Residual endogenous insulin secretion in Japanese children with type 1A diabetes

Association of detectable C-peptide levels with glycemic control and chronic complications in individuals with type 1 diabetes mellitus: A systematic review and meta-analysis

AIMS

Multiple studies have addressed the association between detectable levels of C-peptide and glycemic control, as well as the development of chronic complications of type 1 diabetes mellitus (T1DM), including both macrovascular and microvascular diseases. We aimed to summarize the available evidence on the clinical significance of detectable levels of C-peptide in T1DM.

METHOD

A systematic search was performed on online databases using the following key terms: T1DM, C-peptide, diabetes mellitus complications, and glycemic parameters. We pooled standardized mean difference (SMD) and odds ratios (OR).

RESULTS

Of the 1519 articles retrieved from the initial search, 38 (12 cohort and 26 cross-sectional studies) met our eligibility criteria. Individuals with T1DM in the detectable C-peptide group, compared with the undetectable C-peptide group, had lower mean HbA1c [pooled SMD (95 % confidence interval (95 % CI)): -0.08 (-0.13 to -0.02), I2 = 0 %, p.

VALUE

0.005] and daily insulin dose [-0.41 (-0.65 to -0.18), I2 = 83 %, p.value < 0.001]. They also showed lower odds for retinopathy [pooled crude OR (95 % CI): 0.53 (0.41 to 0.69), I2 = 65 %, p.value < 0.001] and nephropathy complications [0.62 (0.55 to 0.70), I2 = 19 %, p.value < 0.001]; however, the two groups were similar regarding neuropathy [0.92 (0.65 to 1.31), I2 = 0 %, p.

VALUE

0.31].

CONCLUSIONS

The available evidence suggests that individuals with T1DM in the detectable C-peptide group may experience better clinical outcomes.

Association of self-stigma with glycated hemoglobin: A single-center, cross-sectional study of adults with type 1 diabetes in Japan

AIMS/INTRODUCTION

There has been an increase in research on diabetes-related stigma and its association with glycated hemoglobin (HbA1c) over the past years. However, little is known about the association of self-stigma with HbA1c in persons with type 1 diabetes. This study aims to examine the association between self-stigma and HbA1c in Japanese people with type 1 diabetes.

MATERIALS AND METHODS

This cross-sectional study was conducted at a clinic in Tokyo. Questionnaires using nine items from the Japanese version of the Self-Stigma Scale was distributed to outpatients with type 1 diabetes, aged ≥18 years. We excluded outpatients with serious mental disorder, those who required urgent medical treatment or received hemodialysis. Adjusted linear regression analyses tested the association between the score of the 9-item Self-Stigma Scale and HbA1c.

RESULTS

Questionnaires were distributed to 166 eligible participants. A total of 109 participants were included in the final analysis after excluding participants with incomplete answers and laboratory data. After adjusting for age, sex, employment status, body mass index, duration of diabetes and insulin secretion, there was a significant positive association between self-stigma and HbA1c (β = 0.05, 95% confidence interval 0.01 to 0.08).

CONCLUSIONS

This cross-sectional study showed a significant association between self-stigma and HbA1c in persons with type 1 diabetes. Addressing self-stigma might be as equally essential as measuring HbA1c in evaluating glycemic outcome among individuals with type 1 diabetes.

Insulin-dependent diabetes mellitus in older adults: Current status and future prospects

The recent increase in life expectancy has resulted in an increase in the number of older adults with diabetes mellitus. In addition to type 2 diabetes, in which aging is a well‐known risk factor, individuals with type 1 and other types of diabetes are also increasing owing to longevity in the general population and improved prognosis of the disease and comorbidities. Insulin‐dependent state in type 1 diabetes and other types of diabetes, such as diabetes after pancreatectomy, inevitably requires insulin treatment for survival; however, daily injection of insulin is often hampered in older adults due to impaired cognitive function or limited activities of daily living. In this review, we aimed to discuss the current situation of insulin‐dependent diabetes mellitus in older adults and highlight future prospects. Geriatr Gerontol Int 2022; 22: 549–553.

β-Cell failure in diabetes: Common susceptibility and mechanisms shared between type 1 and type 2 diabetes

Diabetes mellitus is etiologically classified into type 1, type 2 and other types of diabetes. Despite distinct etiologies and pathogenesis of these subtypes, many studies have suggested the presence of shared susceptibilities and underlying mechanisms in β-cell failure among different types of diabetes. Understanding these susceptibilities and mechanisms can help in the development of therapeutic strategies regardless of the diabetes subtype. In this review, we discuss recent evidence indicating the shared genetic susceptibilities and common molecular mechanisms between type 1, type 2 and other types of diabetes, and highlight the future prospects as well.