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Kamiński M, Kulecki M, Kasprzak D, Lachowski P, Kulczycka A, Kozłowska M, Klause D, Naskręt D, Flotyńska J, Zozulińska-Ziółkiewicz D, Uruska A. Therapeutic inertia in lipid management among Polish adults with type 1 diabetes - results from the cross-sectional PARADISE T1DM study. Nutr Metab Cardiovasc Dis 2025; 35:103853. [PMID: 39929759 DOI: 10.1016/j.numecd.2025.103853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 11/30/2024] [Accepted: 12/30/2024] [Indexed: 04/26/2025]
Abstract
BACKGROUND AND AIMS Adults with Type 1 diabetes (T1DM) have increased cardiovascular risk. Most of the Polish general population fails to meet lipid goals. Recent data on the effectiveness of dyslipidemia treatment in T1DM population is lacking. We aimed to investigate which part of adults with T1DM met the dyslipidemia treatment goals according to the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) 2016 and 2019 guidelines. METHODS AND RESULTS We recruited adult people with T1DM, for whom a cross-sectional assessment of disease progression was performed. Anthropometric measurements and a basic panel of laboratory tests were conducted for each person. We assessed cardiovascular risk and lipid goals according to the ESC/EAS dyslipidemia guidelines from 2016 to 2019. Among the n = 233 participants, only 34.3 % met the lipid goal according to the 2016 guidelines, while for the 2019 guidelines, merely 13.3 %. Only 12.8 % of individuals with very high cardiovascular risk met the LDL cholesterol goals according to ESC/AES 2016, and 4.9 % when ESC/EAS 2019 guidelines were considered. The median difference between the LDL cholesterol value and the target value was 18.0 (-16.0 to 49.0) mg/dl [20.4 % (-19.8 %-41.2 %)], when considering the 2016 ESC/EAS guidelines, whereas for the 2019 guidelines, it was 36.0 (11.0-60.0) mg/dl [36.3 % (13.9 %-48.0 %)]. CONCLUSION Therapeutic inertia results in the failure to meet the lipid goals according to the ESC/EAS guidelines for 2016 and 2019 in most Polish adults with T1DM. Many adults with T1DM may require intensification of lipid-lowering interventions.
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Affiliation(s)
- Mikołaj Kamiński
- Department of the Treatment of Obesity and Metabolic Disorders, and of Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego 84, 60-569, Poznań, Poland
| | - Michał Kulecki
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland; Doctoral School, Poznan University of Medical Sciences, Poznan, Poland.
| | | | - Paweł Lachowski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Anna Kulczycka
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Maria Kozłowska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Daria Klause
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Dariusz Naskręt
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Justyna Flotyńska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Dorota Zozulińska-Ziółkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
| | - Aleksandra Uruska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, ul. Mickiewicza 2, 60-834, Poznań, Poland
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Longo M, Caruso P, Varro C, Tomasuolo M, Cirillo P, Scappaticcio L, Romano L, Arcaniolo D, Maiorino MI, Bellastella G, De Sio M, Esposito K. Semen quality and metabolic profile in people with type 1 diabetes with and without erectile dysfunction: a cross-sectional study. J Endocrinol Invest 2024; 47:1787-1795. [PMID: 38225528 PMCID: PMC11196288 DOI: 10.1007/s40618-023-02285-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE The aim of the present study is to evaluate the association of metabolic and glycemic variables with semen parameters in patients with type 1 diabetes (T1D) with and without erectile dysfunction (ED). METHODS The study population included 88 adults with T1D using a continuous glucose monitoring, of whom 28 with ED (ED group) and 60 without it (NO ED group). All men completed the International Index of Erectile Function (IIEF-5) and underwent body composition analysis (BIA) and semen analysis. RESULTS ED group showed worse HbA1c levels [median (IQR), 8.4 (7.7, 9.9) vs 7.4 (7, 8.2) %, P < 0.001)], higher insulin dose [60 (51, 65) vs 45 (38, 56) UI/die, P = 0.004)] and a higher total body water and intracellular water as compared with ED group. Men in the ED group presented higher semen volume [2.8 (2.6, 4.2) vs 2.5 (2.2, 2.7) mL, P < 0.001] and sperm concentration [24 (19, 29) vs 20 (12, 23) mil/mL, P = 0.010], but reduced sperm progressive motility [28 (25, 35) vs 35 (25, 36) %, P = 0.011], higher rate of non-progressive motility [15 (10, 15) vs 10 (5, 10) %, P < 0.001] and higher rate of typical morphology [7(5, 8) vs 5 (4, 5) %, P = 0.001]. Based on multivariate logistic regression analysis performed to assess the association between clinical variables and ED, intracellular water (OR 3.829, 95% CI 1.205, 12.163, P = 0.023) resulted as the only independent predictor of ED. CONCLUSION Men with T1D and ED showed worse metabolic profile which is associated with poor semen quality, as compared with those without ED.
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Affiliation(s)
- M Longo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy.
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - P Caruso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C Varro
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - M Tomasuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - P Cirillo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - L Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
| | - L Romano
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - D Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - M I Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - G Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M De Sio
- Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - K Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza Luigi Miraglia 2, 80138, Naples, Italy
- Division of Endocrinology and Metabolic Diseases, University of Campania "Luigi Vanvitelli", Naples, Italy
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Zhang X, Zhu Z, Tang G. Global prevalence of erectile dysfunction and its associated risk factors among men with type 1 diabetes: a systematic review and meta-analysis. Int J Impot Res 2024; 36:365-374. [PMID: 38396263 DOI: 10.1038/s41443-024-00855-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Various observational studies have examined the prevalence and determinants of erectile dysfunction (ED) in men with type 1 diabetes across different geographical areas. Nevertheless, a comprehensive systematic review and meta-analysis to consolidate the worldwide prevalence and risk factors remains lacking. Hence, the primary study objective was to perform an extensive systematic review and meta-analysis that specifically examined ED prevalence and determinants in men with type 1 diabetes. A thorough exploration was conducted by examining electronic databases, such as PubMed, Embase, and Web of Science. The general ED prevalence and a 95% confidence interval (CI) in men with type 1 diabetes were summarized. The relevant risk factors were analyzed by deriving a comprehensive odds ratio (OR) from merging the ORs using fixed- or random-effects models. The sources of heterogeneity were investigated using subgroup analyses and meta-regression. This systematic review and meta-analysis included 19 articles involving 3788 men with type 1 diabetes. The meta-analysis revealed that men with type 1 diabetes had a combined ED prevalence of 42.5% (95% CI: 34.3%-50.8%). This prevalence showed significant heterogeneity (I2 = 96.2%, P < 0.01). Meta-regression revealed that age (P = 0.016) and type 1 diabetes duration (P = 0.004) were significant causes of heterogeneity. Furthermore, the ED risk in men with type 1 diabetes was significantly influenced by age, type 1 diabetes duration, body mass index, glycated hemoglobin (HbA1c), retinopathy, and smoking habits (all P < 0.05). In summary, this systematic review and meta-analysis revealed a significant prevalence of ED in men with type 1 diabetes, highlighting the importance of clinicians addressing concerns regarding ED in this specific group of individuals.
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Affiliation(s)
- Xiaolong Zhang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zhirong Zhu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Guiliang Tang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
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Longo M, Caruso P, Varro C, Tomasuolo M, Cirillo P, Scappaticcio L, Romano L, Arcaniolo D, Maiorino MI, Bellastella G, De Sio M, Esposito K. Semen quality and metabolic profile in people with type 1 diabetes with and without erectile dysfunction: a cross-sectional study. J Endocrinol Invest 2024; 47:1787-1795. [DOI: https:/doi.org/10.1007/s40618-023-02285-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/14/2023] [Indexed: 03/28/2024]
Abstract
Abstract
Purpose
The aim of the present study is to evaluate the association of metabolic and glycemic variables with semen parameters in patients with type 1 diabetes (T1D) with and without erectile dysfunction (ED).
Methods
The study population included 88 adults with T1D using a continuous glucose monitoring, of whom 28 with ED (ED group) and 60 without it (NO ED group). All men completed the International Index of Erectile Function (IIEF-5) and underwent body composition analysis (BIA) and semen analysis.
Results
ED group showed worse HbA1c levels [median (IQR), 8.4 (7.7, 9.9) vs 7.4 (7, 8.2) %, P < 0.001)], higher insulin dose [60 (51, 65) vs 45 (38, 56) UI/die, P = 0.004)] and a higher total body water and intracellular water as compared with ED group. Men in the ED group presented higher semen volume [2.8 (2.6, 4.2) vs 2.5 (2.2, 2.7) mL, P < 0.001] and sperm concentration [24 (19, 29) vs 20 (12, 23) mil/mL, P = 0.010], but reduced sperm progressive motility [28 (25, 35) vs 35 (25, 36) %, P = 0.011], higher rate of non-progressive motility [15 (10, 15) vs 10 (5, 10) %, P < 0.001] and higher rate of typical morphology [7(5, 8) vs 5 (4, 5) %, P = 0.001]. Based on multivariate logistic regression analysis performed to assess the association between clinical variables and ED, intracellular water (OR 3.829, 95% CI 1.205, 12.163, P = 0.023) resulted as the only independent predictor of ED.
Conclusion
Men with T1D and ED showed worse metabolic profile which is associated with poor semen quality, as compared with those without ED.
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