Overweight and obese youth with type 1 or type 2 diabetes share similar elevation in triglycerides during middle and late adolescence

BackgroundOverweight and obesity have been observed in children with type 1 diabetes (T1D). This further increases their future risk of Cardiovascular Disease (CVD) as well as the development of other risk factors, such as dyslipidemia.AimsTo compare lipid profiles in children and adolescents with Type 1 diabetes and lean mass (T1L), Type 1 diabetes and overweight or obese (T1OW/OB), and type 2 diabetes (T2D).MethodsThis was a cross-sectional study of 669 patients with T1D or T2D aged 2–19 years using retrospective data collected from 2003 to 2014. Included patients were categorized into lean (BMI < 85th ile and overweight or Obese (BMI ≥ 85th ile). Patients were subcategorized into three age groups: < 10 years, 10–14 years, and 15–19 years.Results7.6% of patients had T2D. Of the patients with T1D, 58.9% were lean, 26.4% were overweight, and 14.7% were obese. Total Cholesterol (TC), Low-density lipoprotein cholesterol (LDL-C) and Non-HDL-C levels were similar across groups. In the 15–19 years group, Triglycerides (TG) levels were significantly higher in T1OW/OB and similar to T2D. High-density lipoprotein Cholesterol (HDL-C) was significantly lower in T2D. Weight status significantly correlated with TG and HDL-C levels in T1D and T2D groups.ConclusionsT1OW/OB constitutes a significant proportion of the T1D population. Patients with obesity and T1D, especially if in their late adolescence, have an adverse lipid profile pattern that is comparable to adolescents with T2D. Based on these findings, risk for future CVD in T1OW/OB and T2D may be equivalent.     

间歇性禁食法在糖尿病前期及糖尿病病人中的应用进展

对间歇性禁食法的概念、方法及形式、历史发展以及在糖尿病前期及糖尿病病人中的应用效果等进行介绍,阐述间歇性禁食法研究现状,总结间歇性禁食法对糖尿病前期和糖尿病病人的有益影响。     

Gestational alloimmune liver disease treated with exchange transfusion and intravenous immunoglobulin: A case study

Gestational alloimmune liver disease (GALD) is a materno-fetal alloimmune disorder that targets the fetal liver and often causes neonatal liver failure. GALD most commonly presents as neonatal hemochromatosis (NH), which is a severe neonatal liver injury confirmed by extra-hepatic iron accumulation at various sites. With the discovery of the alloimmune mechanism of GALD, exchange transfusion and intravenous immunoglobulin (IVIG) administration are being used as novel treatments. Here, we present a rare case of an 11-day-old female infant who presented with marked hyperbilirubinemia. Laboratory findings showed significantly elevated direct and indirect bilirubin, high ferritin and alpha fetoprotein levels, high transferrin saturation, and severe coagulopathy. Abdominal magnetic resonance imaging revealed markedly reduced T2 signal intensity in the liver and pancreas compared to the spleen, suggesting iron deposition. The infant was diagnosed with NH and successfully treated with exchange transfusion and four doses of IVIG.     

糖尿病合并结核潜伏感染的研究热点与趋势分析

目的 探讨糖尿病合并结核潜伏感染的研究现状、热点与前沿。方法 收集Web of Science核心合集于2000年1月1日至2021年11月20日发表的糖尿病合并结核潜伏感染的相关文章，运用CiteSpace 5.8.R3软件进行可视化分析。结果 共纳入英文文献148篇，近20年来该领域发文量呈上升趋势。美国发文量最多（46篇, 31.08%），机构间合作情况的可视化分析共得到个340节点、929条连线，网络密度为0.0161，作者间合作关系的知识图谱共得到790个节点、2425条连线，网络密度为0.0078，关键词共现分析结果显示，糖尿病合并结核潜伏感染的危险因素、患病率、诊断和治疗是该领域的研究热点和趋势。结论 糖尿病合并结核潜伏感染的发文量不断增加，机构间、区域内和国际范围内的合作有待进一步开展。立足国情，探索慢病共病的管理模式将有助于优化共病管理，进一步推动慢病管理的进程。     

Adherence to Chronic Kidney Disease Screening Guidelines Among Patients With Type 2 Diabetes in a US Administrative Claims Database

ObjectiveTo examine the screening rates for kidney damage and function among patients with type 2 diabetes (T2D) and chronic kidney disease stage at diabetes diagnosis using a US administrative claims database.Patients and MethodsThis cohort study used a claims database enriched with laboratory results data. Patients with T2D (defined as 1 inpatient or 2 outpatient claims for diabetes), aged 18 years or older, and with at least 1 year of follow-up enrollment were identified. Patients with type 1 diabetes, kidney disease, or other related conditions at baseline were excluded. We estimated screening rates using laboratory orders for serum creatinine and estimated glomerular filtration rate (eGFR) measurement and urine albumin to creatinine ratio (UACR). Chronic kidney disease severity was reported using the Kidney Disease: Improving Global Outcomes classification based on laboratory results.ResultsA total of 1,881,447 patients with T2D were eligible for analysis. Mean ± SD age was 63.1±13.1 years; 947,150 patients (50.3%) were male. Serum creatinine tests were ordered within 14 days of the index date among 290,722 patients of 622,915 (46.7%) patients with newly-recognized T2D. Overall, 1,595,964 patients (84.8%) had at least one serum creatinine test ordered during the 1-year follow-up period. Fewer patients received a UACR test during follow-up (814,897 [43.3%]). Less than half of all patients with T2D received a laboratory test order for both serum creatinine and urine albumin measurements during the follow-up period.ConclusionPhysicians treating patients with diabetes are selectively adhering to chronic kidney disease screening guidelines, as indicated by high rates of eGFR testing, but less frequent UACR testing. Despite recommendations to monitor both eGFR and UACR, less than half of patients were screened for albuminuria during the 1-year follow-up.