Rates of Diabetes Mellitus-Related Complications in a Contemporary Adolescent Cohort

Kong, Amanda M.; Donath, Susan; Harper, C Alex; Werther, George A.; Cameron, Fergus

doi:10.1515/jpem.2005.18.3.247

Cited by 8 publications

(3 citation statements)

References 45 publications

(13 reference statements)

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“…This uncertainty is in part due to studies using varying metrics of GV and with differing glycaemic datasets, rendering comparative analysis problematic (Cameron et al 2010. In the context of paediatric type 1 diabetes, clinical microvascular pathology is relatively rare in patients with good metabolic control (Mohsin et al 2005, Kong et al 2005. On the other hand there is an emerging literature highlighting the relative frequency of neurocognitive and psychological pathology in this younger population (Northam et al 2006, Cameron et al 2007.…”

Section: Introductionmentioning

confidence: 99%

Effects of Fluctuating Glucose Levels on Neuronal Cells In Vitro

et al. 2012

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There is increasing evidence for glucose fluctuation playing a role in the damaging effects of diabetes on various organs, including the brain. We aimed to study the effects of glycaemic variation (GV) upon mitochondrial activity using an in vitro human neuronal model. The metabolic disturbance of GV in neuronal cells, was mimicked via exposure of neuroblastoma cells SH-SY5Y to constant glucose or fluctuating (i.e. 6 h cycles) for 24 and 48 h. Mitochondrial dehydrogenase activity was determined via MTT assay. Cell mitochondrial activity (MTT) was moderately decreased in constant high glucose, but markedly decreased following 24 and 48 h of cyclical glucose fluctuations. Glucose transport determined via 2-deoxy-D-[1-(14)C] glucose uptake was regulated in an exaggerated manner in response to glucose variance, accompanied by modest changes in GLUT 1 mRNA abundance. Osmotic components of these glucose effects were investigated in the presence of the osmotic-mimics mannitol and L: -glucose. Both treatments showed that fluctuating osmolality did not result in a significant change in mitochondrial activity and had no effects on (14)Cglucose uptake, suggesting that adverse effects on mitochondrial function were specifically related to metabolically active glucose fluctuations. Apoptosis gene expression showed that both intrinsic and extrinsic apoptotic pathways were modulated by glucose variance, with two major response clusters corresponding to (i) glucose stress-modulated genes, (ii) glucose mediated osmotic stress-modulated genes. Gene clustering analysis by STRING showed that most of the glucose stress-modulated genes were components of the intrinsic/mitochondrial apoptotic pathway including Bcl-2, Caspases and apoptosis executors. On the other hand the glucose mediated osmotic stress-modulated genes were mostly within the extrinsic apoptotic pathway, including TNF receptor and their ligands and adaptors/activators/initiators of apoptosis. Fluctuating glucose levels have a greater adverse effect on neuronal cell energy regulation mechanisms than either sustained high or low glucose levels.

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Section: Introductionmentioning

confidence: 99%

Effects of Fluctuating Glucose Levels on Neuronal Cells In Vitro

et al. 2012

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“…A more holistic approach has been advocated 1 that also takes into account patient satisfaction of care, costs of care and health‐related quality of life (HRQOL). Using this schema of outcome measures over the last 6 years, we have published data from our diabetes clinic pertaining to clinical outcomes, 2,3 psychological outcomes, 4,5 costs of care 6 and HRQOL 2,7,8 …”

Section: Introductionmentioning

confidence: 99%

Satisfaction of care in a tertiary level diabetes clinic: Correlations with diabetes knowledge, clinical outcome and health‐related quality of life

Koves¹,

Boucher²,

Ismail³

et al. 2008

J Paediatrics Child Health

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“…A similar study by Yoo et al (2004) showed that persistent microalbuminuria and macroalbuminuria were observed in 11.3 and 2.8% of patients with DM1. But the study of Kong et al (2005) on post DCCT showed that prevalence of persistent microalbuminuria was 2% in an adolescent cohort with diabetes duration >5 years due to intensive treatment and the decreased rate of complication. This decreasing trend of microvascular complications was also proved by Mohsin et al (2005) by doing further cross sectional analysis of complications from 1990 to 2002.…”

Section: Discussionmentioning

confidence: 98%

Early microalbuminuria in adolescent Type 1 diabetic patients: Experience from a pediatric endocrine clinic in a developing country

Samanta¹

2012

J. Diabetes Endocrinol.

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There are no studies of early microalbuminuria in adolescent Type 1 diabetic patients in the developing world where patients are considerably undernourished and follow conventional treatment regimens in most part. The objective was to assess the presence of microalbuminuria in Type 1 adolescent diabetes mellitus (DM) patients where patients still use conventional treatment regimen. The subjects (n = 30), in the age group of 10 to 18 years, were divided into two groups-good glycaemic (n = 16) and poor glycaemic (n = 14) control groups during end of study period based on their mean HbA1c value (<8.5 vs. ≥8.5, mean value over one year period). Though no subject with good glycaemic control developed microalbuminuria, 5 (35.7%) of the total 14 poor glycaemic control patients had microalbuminuria. Both systolic and diastolic blood pressures were higher in the microalbuminuric group. It is concluded that malnourished adolescent Type 1 diabetic patients who follow conventional treatment regimen and are poorly controlled, may develop very early microalbuminuria.

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Rates of Diabetes Mellitus-Related Complications in a Contemporary Adolescent Cohort

Abstract: In this representative and contemporary cohort of diabetic adolescents the incidence of microvascular diabetes-related complications is quite low.

Cited by 8 publications

References 45 publications

Effects of Fluctuating Glucose Levels on Neuronal Cells In Vitro

Effects of Fluctuating Glucose Levels on Neuronal Cells In Vitro

Satisfaction of care in a tertiary level diabetes clinic: Correlations with diabetes knowledge, clinical outcome and health‐related quality of life

Early microalbuminuria in adolescent Type 1 diabetic patients: Experience from a pediatric endocrine clinic in a developing country

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