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[PMID]:29297078
[Au] Autor:Knip M; Åkerblom HK; Al Taji E; Becker D; Bruining J; Castano L; Danne T; de Beaufort C; Dosch HM; Dupre J; Fraser WD; Howard N; Ilonen J; Konrad D; Kordonouri O; Krischer JP; Lawson ML; Ludvigsson J; Madacsy L; Mahon JL; Ormisson A; Palmer JP; Pozzilli P; Savilahti E; Serrano-Rios M; Songini M; Taback S; Vaarala O; White NH; Virtanen SM; Wasikowa R; Writing Group for the TRIGR Study Group
[Ad] Endereço:University of Helsinki, Helsinki, Finland.
[Ti] Título:Effect of Hydrolyzed Infant Formula vs Conventional Formula on Risk of Type 1 Diabetes: The TRIGR Randomized Clinical Trial.
[So] Source:JAMA;319(1):38-48, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Early exposure to complex dietary proteins may increase the risk of type 1 diabetes in children with genetic disease susceptibility. There are no intact proteins in extensively hydrolyzed formulas. Objective: To test the hypothesis that weaning to an extensively hydrolyzed formula decreases the cumulative incidence of type 1 diabetes in young children. Design, Setting, and Participants: An international double-blind randomized clinical trial of 2159 infants with human leukocyte antigen-conferred disease susceptibility and a first-degree relative with type 1 diabetes recruited from May 2002 to January 2007 in 78 study centers in 15 countries; 1081 were randomized to be weaned to the extensively hydrolyzed casein formula and 1078 to a conventional formula. The follow-up of the participants ended on February 28, 2017. Interventions: The participants received either a casein hydrolysate or a conventional adapted cow's milk formula supplemented with 20% of the casein hydrolysate. The minimum duration of study formula exposure was 60 days by 6 to 8 months of age. Main Outcomes and Measures: Primary outcome was type 1 diabetes diagnosed according to World Health Organization criteria. Secondary outcomes included age at diabetes diagnosis and safety (adverse events). Results: Among 2159 newborn infants (1021 female [47.3%]) who were randomized, 1744 (80.8%) completed the trial. The participants were observed for a median of 11.5 years (quartile [Q] 1-Q3, 10.2-12.8). The absolute risk of type 1 diabetes was 8.4% among those randomized to the casein hydrolysate (n = 91) vs 7.6% among those randomized to the conventional formula (n = 82) (difference, 0.8% [95% CI, -1.6% to 3.2%]). The hazard ratio for type 1 diabetes adjusted for human leukocyte antigen risk group, duration of breastfeeding, duration of study formula consumption, sex, and region while treating study center as a random effect was 1.1 (95% CI, 0.8 to 1.5; P = .46). The median age at diagnosis of type 1 diabetes was similar in the 2 groups (6.0 years [Q1-Q3, 3.1-8.9] vs 5.8 years [Q1-Q3, 2.6-9.1]; difference, 0.2 years [95% CI, -0.9 to 1.2]). Upper respiratory infections were the most common adverse event reported (frequency, 0.48 events/year in the hydrolysate group and 0.50 events/year in the control group). Conclusions and Relevance: Among infants at risk for type 1 diabetes, weaning to a hydrolyzed formula compared with a conventional formula did not reduce the cumulative incidence of type 1 diabetes after median follow-up for 11.5 years. These findings do not support a need to revise the dietary recommendations for infants at risk for type 1 diabetes. Trial Registration: clinicaltrials.gov Identifier: NCT00179777.
[Mh] Termos MeSH primário: Caseínas
Diabetes Mellitus Tipo 1/prevenção & controle
Fórmulas Infantis
[Mh] Termos MeSH secundário: Criança
Diabetes Mellitus Tipo 1/epidemiologia
Intervalo Livre de Doença
Método Duplo-Cego
Feminino
Seguimentos
Seres Humanos
Fenômenos Fisiológicos da Nutrição do Lactente
Recém-Nascido
Masculino
Política Nutricional
Risco
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Caseins); 65072-00-6 (casein hydrolysate)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19826


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[PMID]:29203738
[Au] Autor:Popruha AA; Bobyreva LE; Samarchenko LA; Mykhaylychenko TE
[Ad] Endereço:Higher State Educational Establishment Of Ukraine, "Ukrainian Medical Dental Academy", Poltava, Ukraine.
[Ti] Título:Mathematical model of diabetic encephalopathy.
[So] Source:Wiad Lek;70(5):906-909, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Diabetes mellitus (DM) is one of the leading risk factors for cerebrovascular disorders. The risk of stroke is 3-4 times higher in this population. In 10% of cases of vascular accidents in diabetic patients leads to fatal. The mortality rate for ischemic stroke is undergoing 50-60% and 70-95% of hemorrhagic form. It is known that diabetes increases the course of acute disorders of cerebral circulation. At the same time, there are data that about 415 million of the inhabitants of the planet suffer from diabetes, in 95% of cases they have type 2 diabetes, which is the second risk factor for the development of ischemic stroke after an arterial hypertension. This determines the relevance of studying the factors that affect the development of the ischemic process in patients with diabetes The aim of this research is to optimize the methods for diagnosis of diabetic encephalopathy based on a study of indicators of cerebrovascular hemodynamics, functional state of the brain, metabolic disorders and morphological characteristics of the brain tissue. MATERIALS AND METHODS: It was carried out a comprehensive survey of 537 patients with diabetes, including type 1 diabetes is set to 342 (63.7%) type 2 diabetes - in 195 (36.3%) patients. In 108 (20.1%) patients with diabetes, the clinical syndrome DE not identified in 429 (79.9%) - found DE I, II and stage III disease. CONCLUSIONS: Construction of mathematical model allows to objectify the diagnosis where with the help of clinical and metabolic parameters without expensive equipment. At the same time, the availability of informative indicators identified will allow the doctor to diagnose DE the early stages or to predict its development and to discover at the preclinical stage.
[Mh] Termos MeSH primário: Isquemia Encefálica/etiologia
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 2/complicações
Modelos Teóricos
[Mh] Termos MeSH secundário: Seres Humanos
Hipertensão/complicações
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:28942280
[Au] Autor:Edwards TM; Hamlin HJ; Freymiller H; Green S; Thurman J; Guillette LJ
[Ad] Endereço:Department of Biology, University of the South, Sewanee, TN, USA; Department of Biology, University of Florida, Gainesville, FL, USA; School of Biological Sciences, Louisiana Tech University, Ruston, LA, USA. Electronic address: theamedwards@gmail.com.
[Ti] Título:Nitrate induces a type 1 diabetic profile in alligator hatchlings.
[So] Source:Ecotoxicol Environ Saf;147:767-775, 2018 Jan.
[Is] ISSN:1090-2414
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Type 1 diabetes (T1D) is a chronic autoimmune disease that affects 1 in 300 children by age 18. T1D is caused by inflammation-induced loss of insulin-producing pancreatic beta cells, leading to high blood glucose and a host of downstream complications. Although multiple genes are associated with T1D risk, only 5% of genetically susceptible individuals actually develop clinical disease. Moreover, a growing number of T1D cases occur in geographic clusters and among children with low risk genotypes. These observations suggest that environmental factors contribute to T1D etiology. One potential factor, supported primarily by epidemiological studies, is the presence of nitrate and nitrite in drinking water. To test this hypothesis, female hatchling alligators were exposed to environmentally relevant concentrations of nitrate in their tank water (reference, 10mg/L, or 100mg/L NO -N) from hatch through 5 weeks or 5 months of age. At each time point, endpoints related to T1D were investigated: plasma levels of glucose, triglycerides, testosterone, estradiol, and thyroxine; pancreas, fat body, and thyroid weights; weight gain or loss; presence of immune cells in the pancreas; and pancreatic beta cell number, assessed by antibody staining of nkx6.1 protein. Internal dosing of nitrate was confirmed by measuring plasma and urine nitrate levels and whole blood methemoglobin. Cluster analysis indicated that high nitrate exposure (most animals exposed to 100mg/L NO3-N and one alligator exposed to 10mg/L NO3-N) induced a profile of endpoints consistent with early T1D that could be detected after 5 weeks and was more strongly present after 5 months. Our study supports epidemiological data correlating elevated nitrate with T1D onset in humans, and highlights nitrate as a possible environmental contributor to the etiology of T1D, possibly through its role as a nitric oxide precursor.
[Mh] Termos MeSH primário: Jacarés e Crocodilos/sangue
Diabetes Mellitus Experimental/induzido quimicamente
Diabetes Mellitus Tipo 1/induzido quimicamente
Disruptores Endócrinos/toxicidade
Nitratos/toxicidade
Poluentes Químicos da Água/toxicidade
[Mh] Termos MeSH secundário: Jacarés e Crocodilos/crescimento & desenvolvimento
Animais
Glicemia/análise
Diabetes Mellitus Experimental/sangue
Diabetes Mellitus Tipo 1/sangue
Relação Dose-Resposta a Droga
Disruptores Endócrinos/farmacocinética
Monitoramento Ambiental/métodos
Feminino
Hormônios Esteroides Gonadais/sangue
Nitratos/farmacocinética
Tamanho do Órgão/efeitos dos fármacos
Tiroxina/sangue
Triglicerídeos/sangue
Poluentes Químicos da Água/farmacocinética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Endocrine Disruptors); 0 (Gonadal Steroid Hormones); 0 (Nitrates); 0 (Triglycerides); 0 (Water Pollutants, Chemical); Q51BO43MG4 (Thyroxine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170925
[St] Status:MEDLINE


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[PMID]:29489657
[Au] Autor:Liang K; Ou X; Huang X; Lan Q
[Ti] Título:Agenesis of the dorsal pancreas: a rare cause of insulin-dependent diabetes without abdominal pain: Case report.
[So] Source:Medicine (Baltimore);97(9):e0046, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Agenesis of the dorsal pancreas is a very rare condition with an unknown pathology and etiology, although it may be associated with autosomal dominant or X-linked dominant inheritance or retinoic acid and hedgehog signaling pathway alterations. This condition usually manifests with abdominal pain or pancreatitis, although some cases are asymptomatic. Approximately 50% of affected patients with this disorder present with hyperglycemia or various other anomalies. PATIENT CONCERNS: We report the case of a 23-year-old Chinese woman who visited the Department of Endocrinology and Metabolism with insulin-dependent diabetes but no specific symptoms, signs, or other deformities. Severe diabetic retinopathy indicated a long period of hyperglycemia. DIAGNOSIS: Agenesis of the dorsal pancreas was observed incidentally during the common diagnosis of diabetes, and the diagnosis was established using magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance cholangiopancreatography. INTERVENTIONS: Following the diagnosis of diabetes, insulin replacement therapy was initiated at a dosage of up to 45 U per day. The patient's blood glucose level was monitored, and the insulin dosage was adjusted accordingly. OUTCOMES: The patient's blood glucose levels gradually normalized after insulin treatment and were subsequently maintained with intensive insulin therapy. Treatment for diabetic retinopathy was provided by the Ophthalmology Department. LESSONS: Agenesis of the dorsal pancreas should be considered in a young patient diagnosed with diabetes who presents with obvious diabetes-related complications (e.g., renal, retinal, or neurological) inconsistent with the course of the disease or a history of other congenital anomalies. We recommend the routine use of computed tomography or magnetic resonance imaging when examining young patients with diabetes.
[Mh] Termos MeSH primário: Anormalidades Congênitas
Diabetes Mellitus Tipo 1/etiologia
Pâncreas/anormalidades
[Mh] Termos MeSH secundário: Dor Abdominal
Doenças Assintomáticas
Colangiopancreatografia por Ressonância Magnética
Anormalidades Congênitas/diagnóstico por imagem
Diabetes Mellitus Tipo 1/tratamento farmacológico
Imagem de Difusão por Ressonância Magnética
Feminino
Seres Humanos
Hiperglicemia/etiologia
Hipoglicemiantes/uso terapêutico
Insulina/uso terapêutico
Angiografia por Ressonância Magnética
Pâncreas/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010046


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[PMID]:29489653
[Au] Autor:Xin WX; Fang L; Fang QL; Zheng XW; Ding HY; Huang P
[Ad] Endereço:Laboratory of Clinical Pharmacy.
[Ti] Título:Effect of hypoglycemic agents on survival outcomes of lung cancer patients with diabetes mellitus: A meta-analysis.
[So] Source:Medicine (Baltimore);97(9):e0035, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To assess the association between hypoglycemic agents and prognosis of lung cancer patients with diabetes. METHODS: A comprehensive literature search was performed in PubMed, Web of Science, Embase, and Cochrane Library until May 2017. The search yielded 2593 unique citations, of which 18 articles met inclusion criteria. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated by a fixed-effects or random-effects model. RESULTS: The pooled HRs favoring metformin users were 0.77 for overall survival (OS) (n = 15, 95% CI: 0.68-0.86) and 0.50 for disease-free survival (n = 5, 95% CI: 0.39-0.64). One study assessed the relationship between metformin and cancer-specific survival (CSS), reporting no significant results. No significant association between insulin and OS (n = 2, HR: 0.95, 95% CI: 0.79-1.13) or CSS (n = 2, HR: 1.03, 95% CI: 0.76-1.41) was noted. One study evaluated association of sulfonylureas with lung cancer survival and reported no clinical benefit (HR: 1.10, 95% CI: 0.87-1.40). One study reported no association of thiazolidinediones with lung cancer survival (HR: 1.04, 95% CI: 0.65-1.66). CONCLUSIONS: This meta-analysis demonstrated that metformin exposure might improve survival outcomes in lung cancer patients with diabetes.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Diabetes Mellitus Tipo 2/tratamento farmacológico
Hipoglicemiantes/uso terapêutico
Neoplasias Pulmonares/mortalidade
[Mh] Termos MeSH secundário: Seres Humanos
Insulina/uso terapêutico
Metformina/uso terapêutico
Prognóstico
Compostos de Sulfonilureia/uso terapêutico
Tiazolidinedionas/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin); 0 (Sulfonylurea Compounds); 0 (Thiazolidinediones); 9100L32L2N (Metformin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010035


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[PMID]:29406653
[Au] Autor:Smith NM; Satyshur RD
[Ti] Título:Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.
[So] Source:Pediatr Nurs;42(6):294-9, 2016 Nov-Dec.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem/organização & administração
Assistência à Saúde/métodos
Diabetes Mellitus Tipo 1/enfermagem
Diabetes Mellitus Tipo 1/prevenção & controle
Papel do Profissional de Enfermagem
Enfermagem Pediátrica/métodos
Telemedicina/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Meia-Idade
Satisfação do Paciente/estatística & dados numéricos
População Rural/estatística & dados numéricos
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


  7 / 67869 MEDLINE  
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[PMID]:29406645
[Au] Autor:Sy V
[Ti] Título:Empowering Staff Nurses as Primary Educators to Children with Type 1 Diabetes.
[So] Source:Pediatr Nurs;42(5):247-51, 2016 Sep-Oct.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patient and family education is a critical element of diabetes management. Manychildren with new onset type 1 diabetes present with symptoms of diabeticketoacidosis (DKA) and are hospitalized at diagnosis. These children and theirfamilies receive their initial education in the hospital setting. As soon as bloodglucose levels are stabilized and the acidosis is corrected, the patient is dischargedhome, usually within three days (Nettles, 2005). There is little time toprovide the skills and education, as well as emotional support, for a smooth transitionto home. It is a challenge to achieve these goals if the only resource personfor diabetes education is the clinical nurse specialist (CNS). The CNS for a 14-bed pediatric unit sought to expand the role of the bedside nurse to being the primaryeducator of patients with diabetes through education and support. All nursesattended an eight-hour workshop on diabetes. A DKA protocol was developedthrough multidisciplinary collaboration, and nurses were educated on this protocol.Additionally, the CNS organized a diabetes resource cart that contains thetools for diabetes education. The protocol and education materials wereuploaded in the Pediatric SharePoint site to make them accessible to nurses. Most importantly, the CNS developed a structured patient education plan that isoutcome-oriented, and based on review of current literature and practices in theunit. This initiative resulted in an increase in nursing confidence and expertiserelated to diabetes care as demonstrated by competencies met by nurses andanecdotal evidence from nurses and patients' caregivers.
[Mh] Termos MeSH primário: Currículo
Diabetes Mellitus Tipo 1/enfermagem
Papel do Profissional de Enfermagem
Enfermeiras Pediátricas
Recursos Humanos de Enfermagem no Hospital/psicologia
Educação de Pacientes como Assunto
Enfermagem Pediátrica/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Poder (Psicologia)
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29406634
[Au] Autor:Doyle EA
[Ti] Título:Screening for Disordered Eating Behaviors in Adolescents and Young Adults with Type 1 Diabetes.
[So] Source:Pediatr Nurs;42(4):197-200, 2016 Jul-Aug.
[Is] ISSN:0097-9805
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 1/psicologia
Comportamento Alimentar/psicologia
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico
Transtornos da Alimentação e da Ingestão de Alimentos/etiologia
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia
Programas de Rastreamento/métodos
[Mh] Termos MeSH secundário: Adolescente
Diabetes Mellitus Tipo 1/epidemiologia
Feminino
Seres Humanos
Incidência
Masculino
Prevalência
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:28454703
[Au] Autor:Starikov RS; Inman K; Has P; Iqbal SN; Coviello E; He M
[Ad] Endereço:Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women & Infants Hospital of Rhode Island, Providence, RI, USA; Phoenix Perinatal Associates, Phoenix, AZ, USA; Warren Alpert Medical School of Brown University, Providence, RI, USA.
[Ti] Título:Correlation of placental pathology and perinatal outcomes with Hemoglobin A1c in early pregnancy in gravidas with pregestational diabetes mellitus.
[So] Source:Placenta;52:94-99, 2017 Apr.
[Is] ISSN:1532-3102
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Data on the correlation among Hemoglobin A1c (HbA1c), placental pathology, and perinatal outcome in the pregestational diabetic population is severely lacking. We believe that this knowledge will enhance the management of pregnancies complicated by pregestational diabetes. We hypothesize that placental pathology correlates with glycemic control at an early gestational age. METHODS: This is a retrospective cohort study conducted from 2003 to 2011 at a large tertiary care center. Women included had a singleton gestation, preexisting diabetes mellitus, and information about delivery and placental pathology available for review. Placental pathology and perinatal outcomes were compared across three groups of patients with differing HbA1c levels (<6.5%, 6.5-8.4%, and ≥8.5%). RESULTS: 293 placentas were examined. HbA1c was measured at a mean of 9.5week gestation. Median HbA1c was 7.5%, interquartile range 6.5%-8.9%. 23% of the cohort had HbA1c <6.5%, 41.9% between 6.5% and 8.4%, and 34.8% > 8.5%. BMI varied significantly by group (35.4 vs. 34.4 vs. 32.0 respectively, P = 0.04). Individual placental lesions did not vary with HbA1c levels. The incidence of acute chorioamnionitis differed significantly in the type 1 population and "distal villous hypoplasia" varied in the type 2 population. DISCUSSION: The results show that HbA1c values in early pregnancy are poor predictors of future placental pathologies. As a result, HbA1c values obtained during early gestation (which reflect the level of glycemic control over an extended period of time) do not correlate with any particular placental pathology, despite reflecting the potential for placental insults secondary to pre-gestational diabetes.
[Mh] Termos MeSH primário: Glicemia
Diabetes Mellitus Tipo 1/patologia
Diabetes Mellitus Tipo 2/patologia
Hemoglobina A Glicada/análise
Placenta/patologia
Gravidez em Diabéticas/patologia
[Mh] Termos MeSH secundário: Adulto
Diabetes Mellitus Tipo 1/sangue
Diabetes Mellitus Tipo 2/sangue
Feminino
Seres Humanos
Gravidez
Resultado da Gravidez
Gravidez em Diabéticas/sangue
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Glycated Hemoglobin A); 0 (hemoglobin A1c protein, human)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


  10 / 67869 MEDLINE  
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[PMID]:29298776
[Au] Autor:Weng J; Zhou Z; Guo L; Zhu D; Ji L; Luo X; Mu Y; Jia W; T1D China Study Group
[Ti] Título:Incidence of type 1 diabetes in China, 2010-13: population based study.
[So] Source:BMJ;360:j5295, 2018 01 03.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To estimate the incidence of type 1 diabetes in all age groups in China during 2010-13. DESIGN: Population based, registry study using data from multiple independent sources. SETTING: National registration system in all 505 hospitals providing diabetes care, and communities of patients with diabetes in 13 areas across China, covering more than 133 million person years at risk, approximately 10% of the whole population. PARTICIPANTS: 5018 people of all ages with newly diagnosed type 1 diabetes and resident in the study areas from 1 January 2010 to 31 December 2013. MAIN OUTCOME MEASURES: Incidence of type 1 diabetes per 100 000 person years by age, sex, and study area. Type 1 diabetes was doctor diagnosed and further validated by onsite follow-up. Completeness of case ascertainment was assessed using the capture mark recapture method. RESULTS: 5018 cases of newly diagnosed type 1 diabetes were ascertained: 1239 participants were aged <15 years, 1799 were aged 15-29 years, and 1980 were aged ≥30 years. The proportion of new onset cases in participants aged ≥20 years was 65.3%. The estimated incidence of type 1 diabetes per 100 000 persons years for all ages in China was 1.01 (95% confidence interval 0.18 to 1.84). Incidence per 100 000 persons years by age group was 1.93 (0.83 to 3.03) for 0-14 years, 1.28 (0.45 to 2.11) for 15-29 years, and 0.69 (0.00 to 1.51) for ≥30 years, with a peak in age group 10-14 years. The incidence in under 15s was positively correlated with latitude (r=0.88, P<0.001), although this association was not observed in age groups 15-29 years or ≥30 years. CONCLUSION: Most cases of new onset type 1 diabetes in China occurred among adults. The incidence of type 1 diabetes in Chinese children was among the lowest reported in the study.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 1/epidemiologia
Sistema de Registros
[Mh] Termos MeSH secundário: Adolescente
Adulto
Distribuição por Idade
Idoso
Criança
Pré-Escolar
China/epidemiologia
Diabetes Mellitus Tipo 1/diagnóstico
Feminino
Seres Humanos
Incidência
Lactente
Recém-Nascido
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5295



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