Síndrome metabólico y diabetes mellitus tipo 1: prevalencia y factores relacionados

Chillarón, Josep; Flores-Le-Roux, Juana A.; Goday, Alberto; Benaiges, David; Carrera, María; Puig, Jaume; Cano-Pérez, Juan F.; Pedro‐Botet, Juan

doi:10.1016/s0300-8932(10)70063-4

Cited by 35 publications

(13 citation statements)

References 31 publications

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“…Several studies support the fact that DD is often seen in patients with a family history of T2D[8,17], a finding confirmed by the present study where 45% of the study population had a family history of DM. It is noteworthy that nearly 65% of the DD group required insulin, a discovery concurring with earlier reports in the literature[8,17].…”

Section: Discussionsupporting

confidence: 90%

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Double diabetes in Saudi Arabia: A new entity or an underestimated condition

Braham¹,

Alzaid²,

Robert³

et al. 2016

WJD

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AIMTo determine the clinical and biological characteristics of double diabetes (DD) among young people in Saudi Arabia.METHODSThis was a retrospective descriptive chart review study including 312 young newly diagnosed diabetic patients (aged 12-20 years), whom were admitted over a five year period (January 2009 to December 2013). Family history of diabetes mellitus (DM) (first degree), physical body mass index (BMI), acanthosis nigricans, history of auto-immune disease and laboratory information for glycosylated hemoglobin, basal C peptide level and diabetes autoantibody response (anti-GAD, anti-IA2 and anti-ICA) were collected from medical report. A mean follow-up of 3 years for these patients was performed.RESULTSPatients were categorized into 4 groups, based on the autoantibody response (Ab+ or Ab-) and C-peptide secretion (β+ for fasting level 0.4-2.1 ng/mL and β- if < 0.4 ng/mL). Group1 (type 1a): Ab+ β- (21%), group 2 (type 1b): Ab- β- (9%), group 3 (DD): Ab+ β+ (31%) and group 4 (classic type 2 DM): Ab- β+ (39%). The mean age of the DD patients in our study was 15.1 ± 6.4 years. A total of 41% of the study population presented with diabetic ketoacidosis and 61% of the study population presented with positive family history of DM. The mean BMI was 26.8 kg/m2 with 64% of overweight or obese patients. Ninety two percent of the patients were started on insulin at the time of diagnosis. During a mean follow-up of 3 years, only 32% of the patients with DD required insulin and 78% were on metformin alone or with insulin.CONCLUSIONOur findings enable us to arrive at the conclusion that almost one-third of the young Saudi diabetic patients reveal atypical forms of DM (double diabetes) expressing features resulting from both T1D and T2D.

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Section: Discussionsupporting

confidence: 90%

“…It is noteworthy that nearly 65% of the DD group required insulin, a discovery concurring with earlier reports in the literature[8,17]. During follow-up, nearly half the DD patients (46%) were managed solely on metformin (without necessitating insulin therapy).…”

Section: Discussionsupporting

confidence: 85%

Double diabetes in Saudi Arabia: A new entity or an underestimated condition

Braham¹,

Alzaid²,

Robert³

et al. 2016

WJD

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“…Furthermore, we confirmed that low eGDR is associated with an increased risk of diabetes vascular complications. Although the concept of IR among individuals with type 1 diabetes is not new (3–5), few studies have explored this phenomenon in nonwhite populations or assessed interethnic differences (6,16). To our knowledge, this is the first study of adults with type 1 diabetes that was adequately powered to analyze eGDR, demographic and metabolic confounders, and diabetes complications among three major ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

“…A combination of obesity prevalence and demographic composition of our local community may place our type 1 diabetes population at particularly high risk for IR as well as related macro- and microvascular complications (3,20). Given the high rates of type 2 diabetes often found among Hispanics and blacks, it is not surprising that a significant percentage of our type 1 diabetes clinic cohort shows features of “double diabetes,” that is, evidence of type 2 diabetes features (including greater waist circumference, higher triglycerides, and lower HDL) in the lowest eGDR tertile (10,11).…”

Section: Discussionmentioning

confidence: 99%

Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes

et al. 2013

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OBJECTIVEInsulin resistance has been described in type 1 diabetes mellitus, is related to risk of vascular complications, and may be more common in certain ethnic groups. Estimated glucose disposal rate (eGDR) is a validated clinical tool for estimating insulin sensitivity in type 1 diabetes. Because previous reports of eGDR in adults with type 1 diabetes have included few ethnic minorities, this study explored interethnic differences in eGDR and the relationship of eGDR with diabetic vascular complications.RESEARCH DESIGN AND METHODSWe conducted a cross-sectional study using a sample that included 207 white, black, or Hispanic adults with prior clinical diagnosis of type 1 diabetes who were receiving care at an urban academic medical center. eGDR (milligrams per kilogram per minute) was calculated using HbA1c, waist circumference, and hypertensive status. Race/ethnicity was self-reported. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% CIs of association of eGDR with diabetes complications (cardiovascular disease, retinopathy, albuminuria, and chronic kidney disease above stage 3).RESULTSForty-two percent of the participants were women, and mean age was 45 ± 15 years; 34% were white, 32% were Hispanic, and 34% were black. Ethnicity was significantly associated with eGDR; blacks had significantly lower eGDR (5.66 ± 2.34) than Hispanics (6.70 ± 2.29) and whites (7.20 ± 2.03) (P < 0.001). Patients with the lowest eGDR compared with the highest had a significantly greater risk of any diabetes complication (OR 3.1 [95% CI 1.2–8.1]) compared with the least insulin-resistant patients.CONCLUSIONSIn an urban clinic population of patients with type 1 diabetes, blacks were significantly less insulin sensitive than whites or Hispanics, and lower eGDR was associated with diabetes complications. Further study is needed to determine whether using eGDR to target interventions can improve outcomes.

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“…Years ago, microvascular complications, such as nephropathy, constituted the main cause of morbidity and mortality among patients with T1D [3]. More recently, there has been an increase in the macrovascular complication rate, associated with the presence of other cardiovascular risk factors such as hypertension, hypertriglyceridemia, hypoalphalipoproteinemia and central obesity, all of them in the context of metabolic syndrome (MS) [4].…”

Section: Introductionmentioning

confidence: 99%

Utility of the waist-to-height ratio, waist circumference and body mass index in the screening of metabolic syndrome in adult patients with type 1 diabetes mellitus

Ferreira‐Hermosillo

Ramírez‐Rentería

Mendoza‐Zubieta

et al. 2014

Diabetol Metab Syndr

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BackgroundThe incidence of macrovascular complications and morbidities associated to metabolic syndrome are increasing in patients with type 1 diabetes mellitus (T1DM). The combination of T1DM with features of insulin resistance similar to that of type 2 diabetes (T2DM), sometimes called “double diabetes”, has been associated with central obesity. Since the most methods to accurately detect body fat and insulin resistance are not readily available, we propose that certain indirect indexes for detecting obesity as waist-to-height ratio, waist circumference and body mass index, may be useful when screening for metabolic syndrome in patients with T1DM.MethodsWe performed a transversal evaluation (clinical and biochemical) in all the patients of the T1DM Clinic (n = 120). We determined the presence of metabolic syndrome according to the Joint Statement Criteria by the American Heart Association/ National Heart Lung and Blood Institute and the International Diabetes Federation and the utility of certain anthropometric indexes for predicting double diabetes was evaluated.ResultsThirty seven percent of the patients were considered to have metabolic syndrome using these criteria (n = 30). These patients were significantly older (p = 0.002), have a higher glycated hemoglobin (p = 0.036), cholesterol (p < 0.012) and triglyceride concentration (p < 0.01) as well as body mass index (p = 0.004), waist circumference (p = 0.01) and waist-to-height ratio (p < 0.01) than the group without metabolic syndrome. Also their c-HDL is lower (p < 0.01). A value of 0.52 for waist-to-height ratio correctly classified the largest number of patients (68% of correctly classified) well as the waist circumference (66% of correctly classified) with an adequate specificity and sensibility. Meanwhile the most precise body mass index value only classified correctly to 61% of patients.ConclusionOur data show that waist circumference and waist-to-height ratio indexes are useful to predict the presence of metabolic syndrome in adult patients with type 1 diabetes mellitus.

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Síndrome metabólico y diabetes mellitus tipo 1: prevalencia y factores relacionados

Cited by 35 publications

References 31 publications

Double diabetes in Saudi Arabia: A new entity or an underestimated condition

Double diabetes in Saudi Arabia: A new entity or an underestimated condition

Use of the Estimated Glucose Disposal Rate as a Measure of Insulin Resistance in an Urban Multiethnic Population With Type 1 Diabetes

Utility of the waist-to-height ratio, waist circumference and body mass index in the screening of metabolic syndrome in adult patients with type 1 diabetes mellitus

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