adrenal hyperplasia, obesity, central precocious puberty, and subclinical hypothyroidism. The participants were asked to evaluate the conference after its completion with a questionnaire. Results A total of 8 speakers from Spain, Canada, Costa Rica, and the United States delivered the virtual event to 668 health care professionals from Guatemala, Venezuela, Dominican Republic, Costa Rica, Ecuador, Peru, Uruguay, Mexico, Honduras, Argentina, the United States, Bolivia, Chile, Panama, El Salvador, Nicaragua, Paraguay, Belize, Spain, and Colombia. Name, profession, and country were fully disclosed by 410 (61.4%) of the 668 health care professionals. The profession or level of training of participants were as follows: pediatric endocrinologists (n=129, 19.3%), pediatricians (n=116, 17.4%), general practitioners (n=77, 11.5%), adult endocrinologists (n=34, 5.1%), medical students (n=23, 3.4%), residents in various specialties (n=14, 2.1%), and others (n=17, 2.6%). A total of 23 sessions were offered, most of which were bilingual (Spanish and English). Feedback from the evaluation questionnaire indicated that the content of the conference was very relevant to the participants’ professional practice. Additionally, the participants reported that they were very satisfied with the organization, the web-based platform, and the sessions of the conference. Conclusions Lack of accessibility to the latest and cutting-edge medical education in pediatric endocrinology and diabetes for medical professionals from low- and middle-income countries can be overcome with a virtual conference. Online availability, low cost, and easy-to-use technology were well received from the participants, who were overall very satisfied by the quality and the relevance of the sessions to their professional practice.

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An inexplicable upsurge: The rise in type 1 diabetes

Cited by 10 publications

References 13 publications

Loss of MafA and MafB expression promotes islet inflammation

Loss of MafA and MafB expression promotes islet inflammation

Coaching and Education for Diabetes Distress (CEDD): Protocol for a Randomized Controlled Trial

Bringing the Pediatric Endocrine Spanish Speaking Community Together: First Virtual Pediatric Endocrine Meeting in Low- and Middle-Income Countries in Central and South America

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