Estimated glucose disposal rate in patients under 18 years of age with type 1 diabetes mellitus and overweight or obesity

Palomo-Atance, Enrique; Herrera, M; Muiña, Patricio Giralt; Cano, Rafael Ruiz; Martín, A. León; Muiña, Juan Giralt

doi:10.1016/j.endoen.2013.02.003

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Values of eGDR values were lower also in obese children with T1DM older than 11 years: this may therefore be considered a marker of IR also in children. Insulin dose was higher in diabetic patients with overweight or obesity, especially in IU/m2/day [25]. Kilpatrick et al [5] found similar results: the eGDR at baseline strongly predicted the development of retinopathy, nephropathy, and cardiovascular disease (both micro-and macrovascular complications) whereas insulin dose and International Diabetes Federation (IDF)-defined MS were poor predictors [5].These findings are consistent with those from the Pittsburgh Epidemiology of Diabetes Complications Study: low eGDR (and therefore high IR) seems to be associated with an increased risk of nephropathy [30], peripheral vascular disease [31], and coronary artery disease [32].…”

Section: Discussionmentioning

confidence: 90%

“…Although the role of IR in the development of complications in T1DM1 is known, how to quantify it objectively remains unclear. The gold standard test for measuring insulin sensitivity is representd by euglycaemic-hyperinsulinemic clamp, but it is invasive, expensive and mainly used in research settings [23], whereas HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) or QUICKI (Quantitative Insulin Sensitivity Check Index) cannot be used in patients on insulin treatment [24] and the calculation of daily insulin requirements is not accurate depending on multiple factors [24,25]. This difficulty led to the creation of two validated clinical scores, developed using mathematical models: the Insulin-Sensitivity Score (ISS) for children and adolescents with diabetes, validated with the clamp [26] and the estimated Glucose Disposal Rate (eGDR) [24], with a high correlation with the clamp.…”

Section: Discussionmentioning

confidence: 99%

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Insulin Resistance in Type 1 Diabetes: Evidence and New Insights

Filippo

2018

CRDOJ

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Although the main etiopathogenic mechanism of Type 1 Diabetes Mellitus is autoimmunity, over the past decade it has been shown that Insulin Resistance also plays a key role in the pathogenesis and in the development of micro-and macrovascular complications , defininig a condition termed as "double diabetes". Double diabetes has increased with the raised trend of obesity and it could explain the increased risk of cardiovascular complications in Type 1 Diabetes Mellitus subjects compared to the general population, even in condition of good glycaemic control. There are some tools that allow to use clinical parameters to quantify Insulin Resistance but especially the beneficial effect of complications prevention measures. Recently it has been shown that the management of the metabolic syndrome components can also be effective in reducing the cardiovascular risk in patients with Type 1 Diabetes since the pediatric age.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Insulin Resistance in Type 1 Diabetes: Evidence and New Insights

Filippo

2018

CRDOJ

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“…It was previously thought that the essence of type 1 diabetes was a progressive insulin deficiency resulting from a progressive selfdestruction of β-cells, whereas the sensitivity to insulin operation was maintained. Today, we already know that insulin resistance is also present in type 1 diabetes [63][64][65][66].…”

Section: Insulin Resistance and Metabolic Syndrome In Type 1 Diabetesmentioning

confidence: 99%

Metabolic Syndrome is the Problem in Young Diabetics?

Buczkowska¹

2014

Fam Med Med Sci Res

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Metabolic syndrome is an important problem in a population of children and adolescents. Genetic predisposition and environmental factors such as physical inactivity and increased caloric intake are responsible for the predisposition to metabolic syndrome. Insulin resistance is proposed to have a pivotal role in the development of the metabolic syndrome Metabolic syndrome, which is composed of such factors as insulin resistance, glucose intolerance or diabetes, dyslipidemia and arterial hypertension, contributes to accelerated development of cardiovascular diseases, orthopaedic disorders, and other medical consequences. Early conservative intervention with diet, exercise, and behavioural therapy may prevent the complications of insulin resistance.

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Prevalence of nephropathy in Indian children and youth with type 1 diabetes mellitus

Karguppikar

Oza

Shah

et al. 2022

Journal of Pediatric Endocrinology and Metabolism

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Objectives Children with type 1 diabetes (T1D) having diabetic nephropathy (DN) are at increased risk of developing end stage renal disease. The present study aimed to determine the prevalence of DN and its predictors in Indian children and youth with T1D. Methods This cross-sectional study included 319 children and youth (2.6–21 years) with T1D having disease duration of at least 2 years. Demographic data and laboratory findings were obtained using standard questionnaires and protocols. Diagnosis of diabetic nephropathy was based on albuminuria on two occasions within a period of 3 months. Results The prevalence of DN in our study subjects was 13.4%. 7.5% subjects were known cases of diabetic nephropathy on treatment with enalapril. Hypertension was found in 14.3% subjects with DN in contrast to 4.1% without DN (p<0.05). Duration of diabetes and estimated glucose disposal rate were the important predictors of DN. Interestingly, of the 43 children with DN, 11.3% (n=8) were under 10 years age. Conclusions We found a high prevalence of DN in children and youth with T1D including in children under the age of 10 years. Early screening and timely intervention are required to retard the disease progression and avoid end stage renal disease.

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Estimated glucose disposal rate in patients under 18 years of age with type 1 diabetes mellitus and overweight or obesity

Cited by 6 publications

References 24 publications

Insulin Resistance in Type 1 Diabetes: Evidence and New Insights

Insulin Resistance in Type 1 Diabetes: Evidence and New Insights

Metabolic Syndrome is the Problem in Young Diabetics?

Prevalence of nephropathy in Indian children and youth with type 1 diabetes mellitus

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