Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes-A Cohort Study From the CGJDES

Prevalence and pattern of dyslipidemia in an Egyptian children and adolescents with type 1 diabetes

Background

Hyperglycemia and dyslipidemia are commonly found metabolic abnormalities in diabetic children and adolescents and both increase the risk of cardiovascular disease. This study aimed to assess the prevalence and the pattern of dyslipidemia in Egyptian children and adolescents with type 1 diabetes (T1DM) and determine its relation with the glycemic control.

Results

This retrospective study included 806 children and adolescents with T1DM; 358 (44.42%) males and 448 (55.58%) females. Their mean age was 11.71 ± 3.6 years. Clinical and laboratory data were recruited from patients’ files. Laboratory data include the most recent fasting lipid profile (triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL)), and the mean glycosylated hemoglobin (HbA1c) levels over the preceding year presented in percentage were calculated. Dyslipidemia in children and adolescents with T1DM represented 70.47% (568 patients). No statistically significant differences were detected between patients with and without dyslipidemia. As regards the pattern of dyslipidemia, high LDL and low HDL were the most frequent abnormalities in the study group; 62.16%, 60.21%, respectively. Patients with poor glycemic control (HbA1c > 7.5%) represent 73.45% and they were significantly older, with longer diabetes duration and higher TC, TG, and LDL compared to patients with good glycemic control. Significant positive correlations were found between HbA1c, TG, TC, and LDL with the age and diabetes duration.

Conclusion

We detected high prevalence of dyslipidemia in children and adolescents with T1DM. Therefore, dyslipidemia should be screened for in earlier ages in Egyptian children and adolescents suffering from T1DM. Programs directed to the prevention of dyslipidemia should be conducted, particularly for this group, in order to prevent/delay cardiovascular complications related to dyslipidemia. Also, parents should receive proper education targeting the prevention, control, and care of their diabetic children with dyslipidemia.

Urinary cystatin C as a biomarker of early renal dysfunction in type 2 diabetic patients

AIMS

We aimed to evaluate urinary CysC (cystanin c) as an early marker of diabetic nephropathy in patients with type 2 diabetes and investigate the correlation of urinary CysC with albuminuria and GFR.

METHODOLOGY

This case-controlled study was conducted on 66 type 2 diabetic patients who were classified according to albuminuria into 3 groups and consisting of 20 healthy subjects as the control group. We assessed urinary CysC, urinary albumin excretion rate (UACR).

RESULTS

Urinary CysC levels were significantly higher in normoalbuminuric diabetic compared with healthy control and there was a progressive linear increase in urinary CysC levels with increasing albuminuria in the diabetic patients. Despite insignificant deference in creatinine between participants groups, we observed significant differences between these groups as regard eGFR, urinary CysC, and UACR. Urinary CysC did not have significant correlations with any clinical or biochemical parameters. Moreover, urinary CysC had a statistically significant association with albuminuria and eGFR.

CONCLUSION

Urinary CysC levels correlated with UACR and GFR. It is linked to subclinical tubular injury and can be an earlier marker of kidney involvement, even before albuminuria and it is less influenced by non-renal factors. Therefore, Urinary CysC is useful biomarker for early diagnosis of diabetic nephropathy.

Pathways of emotional autonomy, problem-solving ability, self-efficacy, and self-management on the glycemic control of adolescents with type 1 diabetes: A prospective study

This prospective study tested a model to depict associations between a number of individual characteristics and 6-month glycated hemoglobin (HbA1c) levels in adolescents with type 1 diabetes (T1D). Adolescents (N = 232) aged 10-19 years with T1D were recruited from a medical center in Taiwan. Demographic characteristics, emotional autonomy, problem-solving ability, self-efficacy at baseline, and self-management information three months after baseline were collected using a self-reported questionnaire. HbA1c levels 6 months after study commencement were obtained from medical records. Structural equation modeling was used to test the model. Higher baseline self-efficacy and self-management at 3 months were directly associated with lower 6-month HbA1c levels. Higher baseline problem-solving ability and self-efficacy were directly associated with higher 3-month self-management, and higher baseline problem-solving ability was directly associated with higher baseline self-efficacy. Higher baseline emotional autonomy was directly associated with lower 6-month HbA1c levels but indirectly associated with higher 6-month HbA1c levels through the mediation of lower problem-solving ability, self-efficacy, and 3-month self-management. Findings indicate that improving self-management is essential to improving subsequent glycemic control, which might be achieved by enhancing problem-solving ability and self-efficacy. Strengthening problem-solving ability could diminish the negative impact of emotional autonomy on subsequent glycemic control in adolescents with T1D.

Micro-RNA 196a2 expression and miR-196a2 (rs11614913) polymorphism in T1DM: a pilot study

Background Recent emerging evidence supports the role of miR-196a2 in various human diseases. However, its role in type 1 diabetes mellitus (T1DM) is still underestimated. We aimed, for the first time, to investigate the expression of miR-196a2 in T1DM and the association of miR-196a2 (rs11614913) polymorphism with susceptibility of T1DM in a sample of patients from Cairo, Egypt. Methods The study included 150 patients and 150 healthy subjects. Evaluation of rs11614913 genotypes and miR-196a2 expression was done using the allelic discrimination and quantitative reverse transcriptase polymerase chain reaction (PCR) method, respectively. Results The Hardy-Weinberg equilibrium of single nucleotide polymorphism(SNP) was detected among controls (p = 0.2). Our results revealed that the TT genotype was more frequent in patients (22.6%) than controls (10%) while the CC genotype was more frequent in controls (47.3%) than patients (39.3%) (p = 0.01). The frequency of the T allele was significantly higher in patients than in controls (41.7 vs. 31.3%), while the C allele was more frequent in controls (p = 0.008). After adjustment for traditional risk factors, the association of the TT genotype with T1DM remained significant (TT vs. CC, odds ration [OR] = 3.2, 95% confidence interval [CI]: 1.4-7.4, p = 0.005). Power analysis of the data yielded a statistical power of 80% for the miR-196a2 rs11614913 with T1DM. Relative expression of miR-196a2 showed significant decrease in patients compared to controls (median = 0.09, 0.5, interquartile range [IQR] = 0.03-1.6, 0.1-2.1). However, miR-196a2 expression showed no significant difference between different rs11614913 genotypes (p = 0.5). Conclusions Our findings demonstrated that miR-196a rs11614913 is associated with T1DM and decreased expression of miR-196a2 may play a role in pathogenesis of T1DM.