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Tatulashvili S, Dreves B, Meyer L, Cosson E, Joubert M. Carbohydrate counting knowledge and ambulatory glucose profile in persons living with type 1 diabetes. Diabetes Res Clin Pract 2024; 210:111592. [PMID: 38437987 DOI: 10.1016/j.diabres.2024.111592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 03/06/2024]
Abstract
CONTEXT The amount of consumed carbohydrates is the strongest factor influencing glucose levels during the four hours following a meal. Our aim was to evaluate the association between carbohydrate counting knowledge and continuous glucose monitoring (CGM) parameters in patients with type 1 diabetes (T1D) using different insulin regimens. METHOD In this multicenter prospective study, the GluciQuizz questionnaire was used to evaluate carbohydrate knowledge. CGM data for the 14 days preceding completion of the questionnaire were analyzed. The primary endpoint was evaluation of the correlation between the GluciQuizz total score and time in range (TIR) in the study population. RESULTS The mean age of the 170 participants was 40.7 ± 14.8 years and duration of T1D 18.8 ± 12.1 years. The mean GluciQuizz total score for all participants was 66 ± 13 %. Mean TIR was 58.6 ± 18.7 %. GluciQuizz total score positively correlated with TIR (r = 0.3001; p < 0.0001). This correlation was observed in CSII users (r = 0.2526; p < 0.05) but not in MDI (r = 0.2510; p = 0.1134) and HCL users (r = -0.1065; p = 0.4914). TIR was also negatively correlated with the mean carb count error in all study participants (r = -0.2317; p < 0.01). CONCLUSION In conclusion, as the Gluciquizz score was associated with metabolic control, this easy-to-use self-administered questionnaire could be used widely on a routine basis to assess the carbohydrate knowledge of T1D patients and to offer them targeted education tailored to their needs.
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Affiliation(s)
- Sopio Tatulashvili
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Sorbonne Paris Nord, CINFO, CRNH-IDF, Bobigny, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN); Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
| | | | | | - Emmanuel Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Sorbonne Paris Nord, CINFO, CRNH-IDF, Bobigny, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN); Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
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Hassold N, Bihan H, Moumba YP, Poilane I, Méchaï F, Assad N, Labbe-Gentils V, Sal M, Koutcha ON, Martin A, Radu D, Martinod E, Cordel H, Vignier N, Tatulashvili S, Berkane N, Carbonnelle E, Bouchaud O, Cosson E. BedBiopsy: diagnostic performance of bedside ultrasound-guided bone biopsies for the management of diabetic foot infection. Diabetes Metab 2024:101525. [PMID: 38442769 DOI: 10.1016/j.diabet.2024.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE - We aimed to assess the feasibility and diagnostic performance of ultrasound-guided bone biopsies at the bedside of diabetic patients admitted for suspected foot osteitis not requiring surgery. RESEARCH DESIGN AND METHODS - In this retrospective monocentric study, we compared the performance of ultrasound-guided (n=29 consecutive patients, Dec.2020-Oct.2022) versus surgical (n=24 consecutive patients, Jan.2018-Nov.2020) bone biopsies at confirming or ruling out diabetic foot osteitis (primary outcome). RESULTS - Patient characteristics were similar in the two intervention groups, including arteritis prevalence (62.3%), SINBAD score, and wound location (phalanges 36%, metatarsus 43%, and calcaneus 21%). However, the ultrasound-guided group was older (67 ± 11 versus 60 ± 13 years respectively, P = 0.047) and had more type 2 diabetes (97% versus 75%, P = 0.038). Diagnostic performance (i.e., capacity to confirm or rule out suspected osteitis) was similar for ultrasound-guided (28/29 cases: 25 confirmations, 3 invalidations) and surgical (24 confirmations/24) biopsies, P = 0.358. No biopsy-related side effect or complication was observed for either intervention, even for patients on antiaggregation and/or anticoagulation therapy. The mean (± standard deviation) time necessary to perform the biopsy was shorter in the ultrasound-guided group (2.6 ± 3.0 versus 7.2 ± 5.8 days, respectively, P < 0.001) and wound evolution at three months was more favorable (83.3 versus 41.2%, P = 0.005) (94.4% versus 66.7%, respectively, patients with new surgical procedure within six months excluded; P = 0.055). Even though not statistically significant, healing rates in terms of wound and osteitis at six months were also better in the ultrasound-guided group (wound: 40.9% versus 36.8%; P = 0.790, and osteitis: 81.8 vs 55.6% P = 0.071). CONCLUSION - In diabetic patients with suspected foot osteitis not requiring surgery, bedside ultrasound-guided bone biopsies may constitute a promising alternative to surgical biopsies. This intervention provided excellent tolerance and microbiological documentation, short lead-times, and more favorable wound prognosis.
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Affiliation(s)
- Nolan Hassold
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France.
| | - Hélène Bihan
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; LEPS (Laboratoire Educations et Promotion de la Santé) EA 3412-Université Paris 13
| | - Yolène Pambo Moumba
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | | | - Frédéric Méchaï
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Nabil Assad
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Véronique Labbe-Gentils
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Meriem Sal
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Omar Nouhou Koutcha
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Antoine Martin
- Department of anatomopathology, Avicenne Hospital, Bobigny, France
| | - Dana Radu
- Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny
| | - Emmanuel Martinod
- Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny
| | - Hugues Cordel
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Vignier
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France; IAME, INSERM UMR 1137, Université Sorbonne Paris Nord, Bobigny, France
| | - Sopio Tatulashvili
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | | | - Olivier Bouchaud
- Department of infectious diseases, Avicenne Hospital, Hôpitaux universitaires Paris Seine-Saint-Denis, AP-HP, UFR SMBH, Université Sorbonne Paris Nord, Bobigny, France
| | - Emmanuel Cosson
- Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France
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Guion M, Mandereau-Bruno L, Goria S, Cosson E, Fosse-Edorh S. Eleven-year trends in socioeconomic inequalities in the prevalence and incidence of pharmacologically treated type 2 diabetes in France, 2010-2020. Diabetes Metab 2024; 50:101509. [PMID: 38216030 DOI: 10.1016/j.diabet.2024.101509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024]
Abstract
AIM This study aimed to describe the association between socioeconomic inequalities and the prevalence and incidence of pharmacologically-treated type 2 diabetes in European France over the 2010-2020 period. METHODS Diabetes cases were identified using a validated algorithm from the French National Health Data System. Analysis was restricted to adults aged 45 years and older to focus on type 2 diabetes. Socioeconomic inequalities were measured for all years in European France using the French deprivation index (FDep, 2015 version), which is an area-based deprivation indicator using population-weighted quintiles (Q1 corresponds to the least deprived municipalities). The relative risks of diabetes prevalence and incidence associated with FDep quintiles (Q1 as the reference) were estimated by sex using a log-linear Poisson model adjusted for year, age and French department. The study population was the French health consumers aged 45 years and over (from 24,228,526 in 2010 to 29,772,928 in 2020). RESULTS A positive gradient was observed in the relative risks of type 2 diabetes prevalence and incidence by FDep quintiles over the study period. The strength of the estimated associations increased over the last decade for prevalence among men and women and for incidence among men in the two most deprived quintiles. CONCLUSION Thus, type 2 diabetes prevention should include a proportionate universalism approach, proposing actions of greater intensity in the most deprived areas.
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Affiliation(s)
- Marie Guion
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France; Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France.
| | | | - Sarah Goria
- Data science division, Santé Publique France, Saint-Maurice, France
| | - Emmanuel Cosson
- Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Bobigny, France; Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, University of Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, AP-HP, Bobigny, France
| | - Sandrine Fosse-Edorh
- Department of Non-Communicable Diseases and Trauma, Santé Publique France, Saint-Maurice, France
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Regnault N, Lebreton E, Tang L, Fosse-Edorh S, Barry Y, Olié V, Billionnet C, Weill A, Vambergue A, Cosson E. Maternal and neonatal outcomes according to the timing of diagnosis of hyperglycaemia in pregnancy: a nationwide cross-sectional study of 695,912 deliveries in France in 2018. Diabetologia 2024; 67:516-527. [PMID: 38182910 PMCID: PMC10844424 DOI: 10.1007/s00125-023-06066-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/02/2023] [Indexed: 01/07/2024]
Abstract
AIMS/HYPOTHESIS We aimed to assess maternal-fetal outcomes according to various subtypes of hyperglycaemia in pregnancy. METHODS We used data from the French National Health Data System (Système National des Données de Santé), which links individual data from the hospital discharge database and the French National Health Insurance information system. We included all deliveries after 22 gestational weeks (GW) in women without pre-existing diabetes recorded in 2018. Women with hyperglycaemia were classified as having overt diabetes in pregnancy or gestational diabetes mellitus (GDM), then categorised into three subgroups according to their gestational age at the time of GDM diagnosis: before 22 GW (GDM<22); between 22 and 30 GW (GDM22-30); and after 30 GW (GDM>30). Adjusted prevalence ratios (95% CI) for the outcomes were estimated after adjusting for maternal age, gestational age and socioeconomic status. Due to the multiple tests, we considered an association to be statistically significant according to the Holm-Bonferroni procedure. To take into account the potential immortal time bias, we performed analyses on deliveries at ≥31 GW and deliveries at ≥37 GW. RESULTS The study population of 695,912 women who gave birth in 2018 included 84,705 women (12.2%) with hyperglycaemia in pregnancy: overt diabetes in pregnancy, 0.4%; GDM<22, 36.8%; GDM22-30, 52.4%; and GDM>30, 10.4%. The following outcomes were statistically significant after Holm-Bonferroni adjustment for deliveries at ≥31 GW using GDM22-30 as the reference. Caesarean sections (1.54 [1.39, 1.72]), large-for-gestational-age (LGA) infants (2.00 [1.72, 2.32]), Erb's palsy or clavicle fracture (6.38 [2.42, 16.8]), preterm birth (1.84 [1.41, 2.40]) and neonatal hypoglycaemia (1.98 [1.39, 2.83]) were more frequent in women with overt diabetes. Similarly, LGA infants (1.10 [1.06, 1.14]) and Erb's palsy or clavicle fracture (1.55 [1.22, 1.99]) were more frequent in GDM<22. LGA infants (1.44 [1.37, 1.52]) were more frequent in GDM>30. Finally, women without hyperglycaemia in pregnancy were less likely to have preeclampsia or eclampsia (0.74 [0.69, 0.79]), Caesarean section (0.80 [0.79, 0.82]), pregnancy and postpartum haemorrhage (0.93 [0.89, 0.96]), LGA neonate (0.67 [0.65, 0.69]), premature neonate (0.80 [0.77, 0.83]) and neonate with neonatal hypoglycaemia (0.73 [0.66, 0.82]). Overall, the results were similar for deliveries at ≥37 GW. Although the estimation of the adjusted prevalence ratio of perinatal death was five times higher (5.06 [1.87, 13.7]) for women with overt diabetes, this result was non-significant after Holm-Bonferroni adjustment. CONCLUSIONS/INTERPRETATION Compared with GDM22-30, overt diabetes, GDM<22 and, to a lesser extent, GDM>30 were associated with poorer maternal-fetal outcomes.
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Affiliation(s)
- Nolwenn Regnault
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Elodie Lebreton
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Luveon Tang
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | | | - Yaya Barry
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | - Valérie Olié
- Santé Publique France, the national public health agency, Saint-Maurice, France
| | | | - Alain Weill
- EPI-PHARE Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France
| | - Anne Vambergue
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Lille University Hospital, European Genomics Institute for Diabetes, University of Lille, Lille, France
| | - Emmanuel Cosson
- Department of Diabetology-Endocrinology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Bobigny, France.
- Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), Université Sorbonne Paris Nord and Université Paris CitéInserm, INRAE, CNAM, Bobigny, France.
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Cosson E, Thioye EMM, Tatulashvili S, Vicaut E, Larger E, Sal M, Pinto S, Fabre E, Lalatonne Y, Sutton A, Nachtergaele C, Portal JJ, Zerguine M, Carbillon L, Bihan H. The Prognosis of Glutamic Acid Decarboxylase Antibodies in Women With Hyperglycemia in Pregnancy. J Clin Endocrinol Metab 2024; 109:e1117-e1124. [PMID: 37888829 DOI: 10.1210/clinem/dgad617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Indexed: 10/28/2023]
Abstract
CONTEXT We recently reported that the presence of glutamic acid decarboxylase antibodies (GADA) was not associated with large-for-gestational-age infants in women with hyperglycemia in pregnancy (HIP). OBJECTIVE We explored the association between the presence of GADA and other HIP-related adverse pregnancy outcomes. METHODS This observational prospective study, conducted at a university hospital in a suburb of Paris, France, included 1182 consecutive women with HIP measured for GADA at HIP care initiation between 2012 and 2017. Post hoc analyses for outcomes included gestational weight gain, insulin therapy, cesarean delivery, hypertensive disorders, small-for-gestational-age infant, prematurity, and neonatal hypoglycemia. RESULTS Of the 1182 women studied, 87 (7.4%) had positive (≥ 1 IU/mL) GADA. Although socioeconomic, clinical, and biological characteristics were similar across women in the positive and negative GADA groups, higher fasting plasma glucose values during early HIP screening were observed in the former (5.5 ± 1.5 vs 5.2 ± 0.7 mmol/L respectively, P < .001). At HIP care initiation, fructosamine levels were higher in women with positive GADA (208 ± 23 vs 200 ± 18 µmol/L; P < .05). In the homeostatic model assessment, insulin resistance (HOMA-IR) and beta secretion (HOMA-B) rates were similar in both groups. Gestational weight gain and the rates of all adverse outcomes were similar in both groups except for cesarean delivery (18.4 and 27.3% for positive and negative GADA, respectively; adjusted odds ratio 0.49 [95% CI, 0.26-0.92], P = .026). CONCLUSION Universal measurement of GADA in women with HIP highlighted that 7.4% had positive GADA. No association was observed between GADA and HIP-related adverse pregnancy outcomes, except a lower risk of cesarean delivery.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), 93000 Bobigny, France
| | - Elhadji Mamadou Moussa Thioye
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), 93000 Bobigny, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France
| | - Etienne Larger
- Institut Cochin, CNRS, Inserm, Université de Paris, 75014 Paris, France
- Service de Diabétologie et Immunologie Clinique, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires de Paris Centre-Université Paris Cité, 75014 Paris, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
| | - Sara Pinto
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
| | - Emmanuelle Fabre
- AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Biochemistry Department, 93000 Bobigny, France
- Signalisation, microenvironnement et hémopathies lymphoïdes, Inserm, UMR-978, Université Sorbonne Paris Nord, 93000 Bobigny, France
| | - Yoann Lalatonne
- APHP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Nuclear Medicine, 93000 Bobigny, France
- Laboratory for Vascular Translational Science, Inserm, UMR-1148, Université Sorbonne Paris Nord, 93000 Bobigny, France
| | - Angela Sutton
- AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Biochemistry Department, 93000 Bobigny, France
- Laboratory for Vascular Translational Science, Inserm, UMR-1148, Université Sorbonne Paris Nord, 93000 Bobigny, France
| | - Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France
| | - Jean-Jacques Portal
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France
| | - Mohamed Zerguine
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, 93140 Bondy, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000 Bobigny, France
- LEPS (Laboratoire Educations et Promotion de la Santé) EA 3412-Université Paris 13, 93000 Bobigny, France
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Tang L, Lebreton E, Vambergue A, Fosse-Edorh S, Olié V, Barry Y, Weill A, Cosson E, Regnault N. Cross-sectional study examining factors impacting on uptake of postpartum type 2 diabetes screening among women diagnosed with hyperglycaemia in pregnancy. Diabetes Res Clin Pract 2024; 208:111116. [PMID: 38266823 DOI: 10.1016/j.diabres.2024.111116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 01/26/2024]
Abstract
AIMS Early postpartum glucose screening of women with hyperglycaemia in pregnancy (HIP) can identify women who have the highest risk of developing impaired glucose tolerance and T2DM. This study examines the association between demographics, events during pregnancy, socioeconomic status and postpartum T2DM screening. METHODS Using the French National Health Data System, this cross-sectional study included all deliveries where the mother had HIP in France in 2015, (n = 76,862). The odds ratio (OR) for attending postpartum screening was calculated via multi-level logistic regression. RESULTS T2DM screening uptake at six months postpartum was 42·9% [95 % Confidence Interval: 42·6-43·3]. Several characteristics were associated with lower uptake: living in the most deprived area(OR = 0·78[0·74-0·83]); being < 25 years-old (reference age group 25-29;≤17: 0.53 [0·31-0·90];18-24: 0.73[0·69-0·78]); smoking (0·65[0·62-0·68]); obesity (0·93[0·89-0·97]); caesarean delivery (0·95[0·92-0·99]). Factors associated with higher uptake included primiparity (1·30[1·26-1·34]); having followed the French recommendations for HIP screening (1·24[1·20-1·28]); insulin prescription (1·75[1·69-1·81]) and pre-eclampsia (1·30[1·19-1·42]). p < 0.01 is justified due to sample size. CONCLUSION Improving identification of factors affecting postpartum T2DM screening uptake, such as demographics, socioeconomic context and events during pregnancy, may lead to development of target interventions to aide adherence to screening regime and thereby diagnosis of women with prediabetes or diabetes, for whom secondary and tertiary prevention is crucial.
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Affiliation(s)
- Luveon Tang
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France.
| | - Elodie Lebreton
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Anne Vambergue
- Endocrinology, Diabetology, Metabolism and Nutrition Department, Lille University Hospital, European Genomics Institute for Diabetes, University of Lille, France
| | - Sandrine Fosse-Edorh
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Valérie Olié
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Yaya Barry
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
| | - Alain Weill
- EPI-PHARE Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM) and French National Health Insurance (CNAM), Saint-Denis, France; Paris 13 University, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Department of Endocrinology, CRNH-IdF, CINFO, Bobigny, France
| | - Emmanuel Cosson
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA, France
| | - Nolwenn Regnault
- Santé Publique France, French National Public Health Agency, S(t) Maurice, France
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Fysekidis M, Cosson E, Sabouret P, Takbou K, Sutton A, Charnaux N, Banu I, Testa A, Biondi-Zoccai G, Vicaut E, Valensi P. Insulin analogs as an add-on to metformin after failure to oral treatment in type 2 diabetic patients increase diastole duration. The INSUlin Regimens and VASCular Functions (INSUVASC) study. Minerva Cardiol Angiol 2023; 71:659-672. [PMID: 37405711 DOI: 10.23736/s2724-5683.23.06139-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND Fast acting insulin analogues are known to improve arterial stiffness. The combination of metformin with insulin represents a widely used therapeutic strategy in diabetes. We hypothesized that insulin treatment in patients with type 2 diabetes (T2D) with long-acting, fast-acting or basal bolus insulin as an add-on to metformin would provide additional improvement of arterial stiffness. METHODS The INSUlin Regimens and VASCular Functions (INSUVASC) study is a pilot, randomized, open label three-arms study that included 42 patients with type 2 diabetes (T2D) in primary prevention, after a failure to oral antidiabetic agents. Arterial stiffness measurements were performed at fasting and after a standardized breakfast. During the first visit (V1) pre-randomization, participants took only metformin to perform the tests. The same tests were repeated after 4 weeks of insulin treatment during the second visit (V2). RESULTS Data were available for final analysis in 40 patients, with a mean age of 53.6±9.7 years and a mean duration of diabetes of 10.6±5.6 years. Twenty-one were females (52.5%), hypertension and dyslipidemia were present in 18 (45%) and 17 patients (42.5%), respectively. After insulin treatment, the metabolic control was associated to a decrease in oxidative stress and improvement of endothelial functions, with a post prandial diastole duration increased and a decrease of the peripheral arterial stiffness, with a better post prandial pulse pressure ratio and ejection duration after insulin. In hypertensive patients, insulin treatment provided positive effects by decreasing the pulse wave velocity and improving reflection time. CONCLUSIONS A short time treatment by insulin in addition to metformin improved myocardial perfusion. Moreover, insulin treatment in hypertensive patients provides a better hemodynamic profile in large arteries.
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Affiliation(s)
- Marinos Fysekidis
- Department of Endocrinology, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Paris13 University, Sorbonne Paris Cité, Paris, France -
- Department of Diabetology-Nutrition, Research Center for Human Nutrition of Ile-de-France, Integrated Obesity Center of North Ile-de-France (CINFO), Bondy, France -
- Center of Research in Epidemiology and Statistics (UMR U1153), National Institute of Health and Medical Research (Inserm), Université Paris13, Sorbonne Paris Cité, Bobigny, France -
| | - Emmanuel Cosson
- Department of Endocrinology, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Paris13 University, Sorbonne Paris Cité, Paris, France
- Department of Diabetology-Nutrition, Research Center for Human Nutrition of Ile-de-France, Integrated Obesity Center of North Ile-de-France (CINFO), Bondy, France
- Center of Research in Epidemiology and Statistics (UMR U1153), National Institute of Health and Medical Research (Inserm), Université Paris13, Sorbonne Paris Cité, Bobigny, France
| | - Pierre Sabouret
- Heart Institute, Pitié-Salpétrière Hospital, Sorbonne University, Paris, France
- National College of French Cardiologists, Paris, France
| | - Karim Takbou
- Department of Endocrinology, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Paris13 University, Sorbonne Paris Cité, Paris, France
| | - Angela Sutton
- Biochemistry Department, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Bondy, France
| | - Nathalie Charnaux
- Biochemistry Department, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Bondy, France
| | - Isabela Banu
- Department of Endocrinology, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Paris13 University, Sorbonne Paris Cité, Paris, France
| | - Alberto Testa
- Sapienza School for Advanced Studies, Sapienza University, Rome, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | - Eric Vicaut
- Clinical Research Unit, Lariboisière-St Louis, Fernand Widal Hospitals, Assistence Publique - Hôpitaux de Paris, Paris, France
| | - Paul Valensi
- Department of Endocrinology, Jean Verdier Hospital, Assistence Publique - Hôpitaux de Paris, Paris13 University, Sorbonne Paris Cité, Paris, France
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Bihan H, Nachtargeale C, Vicaud E, Sal M, Berkane N, Pinto S, Tatulashvili S, Fermaut M, Carbillon L, Cosson E. Impact of experiencing multiple vulnerabilities on fetal growth and complications in women with hyperglycemia in pregnancy. BMC Pregnancy Childbirth 2023; 23:740. [PMID: 37853313 PMCID: PMC10585815 DOI: 10.1186/s12884-023-06048-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND In women with hyperglycemia in pregnancy living in France, psychosocial deprivation is associated with both earlier and greater exposure to the condition, as well as poorer maternofetal prognosis. We explored the impact of this and two other socioeconomic vulnerability indicators-food insecurity and poor language proficiency-on adherence to prenatal care and maternal and fetal outcomes. METHODS In a socially deprived suburb of Paris, we selected women who delivered between 01/01/2012 and 31/12/2018 and received care (nurse, dietician, diabetologist evaluation, advice, regular follow-up to adjust insulin doses if requested) for hyperglycemia in pregnancy. We analyzed the associations between individual psychosocial deprivation, food insecurity, French language proficiency (variables assessed by individual questionnaires) and fetal growth (main outcome), as well as other core maternal and fetal outcomes. RESULTS Among the 1,168 women included (multiethnic cohort, 19.3% of whom were Europeans), 56%, 17.9%, and 27.5% had psychosocial deprivation, food insecurity, and poor French language proficiency, respectively. Forty-three percent were prescribed insulin therapy. Women with more than one vulnerability had more consultations for diabetes. The rates for small (SGA), appropriate (AGA), and large-for-gestational-age (LGA) infant were 11.4%, 76.5% and 12.2%, respectively. These rates were similar in women with and without psychosocial deprivation, and in those with and without food insecurity. Interestingly, women with poor French language proficiency had a higher odds ratio of delivering a small- or large-for-gestational age infant than those with good proficiency. CONCLUSION We found similar pregnancy outcomes for women with hyperglycemia in pregnancy living in France, irrespective of whether or not they had psychosocial deprivation or food insecurity. Optimized single-center care with specialized follow-up could contribute to reduce inequalities in maternal and fetal outcomes in women with hyperglycemia in pregnancy.
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Affiliation(s)
- Helene Bihan
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, CRNH-IdF, CINFO, Université Sorbonne Paris Nord Bobigny, France.
- Laboratoire Educations Et Promotion de La Santé, LEPS, Université Sorbonne Paris Nord Bobigny, UR3412, Villetaneuse, France.
| | - Charlotte Nachtargeale
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75009, Paris, France
| | - Eric Vicaud
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75009, Paris, France
| | - Meriem Sal
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, CRNH-IdF, CINFO, Université Sorbonne Paris Nord Bobigny, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, CRNH-IdF, CINFO, Université Sorbonne Paris Nord Bobigny, France
| | - Sara Pinto
- Unit of Endocrinology Diabetology Nutrition, AP-HP, Jean Verdier Hospital, CINFO, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Sopio Tatulashvili
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, CRNH-IdF, CINFO, Université Sorbonne Paris Nord Bobigny, France
| | - Marion Fermaut
- Department of Obstetrics and Gynecology, AP-HP, Jean Verdier Hospital, Paris 13 University, 93143, Sorbonne Paris Cité, Bondy, France
| | - Lionel Carbillon
- Department of Obstetrics and Gynecology, AP-HP, Jean Verdier Hospital, Paris 13 University, 93143, Sorbonne Paris Cité, Bondy, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, CRNH-IdF, CINFO, Université Sorbonne Paris Nord Bobigny, France
- Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Inserm (U1153), Université Paris 13, COMUE Sorbonne-Paris-Cité, Inra (U1125), Centre d'Epidémiologie Et Statistiques Paris Cité, 93017, CnamBobigny, France
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Magréault S, Charbit J, Berkane N, Jaureguy F, Carbonnelle E, Cosson E, Jullien V, Bihan H. Usefulness of Therapeutic Drug Monitoring to Manage Clindamycin-Rifampicin Interaction in a Patient with Diabetic Foot Osteomyelitis. Ther Drug Monit 2023; 45:703-706. [PMID: 37559218 DOI: 10.1097/ftd.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Affiliation(s)
- Sophie Magréault
- Department of Pharmacology, AP-HP, Jean Verdier Hospital, Sorbonne Paris Nord and Sorbonne Paris Cité University, IAME, Bobigny, France
| | - Judith Charbit
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Sorbonne Paris Cité University, Bobigny, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Sorbonne Paris Cité University, Bobigny, France
| | - Françoise Jaureguy
- Department of Clinical Microbiology, AP-HP, Avicenne Hospital, Sorbonne Paris Nord and Sorbonne Paris Cité University, IAME, Bobigny, France; and
| | - Etienne Carbonnelle
- Department of Clinical Microbiology, AP-HP, Avicenne Hospital, Sorbonne Paris Nord and Sorbonne Paris Cité University, IAME, Bobigny, France; and
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Sorbonne Paris Cité University, Bobigny, France
| | - Vincent Jullien
- Department of Pharmacology, AP-HP, Jean Verdier Hospital, Sorbonne Paris Nord University, Bobigny, France
| | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Sorbonne Paris Cité University, Bobigny, France
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Debras C, Deschasaux-Tanguy M, Chazelas E, Sellem L, Druesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Agaësse C, De Sa A, Lutchia R, Julia C, Kesse-Guyot E, Allès B, Galan P, Hercberg S, Huybrechts I, Cosson E, Tatulashvili S, Srour B, Touvier M. Artificial Sweeteners and Risk of Type 2 Diabetes in the Prospective NutriNet-Santé Cohort. Diabetes Care 2023; 46:1681-1690. [PMID: 37490630 PMCID: PMC10465821 DOI: 10.2337/dc23-0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/09/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To study the relationships between artificial sweeteners, accounting for all dietary sources (total and by type of artificial sweetener) and risk of type 2 diabetes (T2D), in a large-scale prospective cohort. RESEARCH DESIGN AND METHODS The analyses included 105,588 participants from the web-based NutriNet-Santé study (France, 2009-2022; mean age 42.5 ± 14.6 years, 79.2% women). Repeated 24-h dietary records, including brands and commercial names of industrial products, merged with qualitative and quantitative food additive composition data, enabled artificial sweetener intakes to be accurately assessed from all dietary sources. Associations between artificial sweeteners (total, aspartame, acesulfame potassium [K], and sucralose) and T2D were investigated using Cox proportional hazard models adjusted for potential confounders, including weight variation during follow-up. RESULTS During a median follow-up of 9.1 years (946,650 person-years, 972 incident T2D), compared with nonconsumers, higher consumers of artificial sweeteners (i.e., above the sex-specific medians of 16.4 mg/day in men and 18.5 mg/day in women) had higher risks of developing T2D (hazard ratio [HR] 1.69; 95% CI 1.45-1.97; P-trend <0.001). Positive associations were also observed for individual artificial sweeteners: aspartame (HR 1.63 [95% CI 1.38-1.93], P-trend <0.001), acesulfame-K (HR 1.70 [1.42-2.04], P-trend <0.001), and sucralose (HR 1.34 [1.07-1.69], P-trend = 0.013). CONCLUSIONS Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases. These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives. This study provides important insights in the context of on-going reevaluation of artificial sweeteners by health authorities worldwide.
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Affiliation(s)
- Charlotte Debras
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Mélanie Deschasaux-Tanguy
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Eloi Chazelas
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Laury Sellem
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Nathalie Druesne-Pecollo
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Younes Esseddik
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Fabien Szabo de Edelenyi
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Cédric Agaësse
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Alexandre De Sa
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Rebecca Lutchia
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Chantal Julia
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Benjamin Allès
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Inge Huybrechts
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Emmanuel Cosson
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
- Diabetology, Endocrinology and Nutrition Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Sopio Tatulashvili
- Diabetology, Endocrinology and Nutrition Department, Avicenne Hospital, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Bernard Srour
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), INSERM U1153, INRAE U1125, CNAM, Sorbonne Paris Nord University, Epidemiology and Statistics Research Centre, University of Paris Cité (CRESS), Bobigny, France
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Cosson E, Tatulashvili S, Vicaut E, Pinto S, Sal M, Nachtergaele C, Berkane N, Benbara A, Fermaut M, Portal JJ, Carbillon L, Bihan H. Glycemic status during pregnancy according to fasting and post-load glucose values: The association with adverse pregnancy outcomes. An observational study. Diabetes Metab 2023; 49:101469. [PMID: 37648077 DOI: 10.1016/j.diabet.2023.101469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/31/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023]
Abstract
AIM Prognosis of treated hyperglycemia in pregnancy (HIP) may differ according to whether diagnosis following an oral glucose tolerance test (OGTT) is based on high fasting and/or high post-load glucose values. METHODS From a multiethnic prospective study, we included 8,339 women screened for HIP after 22 weeks of gestation. We evaluated the risk of large-for-gestational-age (LGA) infant (primary endpoint) and other adverse pregnancy outcomes according to HIP status in four groups defined as follows: no HIP (n = 6,832, reference); isolated fasting HIP (n = 465), isolated post-load HIP (n = 646), and fasting and post-load HIP (n = 396). RESULTS After adjusting for age, body mass index, ethnicity, smoking during pregnancy and parity, compared with no HIP, the adjusted odds ratios [95% confidence interval] for LGA infant were higher in the isolated fasting HIP (1.47 [1.11-1.96]) and fasting and post-load HIP (1.65 [1.23-2.21]) groups, but not in the isolated post-load HIP (1.13 [0.86-1.48]) group. The adjusted odds ratios for preterm delivery and neonatal intensive care unit were higher in the post-load HIP group (1.44 [1.03-2.03] and 1.28 [1.04-1.57], respectively), the fasting and post-load HIP group (1.81 [1.23-2.68] and 1.42 [1.10-1.81], respectively) but not in the isolated fasting HIP group (1.34 [0.90-2.00] and 1.20 [0.94-1.52], respectively). CONCLUSION Despite glucose-lowering care and adjustment for confounders, compared with no HIP, fasting HIP was associated with a higher rate of LGA infant, whereas post-load HIP was associated with higher preterm delivery and neonatal intensive care unit admission rates.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France
| | - Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France
| | - Amélie Benbara
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Marion Fermaut
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Jean-Jacques Portal
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France
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Sow MA, Treiber G, Cosson E, Mutunzi Y, Magne J, Boulogne C, Salle L, Boukhris M, Nobecourt E, Aboyans V. Distribution and determinants of coronary artery calcium score in asymptomatic patients with Type-2 diabetes: The French-CAC100 score. Diabetes Res Clin Pract 2023; 203:110871. [PMID: 37572948 DOI: 10.1016/j.diabres.2023.110871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/25/2023] [Accepted: 08/10/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Coronary artery calcium score (CACS) refines the cardiovascular disease (CVD) risk prediction in patients with Type-2 diabetes (T2D). We aimed to identify the determinants for high CACS in CVD-free patients with T2D. METHODS We studied 796 patients with T2D with CACS measured in three centers: two in continental France and a third in the Reunion Island. To predict a CACS ≥ 100, we derived a risk score in patients in continental France, and validated it in those in the Reunion Island. RESULTS The distributions of CACS distributions were similar among patients in continental France and Reunion Island. The French-CAC100 score included 5 parameters (age, sex, diabetes duration, non-CV end-organ damage and presence of ≥ 2 other CVD risk factors), ranging from 0 to 22 points. Similar areas under the curves were found for the risk score in both settings (0.80 vs. 0.73, p = 0.10). A French-CAC100 score < 10 excluded the odds for CACS ≥ 100 and CACS ≥ 400 with negative predictive values of 90% and 97% respectively, avoiding 58% of CT-scans. CONCLUSION Regardless of the geographic area, patients with T2D share similar risk factors for high CACS. The French-CAC100 score allows the identification of those at higher risk of elevated CACS.
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Affiliation(s)
- Mamadou Adama Sow
- EpiMaCT -INSERM 1094 & IRD290, University of Limoges, 87025, 2, Rue Marcland, Limoges, France; Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France.
| | - Guillaume Treiber
- Inserm U1188 Diabète Athérothrombose Thérapies Réunion Océan Indien, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, AP-HP, Bobigny, France
| | - Yves Mutunzi
- EpiMaCT -INSERM 1094 & IRD290, University of Limoges, 87025, 2, Rue Marcland, Limoges, France; Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France
| | - Julien Magne
- EpiMaCT -INSERM 1094 & IRD290, University of Limoges, 87025, 2, Rue Marcland, Limoges, France; Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France
| | - Cyrille Boulogne
- Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France
| | - Laurence Salle
- EpiMaCT -INSERM 1094 & IRD290, University of Limoges, 87025, 2, Rue Marcland, Limoges, France; Department of Endocrinology, Diabetology and Metabolism, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France
| | - Marouane Boukhris
- Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France
| | - Estelle Nobecourt
- Inserm U1188 Diabète Athérothrombose Thérapies Réunion Océan Indien, France; Inserm U1410, Reunion University Hospital, Reunion Island, France
| | - Victor Aboyans
- EpiMaCT -INSERM 1094 & IRD290, University of Limoges, 87025, 2, Rue Marcland, Limoges, France; Department of Cardiology, Dupuytren 2 University Hospital, 16, Rue B. Descottes, 87042, Limoges, France.
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Carbillon L, Benbara A, Cosson E. Gestational diabetes mellitus, pre-eclampsia and future cardiovascular disease: Need to consider both BMI and gestational weight gain to investigate the link. BJOG 2023. [PMID: 37435636 DOI: 10.1111/1471-0528.17608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Lionel Carbillon
- Department of Obstetrics and Gynaecology, Paris-Seine Saint Denis University Hospitals, Assistance Publique - Hopitaux de Paris, Bondy, France
- Sorbonne North Paris University - UFR SMBH - Campus de Bobigny, Bobigny, France
| | - Amélie Benbara
- Department of Obstetrics and Gynaecology, Paris-Seine Saint Denis University Hospitals, Assistance Publique - Hopitaux de Paris, Bondy, France
| | - Emmanuel Cosson
- Sorbonne North Paris University - UFR SMBH - Campus de Bobigny, Bobigny, France
- Department of Endocrinology, Diabetology, Nutrition, Paris-Seine Saint Denis University Hospitals, Assistance Publique - Hôpitaux de Paris, Bondy, France
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Thioye EMM, Vicaut E, Larger E, Sal M, Pinto S, Berkane N, Fabre E, Lalatonne Y, Sutton A, Nachtergaele C, Portal JJ, Carbillon L, Bihan H, Cosson E. GAD Antibodies in Women With Hyperglycemia in Pregnancy: No Association With Large-for-Gestational-Age Birth Weight. Diabetes Care 2023:148876. [PMID: 37159925 DOI: 10.2337/dc22-2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Affiliation(s)
- Elhadji Mamadou Moussa Thioye
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Etienne Larger
- Institut Cochin, CNRS, INSERM, Université de Paris, Paris, France
- Service de Diabétologie et Immunologie Clinique, Cochin Hospital, AP-HP, Hôpitaux Universitaires de Paris Centre-Université Paris Cité, Paris, France
| | - Meriem Sal
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
| | - Sara Pinto
- Unit of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
| | - Emmanuelle Fabre
- Department of Biochemistry, AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
- INSERM, UMR-978 "Signalisation, microenvironnement et hémopathies lymphoïdes," Université Sorbonne Paris Nord, Bobigny, France
| | - Yoann Lalatonne
- Department of Nuclear Medicine, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
- INSERM, UMR-1148 "Laboratory for Vascular Translational Science," Université Sorbonne Paris Nord, Bobigny, France
| | - Angela Sutton
- Department of Biochemistry, AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
- INSERM, UMR-1148 "Laboratory for Vascular Translational Science," Université Sorbonne Paris Nord, Bobigny, France
| | - Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Jean-Jacques Portal
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Lionel Carbillon
- Department of Obstetrics and Gynecology, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
- Laboratoire Educations et Promotion de la Santé EA 3412, Paris 13 University, Bobigny, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, Unité de Recherche Epidémiologique Nutritionnelle, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris 13, Bobigny, France
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Vallis M, Ryan H, Berard L, Cosson E, Kristensen FB, Levrat-Guillen F, Naiditch N, Rabasa-Lhoret R, Polonsky W. How Continuous Glucose Monitoring Can Motivate Self-Management: Can Motivation Follow Behaviour? Can J Diabetes 2023:S1499-2671(23)00064-3. [PMID: 37044242 DOI: 10.1016/j.jcjd.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Motivation to adhere to clinical recommendations requires engagement and urgency to act is one of many factors that contribute to achieving glycemic benefits in people with type 2 diabetes (PwT2D). Continuous glucose monitoring (CGM) devices are associated with improved glycemic benefits. We conducted a qualitative assessment of PwT2D who found using CGM extremely beneficial, examining the potential for CGM to elicit motivation to engage in self-management behaviours. METHODS Participants using CGM were recruited through social media, interviewed and transcripts analyzed (template analysis using thematic analysis) to generate coded responses and inductive themes by two raters. RESULTS Thirteen participants (84.6% women, T2D > 5 years and CGM usage > 6 months) were interviewed. Codes were organized around 3 themes: improved self-management; experience of glucose sensing technology vis-a-vis general positive or negative experience. Improved self-management was reflected in how the CGM technology provided personalized knowledge and ability to self-manage, particularly in contrast to finger pricking. Positive experience included motivation for behaviour changes, improved relationships with healthcare providers and in social situations. This translated into a sense of improved health and an avoidance of complications. Negative experience included costs, concern over location and comfort of the device. CONCLUSIONS CGM technology profoundly impacts multiple aspects of self-management and care for PwT2D. Developing a validated instrument to assess identified constructs could contribute to developing interventions leveraging benefits of this technology, particularly with regard to the motivational constructs of engagement and urgency.
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Affiliation(s)
| | - Hana Ryan
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | | | - Nicolas Naiditch
- Fédération Française des Diabétiques, Paris, Île-de-France, France
| | - Remi Rabasa-Lhoret
- Institut de Recherches Cliniques de Montréal & Université de Montréal, Montréal, Canada
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Pinto S, Croce L, Carlier L, Cosson E, Rotondi M. Thyroid dysfunction during gestation and gestational diabetes mellitus: a complex relationship. J Endocrinol Invest 2023:10.1007/s40618-023-02079-3. [PMID: 37024642 PMCID: PMC10372128 DOI: 10.1007/s40618-023-02079-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Gestational diabetes mellitus (GDM) and thyroid dysfunction during gestation (GTD) are the two most prevalent endocrinopathies during pregnancy. The aim of the present review is to provide an overview of the peculiar aspects of GDM and GTD, to highlight the potential interactions and clinical consequences of these two frequent clinical conditions. METHODS A literature review regarding GDM and GTD was carried out with particular interest on meta-analyses and human studies dealing with the (i) shared risk factors between GDM and GTD, (ii) the epidemiological link between GTD and GDM, (iii) physiopathologic link between GTD and GDM, (iv) clinical consequences of GDM and GTD, and (v) post-partum implications of GDM and GTD. RESULTS The association between GDM and GTD is common and may be explained by the insulin-resistance state due to maternal GTD, to alterations in the placentation process or to the many shared risk factors. Discrepant results of epidemiologic studies can be explained, at least in part, by the changes in diagnostic criteria and screening strategies throughout the years for both conditions. GDM and GTD impact pregnancy outcome and have post-partum long-term consequences, but more studies are needed to prove an additional adverse effect. CONCLUSIONS Based on the epidemiological and physio-pathological link between GDM and GTD, it could be suggested that a diagnosis of GTD could lead to screen GDM and the other way round.
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Affiliation(s)
- S Pinto
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - L Croce
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy
| | - L Carlier
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - E Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - M Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy.
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy.
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy.
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Valensi P, Berkane N, Pinto S, Sellier N, Soussan M, Nguyen MT, Cosson E. Performance of the 2019 ESC/EASD guideline strategy for the screening of silent coronary artery disease in patients with diabetes. Cardiovasc Diabetol 2023; 22:33. [PMID: 36793073 PMCID: PMC9930289 DOI: 10.1186/s12933-023-01760-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The 2019 guidelines for cardiovascular risk stratification by the European Society of Cardiology and European Association for the Study of Diabetes (ESC-EASD) suggested screening for silent coronary disease in very high risk patients with severe target organ damage (TOD) (i.e. peripheral occlusive arterial disease or severe nephropathy) or high coronary artery calcium (CAC) score. This study aimed to test the validity of this strategy. METHODS In this retrospective study, we included 385 asymptomatic patients with diabetes and no history of coronary disease but with TOD or ≥ 3 risk factors in addition to diabetes. CAC score was measured using computed tomography scan and a stress myocardial scintigraphy was performed to detect silent myocardial ischemia (SMI), with subsequent coronary angiography in those with SMI. Various strategies to select patients to be screened for SMI were tested. RESULTS CAC score was ≥ 100 Agatston units (AU) in 175 patients (45.5%). SMI was present in 39 patients (10.1%) and among the 30 patients who underwent angiography, 15 had coronary stenoses and 12 had a revascularization procedure. The most effective strategy consisted in performing myocardial scintigraphy in the 146 patients with severe TOD and, among the 239 other patients without severe TOD, in those with CAC ≥ 100 AU: this strategy provided 82% sensitivity for SMI diagnosis, and identified all the patients with stenoses. CONCLUSION The ESC-EASD guidelines suggesting SMI screening in asymptomatic patients with very high risk assessed by severe TOD or high CAC score appears effective and could identify all the patients with stenoses eligible for revascularization.
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Affiliation(s)
- Paul Valensi
- Unit of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Avenue du 14 Juillet. 93140, Bondy, France.
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Sara Pinto
- Unit of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Avenue du 14 Juillet. 93140, Bondy, France
| | - Nicolas Sellier
- Department of Radiology, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Michael Soussan
- Department of Nuclear Medicine, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Bobigny, France
| | - Minh Tuan Nguyen
- Unit of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Avenue du 14 Juillet. 93140, Bondy, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France.,Unité de Recherche Epidémiologique Nutritionnelle, Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Bobigny, France
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Nachtergaele C, Vicaut E, Tatulashvili S, Sal M, Berkane N, Pinto S, Fabre E, Sutton A, Bihan H, Carbillon L, Cosson E. Marqueurs glycémiques non conventionnels et évènements de grossesse chez les femmes présentant une hyperglycémie pendant la grossesse. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Gbessoua M, Charbit J, Berkane N, Sal M, Rezgani I, Cosson E, Bihan H. Choc cardiogénique à l’anesthésie dans la prise en charge d’une maladie de basedow réfractaire, révélée par la cordarone et traitée par lithium. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Cosson E, Berkane N, Pinto S, Bihan H, Tatulashvili S, Soussan M, Sellier N, Nguyen MT, Valensi P. Clinical relevance of coronary risk classification and reclassification with coronary artery calcium score in asymptomatic people living with diabetes. An observational study. Diabetes Metab 2023; 49:101412. [PMID: 36414170 DOI: 10.1016/j.diabet.2022.101412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
AIMS To explore (i) in what proportion and direction coronary artery calcium (CAC) score reclassifies coronary risk in asymptomatic diabetic patients at high a priori coronary risk, and (ii) whether screening for asymptomatic myocardial ischemia / coronary stenosis only in patients at very high coronary risk - whether a priori or combined with those reclassified at very high risk according to their CAC score - has good sensitivity to detect these conditions. METHODS We retrospectively selected 377 asymptomatic primary prevention diabetic patients at high or very high a priori coronary risk according to national guidelines. All had their CAC score measured and underwent stress myocardial scintigraphy to detect myocardial ischemia. Those identified with ischemia then had a coronary angiography to identify coronary stenoses. RESULTS Of the selected patients, 242 and 135 patients had a high and very high a priori coronary risk, respectively. After taking into account their CAC score, the former were reclassified into three risk categories: moderate (n = 159, 66%), high (n = 38) and very high (45 patients) risk. Myocardial ischemia was identified in 35 patients and coronary stenoses in 14 of the latter. Had a stress scintigraphy been performed only in the 135 patients at very high risk a priori, 18 patients would have been detected with ischemia (sensitivity 51%), and 9 with coronary stenoses (sensitivity 64%). Had a scintigraphy also been performed on the 45 patients at very high risk after CAC-reclassification, an additional 7 and 5 patients with ischemia and coronary stenoses, respectively, would have been identified. CONCLUSION Following national guidelines, 66% of our population of asymptomatic diabetic persons at high a priori coronary risk were reclassified into the moderate risk category, translating into less stringent goals for risk factor control. Eighteen percent were reclassified into the very high-risk category, leading to 100% detection sensitivity for patients with ischemia and coronary stenoses.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France; UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
| | - Narimane Berkane
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Sara Pinto
- AP-HP, Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - Hélène Bihan
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France; Laboratoire Educations et Pratiques de Santé UR 3412, UFR Santé, Médecine, Biologie Humaine, Université Paris Sorbonne Paris Nord, 74, rue Marcel Cachin -93017 Bobigny cedex, France
| | - Sopio Tatulashvili
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France; UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Michael Soussan
- AP-HP, Department of Nuclear Medicine, Avicenne Hospital, Bobigny, France
| | - Nicolas Sellier
- AP-HP, Department of Radiology, Jean Verdier Hospital, Bondy, France
| | - Minh Tuan Nguyen
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Paul Valensi
- AP-HP, Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
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Quansah DY, De Giorgi S, Le Dizes O, Camponovo C, Benhalima K, Cosson E, Puder JJ. Reactive hypoglycaemia during the OGTT after gestational diabetes mellitus: Metabolic implications and evolution. Diabet Med 2022; 39:e14920. [PMID: 35870144 PMCID: PMC9804199 DOI: 10.1111/dme.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/17/2022] [Accepted: 07/21/2022] [Indexed: 01/05/2023]
Abstract
AIMS Gestational diabetes (GDM) presents an increased cardio-metabolic risk and is diagnosed with an oral glucose tolerance test (OGTT). Reactive hypoglycaemia (RH) during the OGTT in pregnancy is associated with adverse outcomes. Although postpartum OGTT after GDM is recommended, the occurrence and implications of RH are unknown. We investigated the prevalence, metabolic implications and longitudinal evolution of RH at 6-8 weeks postpartum in women with a history of GDM. METHODS Between 2011 and 2021, we consecutively followed 1237 women with previous GDM undergoing an OGTT at 6-8 weeks postpartum. RH was defined as 2-h glucose <3.9 mmoL/L after the OGTT. Metabolic outcomes were compared in women with and without RH (RH+/RH-). We also included a subcohort of 191 women with data on insulin sensitivity/secretion indices (MATSUDA, HOMA-IR, insulin-adjusted-secretion ISSI-2). RESULTS The postpartum prevalence of RH was 12%. RH+ women had a more favourable metabolic profile including a 2-5-times lower prevalence of glucose intolerance and metabolic syndrome at 6-8 weeks postpartum compared to RH- (all p ≤ 0.034). In the subcohort, women with RH+ had higher insulin sensitivity, higher ISSI-2 and an earlier glucose peak after OGTT (p ≤ 0.049) compared to RH- women at the same time point. Insulin resistance increased and ISSI-2 decreased over the first year postpartum in both groups. These changes were associated with a 50% reduction in overall RH prevalence at 1-year postpartum. Some of the favourable profiles of RH+ persisted at 1-year postpartum, without group differences in the longitudinal metabolic changes. CONCLUSIONS At 6-8 weeks postpartum, RH was frequent in women after GDM and associated with a better metabolic profile including increased insulin sensitivity and higher insulin-adjusted-secretory capacity. RH might be a marker of favourable metabolic prognosis in women with a history of GDM.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman‐Mother‐ChildLausanne University HospitalLausanneSwitzerland
| | - Sara De Giorgi
- Service of Endocrinology, Diabetes and Metabolism, Department of MedicineLausanne University HospitalLausanneSwitzerland
| | - Olivier Le Dizes
- Service of Endocrinology, Diabetes and Metabolism, Department of MedicineLausanne University HospitalLausanneSwitzerland
| | - Chiara Camponovo
- Clinic for Endocrinology and Diabetology, Lugano Regional HospitalEnte Ospedaliero Cantonale (EOC)LuganoSwitzerland
| | | | - Emmanuel Cosson
- Department of Endocrinology‐Diabetology‐Nutrition, AP‐HPAvicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH‐IdF, CINFOBobignyFrance
- Sorbonne Paris CitéUMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13BobignyFrance
| | - Jardena J. Puder
- Obstetric Service, Department Woman‐Mother‐ChildLausanne University HospitalLausanneSwitzerland
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Tatulashvili S, Baptiste Julla J, Sritharan N, Rezgani I, Levy V, Bihan H, Riveline JP, Cosson E. Ambulatory Glucose Profile According to Different Phases of the Menstrual Cycle in Women Living With Type 1 Diabetes. J Clin Endocrinol Metab 2022; 107:2793-2800. [PMID: 35869507 DOI: 10.1210/clinem/dgac443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Indexed: 02/07/2023]
Abstract
CONTEXT Some women living with type 1 diabetes complain of changes in glucose values according to the different phases of menstruation. OBJECTIVE To evaluate this variability through continuous glucose monitoring (CGM) data in type 1 diabetes patients. DESIGN Observational study. SETTING Ambulatory data, recruitment in 2 centers in the Paris region. PATIENTS Twenty-four women with type 1 diabetes having spontaneous menstrual cycles. INTERVENTION Collection of CGM data for 62 spontaneous menstrual cycles, with evaluation of five 3-day phases during each cycle: (1) early follicular (menstruations), (2) mid-follicular, (3) peri-ovulatory, (4) mid-luteal, and (5) late luteal. MAIN OUTCOME MEASURE Time in range (TIR, prespecified). RESULTS TIR decreased for each consecutive phase (61 ± 18%; 59 ± 18%; 59 ± 20%; 57 ± 18%; and 55 ± 20%, P = 0.02). The linear mixed model highlighted a decrease in TIR in the mid-luteal (P = 0.03) and late luteal (P < 0.001) phases compared with the early follicular phase. Time above range was significantly higher during the late luteal phase than the early follicular phase (P = 0.003). Time below range was significantly higher during the mid-follicular phase than in the early follicular phase. CONCLUSION In most of the study population, glucose levels rose linearly throughout the menstrual cycle, reaching a maximum in the late luteal phase. A sharp decrease was seen for most participants at the beginning of menstrual bleeding. This should be taken into consideration in daily care of type 1 diabetes patients to avoid hypoglycemia.
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Affiliation(s)
- Sopio Tatulashvili
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France
| | - Jean Baptiste Julla
- AP-HP, Endocrinology and Diabetes Unit, Lariboisiere Hospital, University of Paris-Cité, 75010 Paris, France
- Unite INSERM U1151 Immunity and Metabolism in Diabetes, ImMeDiab Team, Institut Necker Enfants Malades, and Universite de Paris, Paris 75015, France
| | - Nanthara Sritharan
- AP-HP, Clinical Research Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
| | - Imen Rezgani
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
| | - Vincent Levy
- AP-HP, Clinical Research Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
| | - Helene Bihan
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
| | - Jean-Pierre Riveline
- AP-HP, Endocrinology and Diabetes Unit, Lariboisiere Hospital, University of Paris-Cité, 75010 Paris, France
- Unite INSERM U1151 Immunity and Metabolism in Diabetes, ImMeDiab Team, Institut Necker Enfants Malades, and Universite de Paris, Paris 75015, France
| | - Emmanuel Cosson
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, SMBH Paris 13, 93000 Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, F-93017, Bobigny, France
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23
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Cariou B, Wargny M, Boureau AS, Smati S, Tramunt B, Desailloud R, Lebeault M, Amadou C, Ancelle D, Balkau B, Bordier L, Borot S, Bourgeon M, Bourron O, Cosson E, Eisinger M, Gonfroy-Leymarie C, Julla JB, Marchand L, Meyer L, Seret-Bégué D, Simon D, Sultan A, Thivolet C, Vambergue A, Vatier C, Winiszewski P, Saulnier PJ, Bauduceau B, Gourdy P, Hadjadj S. Impact of diabetes on COVID-19 prognosis beyond comorbidity burden: the CORONADO initiative. Diabetologia 2022; 65:1436-1449. [PMID: 35701673 PMCID: PMC9197674 DOI: 10.1007/s00125-022-05734-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/06/2022] [Indexed: 12/11/2022]
Abstract
AIMS/HYPOTHESIS Diabetes has been recognised as a pejorative prognostic factor in coronavirus disease 2019 (COVID-19). Since diabetes is typically a disease of advanced age, it remains unclear whether diabetes remains a COVID-19 risk factor beyond advanced age and associated comorbidities. We designed a cohort study that considered age and comorbidities to address this question. METHODS The Coronavirus SARS-CoV-2 and Diabetes Outcomes (CORONADO) initiative is a French, multicentric, cohort study of individuals with (exposed) and without diabetes (non-exposed) admitted to hospital with COVID-19, with a 1:1 matching on sex, age (±5 years), centre and admission date (10 March 2020 to 10 April 2020). Comorbidity burden was assessed by calculating the updated Charlson comorbidity index (uCCi). A predefined composite primary endpoint combining death and/or invasive mechanical ventilation (IMV), as well as these two components separately, was assessed within 7 and 28 days following hospital admission. We performed multivariable analyses to compare clinical outcomes between patients with and without diabetes. RESULTS A total of 2210 pairs of participants (diabetes/no-diabetes) were matched on age (mean±SD 69.4±13.2/69.5±13.2 years) and sex (36.3% women). The uCCi was higher in individuals with diabetes. In unadjusted analysis, the primary composite endpoint occurred more frequently in the diabetes group by day 7 (29.0% vs 21.6% in the no-diabetes group; HR 1.43 [95% CI 1.19, 1.72], p<0.001). After multiple adjustments for age, BMI, uCCi, clinical (time between onset of COVID-19 symptoms and dyspnoea) and biological variables (eGFR, aspartate aminotransferase, white cell count, platelet count, C-reactive protein) on admission to hospital, diabetes remained associated with a higher risk of primary composite endpoint within 7 days (adjusted HR 1.42 [95% CI 1.17, 1.72], p<0.001) and 28 days (adjusted HR 1.30 [95% CI 1.09, 1.55], p=0.003), compared with individuals without diabetes. Using the same adjustment model, diabetes was associated with the risk of IMV, but not with risk of death, within 28 days of admission to hospital. CONCLUSIONS/INTERPRETATION Our results demonstrate that diabetes status was associated with a deleterious COVID-19 prognosis irrespective of age and comorbidity status. TRIAL REGISTRATION ClinicalTrials.gov NCT04324736.
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Grants
- the Fondation Francophone de Recherche sur le Diabète (FFRD), supported by Novo Nordisk, Merck Sharpe Dome (MSD), Abbott, AstraZeneca, Lilly and FFD (Fédération Française des Diabétiques) – CORONADO initiative emergency grant
- The CORONADO control leg of the study was supported by a grant from the French Ministry of Health
- Société Francophone du Diabète (SFD) – CORONADO initiative emergency grant
- Fonds de dotation du CHU de Nantes (CORONADO project: Sanofi, Air Liquid Healthcare, Novo Nordisk, NHC, Allergan, Lifescan)
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Affiliation(s)
- Bertrand Cariou
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France.
| | - Matthieu Wargny
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
- CHU Nantes, Inserm CIC 1413, Pôle Hospitalo-Universitaire 11 : Santé Publique, Clinique des données, Nantes, France
| | - Anne-Sophie Boureau
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
- CHU Nantes, Pôle de Gérontologie Clinique, Nantes, France
| | - Sarra Smati
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
| | - Blandine Tramunt
- Service de Diabétologie, Maladies Métaboliques & Nutrition, CHU Toulouse, Institut des Maladies Métaboliques & Cardiovasculaires, UMR1297 Inserm/UT3, Université de Toulouse, Toulouse, France
| | - Rachel Desailloud
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PériTox UMR_I 01, University of Picardie Jules Verne, Amiens, France
| | - Maylis Lebeault
- Département de Diabétologie, Centre Hospitalier Universitaire, Angers, France
| | - Coralie Amadou
- Département de Diabétologie, Centre Hospitalier Sud Francilien, Corbeil Essonne, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, Paris, France
| | - Deborah Ancelle
- Service endocrinologie-diabétologie-nutrition, CH Le Havre, Montivilliers, France
| | - Beverley Balkau
- Épidémiologie Clinique, Centre de Recherche en Épidémiologie et Santé des Populations, Inserm U1018, Université Paris-Saclay, USVQ, Université Paris-Sud, Villejuif, France
| | - Lyse Bordier
- Service d'endocrinologie et maladies métaboliques, H.I.A Bégin, Saint-Mandé, France
| | - Sophie Borot
- Department of Endocrinology, Diabetology and Nutrition, Besançon University Hospital, Besançon, France
| | - Muriel Bourgeon
- Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Paris-Saclay University, Antoine Béclère Hospital, Clamart, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Olivier Bourron
- Assistance Publique Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié-Salpêtrière - Charles-Foix; Inserm, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06; Institute of Cardiometabolism and Nutrition ICAN, Sorbonne Université, Paris, France
| | - Emmanuel Cosson
- Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology, Diabetology and Nutrition, CRNH-IdF, CINFO, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm / U11125 INRAE / CNAM / Paris13 University, Nutritional Epidemiological Research Unit, Bobigny, France
| | - Martin Eisinger
- Hôpital de la Conception, Service d'Endocrinologie, Maladies Métaboliques et Nutrition, Marseille, France
- Inserm, INRAE, C2VN, Aix Marseille Univ, Marseille, France
| | | | - Jean-Baptiste Julla
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | | | - Laurent Meyer
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Dominique Seret-Bégué
- Unité de Diabétologie, Endocrinologie et Nutrition, Centre Hospitalier de Gonesse, Gonesse, France
| | | | - Ariane Sultan
- Department of Endocrinology-Diabetology-Nutrition, CHU Montpellier, University of Montpellier, Montpellier, France
- PhyMedExp, CHU Montpellier, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Charles Thivolet
- Centre du Diabète DIAB-eCARE, Hospices Civils de Lyon et Laboratoire CarMeN, Inserm, INRA, INSA, Université Claude Bernard Lyon 1, Lyon, France
- Société Francophone du Diabète (SFD), Paris, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology, Metabolism and Nutrition Lille University Hospital, Lille, France
- European Genomic Institute of Diabetes, University School of Medicine, Lille, France
| | - Camille Vatier
- Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Department of Endocrinology, Paris, France
- Inserm UMRS 938, Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Patrice Winiszewski
- Service d'Endocrinologie, Diabétologie et Nutrition, Hôpital Nord Franche-Comté, Trévenans, France
| | - Pierre-Jean Saulnier
- Clinical Investigation Centre CIC1402, University of Poitiers, Inserm, CHU Poitiers, Poitiers, France
| | - Bernard Bauduceau
- Service d'endocrinologie et maladies métaboliques, H.I.A Bégin, Saint-Mandé, France
- Fondation Francophone pour la Recherche sur le Diabète (FFRD), Paris, France
| | - Pierre Gourdy
- Service de Diabétologie, Maladies Métaboliques & Nutrition, CHU Toulouse, Institut des Maladies Métaboliques & Cardiovasculaires, UMR1297 Inserm/UT3, Université de Toulouse, Toulouse, France
| | - Samy Hadjadj
- CHU Nantes, CNRS, Inserm, l'institut du thorax, Nantes Université, Nantes, France
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24
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Cosson E, Vicaut E, Tatulashvili S, Portal JJ, Nachtergaele C, Sal M, Berkane N, Pinto S, Rezgani A, Carbillon L, Bihan H. Is there a residual risk of large-for-gestational-age infant related to gestational diabetes mellitus when it is treated? Diabetes Metab 2022; 48:101376. [PMID: 35907622 DOI: 10.1016/j.diabet.2022.101376] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The hyperglycaemia and adverse pregnancy outcomes (HAPO) study, where hyperglycaemia was untreated, showed a continuous association between large-for-gestational-age (LGA) infant and seven increasing categories of fasting plasma glucose (PG), 1-hour and 2-hour PG values after a 75 g oral glucose tolerance test at 24-32 gestational weeks. We evaluated whether the excess risk persisted in the 6th and 7th glucose categories - corresponding to women treated for gestational diabetes mellitus (GDM). PATIENTS AND METHODS We included 7,190 women meeting the HAPO criteria, of whom 655 (9.2%) were treated for GDM (dietary education in all; insulin therapy in 150 (20.3%)). We evaluated the adjusted odds ratio (aOR) for each glucose category (reference 1st category) for LGA infant. RESULTS The aOR for LGA linearly increased from the 1st to 5th categories of fasting, 1-hour and 2-hour PG. Specifically, the aORs for the 5th category were 2.20 (95% confidence interval 1.41-3.44), 2.25 (1.11-4.59), and 2.51 (1.63-3.85), respectively. The aORs for the 6th category were globally stable at 2.52 (1.46-4.36), 2.87 (1.48-5.54), and 2.47 (1.46-4.16), respectively. The same was true for the 7th category: 1.41 (0.56-3.55), 2.84 (1.03-7.86), and 3.53 (1.77-7.06), respectively. CONCLUSION We confirmed the association between increasing PG category and LGA infant in women without GDM. We did not observe a residual risk of LGA infant in women treated for GDM in our hospital, irrespective of elevated fasting, 1-hour, or 2-hour PG diagnosis. The risk of LGA infant was globally similar to that in women with high normal glucose values.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Jean-Jacques Portal
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Amel Rezgani
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Lionel Carbillon
- AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Biochemistry Department, Bobigny, France; AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
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25
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Gomez-Peralta F, Choudhary P, Cosson E, Irace C, Rami-Merhar B, Seibold A. Understanding the clinical implications of differences between glucose management indicator and glycated haemoglobin. Diabetes Obes Metab 2022; 24:599-608. [PMID: 34984825 DOI: 10.1111/dom.14638] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/20/2021] [Accepted: 01/01/2022] [Indexed: 12/18/2022]
Abstract
Laboratory measured glycated haemoglobin (HbA1c) is the gold standard for assessing glycaemic control in people with diabetes and correlates with their risk of long-term complications. The emergence of continuous glucose monitoring (CGM) has highlighted limitations of HbA1c testing. HbA1c can only be reviewed infrequently and can mask the risk of hypoglycaemia or extreme glucose fluctuations. While CGM provides insights in to the risk of hypoglycaemia as well as daily fluctuations of glucose, it can also be used to calculate an estimated HbA1c that has been used as a substitute for laboratory HbA1c. However, it is evident that estimated HbA1c and HbA1c values can differ widely. The glucose management indicator (GMI), calculated exclusively from CGM data, has been proposed. It uses the same scale (% or mmol/mol) as HbA1c, but is based on short-term average glucose values, rather than long-term glucose exposure. HbA1c and GMI values differ in up to 81% of individuals by more than ±0.1% and by more than ±0.3% in 51% of cases. Here, we review the factors that define these differences, such as the time period being assessed, the variation in glycation rates and factors such as anaemia and haemoglobinopathies. Recognizing and understanding the factors that cause differences between HbA1c and GMI is an important clinical skill. In circumstances when HbA1c is elevated above GMI, further attempts at intensification of therapy based solely on the HbA1c value may increase the risk of hypoglycaemia. The observed difference between GMI and HbA1c also informs the important question about the predictive ability of GMI regarding long-term complications.
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Affiliation(s)
| | - Pratik Choudhary
- Leicester Diabetes Centre - Bloom, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Concetta Irace
- Department of Health Science, University Magna Graecia, Catanzaro, Italy
| | - Birgit Rami-Merhar
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
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26
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Gaborit B, Cosson E, Darmon P, Dutour A. Slimming cardiac adipose tissue with liraglutide: pericardial is not epicardial fat (the LIRAFLAME substudy). Diabetes Obes Metab 2022; 24:578-579. [PMID: 34738693 DOI: 10.1111/dom.14595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Bénédicte Gaborit
- Aix Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
| | - Emmanuel Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Patrice Darmon
- Aix Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
| | - Anne Dutour
- Aix Marseille Univ, APHM, INSERM, INRAE, C2VN, Department of Endocrinology, Metabolic Diseases and Nutrition, Marseille, France
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27
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Quansah DY, Gross J, Gilbert L, Pauchet A, Horsch A, Benhalima K, Cosson E, Puder JJ. Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study. J Clin Endocrinol Metab 2022; 107:e996-e1008. [PMID: 34718650 DOI: 10.1210/clinem/dgab791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. OBJECTIVE We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. METHODS This prospective cohort included 1185 All women with cGDM and 76 women with eGDM. The eGDM group had GDM risk factors (BMI >30 kg/m2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age, and diagnosed using American Diabetes Association prediabetes criteria. All women underwent lifestyle adaptations. Obstetric, neonatal, mental, and cardiometabolic outcomes were assessed during pregnancy and postpartum. RESULTS The eGDM group had lower gestational weight gain than cGDM (10.7 ± 6.2 vs 12.6 ± 6.4; P = 0.03) but needed more medical treatment (66% vs 42%; P < 0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%; P = 0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (P ≤ 0.001). In eGDM, the postpartum prevalence of the metabolic syndrome (MetS) was 1.8-fold, prediabetes was 3.1-fold, and diabetes was 7.4-fold higher than cGDM (waist circumference-based MetS: 62% vs 34%/BMI-based MetS: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all P < 0.001). These differences remained unchanged after adjusting for GDM risk factors. CONCLUSION Compared with cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM risk factors and gestational weight gain. This hints to a preexisting risk profile in eGDM.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Amelie Pauchet
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Katrien Benhalima
- Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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28
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Cosson E, Nachtergaele C, Vicaut E, Tatulashvili S, Sal M, Berkane N, Pinto S, Fabre E, Benbara A, Fermaut M, Sutton A, Valensi P, Carbillon L, Bihan H. Metabolic characteristics and adverse pregnancy outcomes for women with hyperglycaemia in pregnancy as a function of insulin resistance. Diabetes Metab 2022; 48:101330. [PMID: 35114388 DOI: 10.1016/j.diabet.2022.101330] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 12/13/2022]
Abstract
AIM Recent studies have shown that women with hyperglycaemia in pregnancy and insulin resistance have a greater risk of adverse pregnancy outcomes than women with normoglycaemic pregnancies. This study aimed to determine adverse pregnancy outcomes of women with hyperglycaemia in pregnancy only as a function of insulin resistance. METHODS From a prospective cohort study, we included 1,423 women with hyperglycaemia in pregnancy whose insulin resistance was evaluated using homeostatic model assessment for insulin resistance (HOMA-IR) when care was first provided for this condition. We compared the adverse pregnancy outcomes for different tertiles of HOMA-IR (intertertile range 1.9 and 3.3). RESULTS Increasing HOMA-IR tertiles were positively associated with the rate of insulin therapy (tertile 1, 2 and 3: 32.7, 47.0 and 58.7%, P < 0.0001), caesarean section (23.7, 26.0 and 32.2%, respectively, P < 0.01), gestational hypertension (1.3, 2.8 and 5.4% respectively, P < 0.01), preeclampsia (1.5, 2.8 and 4.5% respectively, P < 0.05), large-for-gestational-age infant (13.3, 10.4 and 17.6% respectively, P < 0.05), and neonatal hypoglycaemia (0.8, 1.5 and 3.2% respectively, P < 0.05). Women in the 3rd HOMA-IR tertile were more likely to have insulin therapy (odds ratio 2.09 (95% interval confidence 1.61-2.71)), hypertensive disorders (2.26 (1.42-3.36)), and large-for-gestational-age infant (1.42 (1.01-1.99)) than those in the 1st and 2nd tertiles combined in multivariable logistic regression analyses adjusted for gestational age at HOMA-IR measurement, glycaemic status, age, body mass index, family history of diabetes, parity and ethnicity. CONCLUSION Despite suitable care and increased rates of insulin therapy during pregnancy, higher insulin resistance in women with hyperglycaemia in pregnancy was associated with a greater risk of adverse pregnancy outcomes.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
| | - Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Emmanuelle Fabre
- AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Biochemistry Department, Bobigny, France
| | - Amélie Benbara
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Marion Fermaut
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Angela Sutton
- AP-HP, Avicenne and Jean Verdier Hospitals, Paris 13 University, Sorbonne Paris Cité, Biochemistry Department, Bobigny, France
| | - Paul Valensi
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
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Quansah DY, Gilbert L, Kosinski C, Le Dizès O, Horsch A, Benhalima K, Cosson E, Puder JJ. Cardio-Metabolic and Mental Health Outcomes Before and During the COVID-19 Pandemic in a Cohort of Women With Gestational Diabetes Mellitus in Switzerland. Front Endocrinol (Lausanne) 2022; 13:948716. [PMID: 35957818 PMCID: PMC9361046 DOI: 10.3389/fendo.2022.948716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been associated with worsened metabolic and mental health in the general and perinatal population. The postpartum is a critical moment regarding these outcomes particularly in women with gestational diabetes mellitus (GDM). We investigated the cardio-metabolic and mental health outcomes before and during the pandemic in this population. METHODS This cohort study included 418 women with GDM, recruited during two distinct periods. This included 180 women exposed to the pandemic (E+) and recruited between May 2020-April 2021 and 238 women who were not exposed to the pandemic during their postpartum period (attended a year before=non-exposed (E-)) and recruited between January-December 2019. Among the E+, a nested-subcohort of 120 women were exposed both during pregnancy and postpartum. During the pandemic, we adopted a hybrid follow-up of women that consisted of in-person consultations, regular contact via phone calls (35%), sent recorded exercise guide to patients to follow at home and linked to our website. We specifically focused on maintaining motivation and keeping a strong focus on healthy lifestyle behaviors. Obstetric, neonatal, cardio-metabolic and mental health outcomes were assessed during pregnancy and postpartum. RESULTS The pandemic was not associated with worsened weight, weight retention, glucose tolerance, metabolic syndrome, well-being or depression in the postpartum with the exception of a minimally increased HbA1c, diastolic blood pressure and lower emotional eating scores in E+ women (all p ≤ 0.046). In the nested subcohort, E+ women had a slightly increased HbA1c at the first GDM visit and a higher need for glucose-lowering medication (both p ≤ 0.014), but HbA1c at the end of pregnancy and other cardio-metabolic, mental health, obstetric and neonatal outcomes during pregnancy were similar. CONCLUSIONS The pandemic was not associated with any clinically relevant worsening of cardio-metabolic, mental health, obstetrical and neonatal outcomes in our GDM cohort. This was possibly due to a continued hybrid follow-up, and the partial lockdown in Switzerland.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Dan Yedu Quansah,
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Christophe Kosinski
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Le Dizès
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Katrien Benhalima
- Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Jardena J. Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Cosson E, Nguyen MT, Rezgani I, Berkane N, Pinto S, Bihan H, Tatulashvili S, Taher M, Sal M, Soussan M, Brillet PY, Valensi P. Epicardial adipose tissue volume and myocardial ischemia in asymptomatic people living with diabetes: a cross-sectional study. Cardiovasc Diabetol 2021; 20:224. [PMID: 34819079 PMCID: PMC8613918 DOI: 10.1186/s12933-021-01420-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/14/2021] [Indexed: 12/18/2022] Open
Abstract
Background Epicardial adipose tissue (EAT) is considered a novel diagnostic marker for cardiometabolic disease. This study aimed to evaluate whether EAT volume was associated with stress-induced myocardial ischemia in asymptomatic people living with diabetes—independently of confounding factors—and whether it could predict this condition. Methods We included asymptomatic patients with diabetes and no coronary history, who had undergone both a stress a myocardial scintigraphy to diagnose myocardial ischemia, and a computed tomography to measure their coronary artery calcium (CAC) score. EAT volume was retrospectively measured from computed tomography imaging. Determinants of EAT volume and asymptomatic myocardial ischemia were evaluated. Results The study population comprised 274 individuals, including 153 men. Mean (± standard deviation) age was 62 ± 9 years, and 243, 23 and 8 had type 2, type 1, or another type of diabetes, respectively. Mean body mass index was 30 ± 6 kg/m2, and mean EAT volume 96 ± 36 cm3. Myocardial ischemia was detected in 32 patients (11.7%). EAT volume was positively correlated with age, body mass index and triglyceridemia, but negatively correlated with HbA1c, HDL- and LDL-cholesterol levels. Furthermore, EAT volume was lower in people with retinopathy, but higher in men, in current smokers, in patients with nephropathy, those with a CAC score > 100 Agatston units, and finally in individuals with myocardial ischemia (110 ± 37 cm3 vs 94 ± 37 cm3 in those without myocardial ischemia, p < 0.05). The association between EAT volume and myocardial ischemia remained significant after adjustment for gender, diabetes duration, peripheral macrovascular disease and CAC score. We also found that area under the ROC curve analysis showed that EAT volume (AROC: 0.771 [95% confidence interval 0.683–0.858]) did not provide improved discrimination of myocardial ischemia over the following classic factors: gender, diabetes duration, peripheral macrovascular disease, retinopathy, nephropathy, smoking, atherogenic dyslipidemia, and CAC score (AROC 0.773 [0.683–0.862]). Conclusions EAT may play a role in coronary atherosclerosis and coronary circulation in patients with diabetes. However, considering EAT volume is not a better marker for discriminating the risk of asymptomatic myocardial ischemia than classic clinical data.
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Affiliation(s)
- Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France. .,Unité de Recherche Epidémiologique Nutritionnelle, UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Bobigny, France.
| | - Minh Tuan Nguyen
- Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, AP-HP, Université Paris 13, Bondy, France
| | - Imen Rezgani
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France
| | - Sara Pinto
- Unit of Diabetology, Jean Verdier Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, Bondy, France
| | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France.,Laboratoire Educations et Pratiques de Santé UR 3412, UFR Santé, Médecine, Biologie Humaine, Université Paris Sorbonne Paris Nord, 74, Rue Marcel Cachin, 93017, Bobigny Cedex, France
| | - Sopio Tatulashvili
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France
| | - Malak Taher
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France
| | - Meriem Sal
- Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, 125 Rue de Stalingrad, 93000, Bobigny Cedex, France
| | - Michael Soussan
- Department of Nuclear Medicine, Avicenne Hospital, AP-HP, Bobigny, France
| | | | - Paul Valensi
- Unit of Diabetology, Jean Verdier Hospital, CRNH-IdF, CINFO, AP-HP, Université Paris 13, Sorbonne Paris Cité, Bondy, France
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31
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Riveline JP, Vergés B, Detournay B, Picard S, Benhamou PY, Bismuth E, Bordier L, Jeandidier N, Joubert M, Roussel R, Sola-Gazagnes A, Bonnefond A, Clavel S, Velayoudom FL, Beltrand J, Hanaire H, Fontaine P, Thivolet C, Servy H, Tubiana S, Lion S, Gautier JF, Larger E, Vicaut E, Sablone L, Fagherazzi G, Cosson E. Design of a prospective, longitudinal cohort of people living with type 1 diabetes exploring factors associated with the residual cardiovascular risk and other diabetes-related complications: The SFDT1 study. Diabetes Metab 2021; 48:101306. [PMID: 34813929 DOI: 10.1016/j.diabet.2021.101306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
Type 1 diabetes mellitus (T1DM) is associated with a high risk of cardiovascular (CV) complications, even after controlling for traditional CV risk factors. Therefore, determinants of the residual increased CV morbidity and mortality remain to be discovered. This prospective cohort of people living with T1DM in France (SFDT1) will include adults and children aged over six years living with T1DM, recruited throughout metropolitan France and overseas French departments and territories. The primary objective is to better understand the parameters associated with CV complications in T1DM. Clinical data and biobank samples will be collected during routine visits every three years. Data from connected tools, including continuous glucose monitoring, will be available during the 10-year active follow-up. Patient-reported outcomes, psychological and socioeconomic information will also be collected either at visits or through web questionnaires accessible via the internet. Additionally, access to the national health data system (Health Data Hub) will provide information on healthcare and a passive 20-year medico-administrative follow-up. Using Health Data Hub, SFDT1 participants will be compared to non-diabetic individuals matched on age, gender, and residency area. The cohort is sponsored by the French-speaking Foundation for Diabetes Research (FFRD) and aims to include 15,000 participants.
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Affiliation(s)
- J P Riveline
- Department of Diabetology and Endocrinology, Lariboisiere Hospital, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, Paris 75010, France; Unite INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Universite de Paris, Paris, France.
| | - B Vergés
- Department of Endocrinology-Diabetology, INSERM LNC UMR1231, University of Burgundy, Dijon, France
| | - B Detournay
- CEMKA, 43 boulevard du Maréchal Joffre, Bourg-la-Reine, France
| | - S Picard
- Endocrinology and Diabetes, Point Medical, Rond-Point de la Nation, Dijon 21000, France
| | - P Y Benhamou
- INSERM U1055, LBFA, Endocrinologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - E Bismuth
- Hôpital Universitaire Robert-Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Université de Paris, Paris F-75019, France
| | - L Bordier
- Department of Diabetology and Endocrinology, Begin Military Hospital, Saint Mandé, France
| | - N Jeandidier
- Department of Endocrinology, Diabetes, Nutrition, Hospices Civils Strasbourg, UdS, Strasbourg 67000, France
| | - M Joubert
- Diabetes Care Unit - Caen University Hospital - UNICAEN, Caen, France
| | - R Roussel
- Department of Diabetology, Endocrinology, and Nutrition, Bichat-Claude Bernard Hospital, Paris,France; Unite INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Universite de Paris, Paris, France
| | - A Sola-Gazagnes
- Department of Diabetology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - A Bonnefond
- Université de Lille, Inserm UMR1283, CNRS UMR8199, Institut Pasteur de Lille, CHU de Lille, Lille, France
| | - S Clavel
- Department of Diabetology Endocrinology Hotel Dieu Le Creusot, France
| | - F L Velayoudom
- Department of Diabetology and Endocrinology, University Hospital of Guadeloupe, Inserm UMR1283, CNRS UMR8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, Lille University Hospital, Lille 59000, France
| | - J Beltrand
- Endocrinologie, Gynécologie et Diabétologie Pédiatrique, APHP Centre, Hôpital Universitaire Necker Enfants Malades, Université de Paris - Inserm U1016, Institut Cochin, Paris, France
| | - H Hanaire
- Department of Diabetology, University Hospital of Toulouse, University of Toulouse, France
| | - P Fontaine
- Department of Endocrinology, Diabetology and Nutrition University Hospital of Lille, University of Lille, France
| | - C Thivolet
- Center for Diabetes DIAB-eCARE, Hospices Civils de Lyon and Lyon 1 University, Lyon France
| | - H Servy
- e-health Services Sanoïa, 188 av 2nd DB, Gémenos 13420, France
| | - S Tubiana
- AP-HP, Hôpital Bichat, Centre de Ressources Biologiques, Paris F-75018, France
| | - S Lion
- Société Francophone du Diabète, Paris, France
| | - Jean-François Gautier
- Department of Diabetology and Endocrinology, Lariboisiere Hospital, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, 2 rue Ambroise Paré, Paris 75010, France; Unite INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Universite de Paris, Paris, France
| | - Etienne Larger
- AP-HP.Centre-Université de Paris, INSERM U1016, Institut Cochin Paris, France
| | - E Vicaut
- AP-HP, Hôpital F.Widal, Clinical Trial Unit, Paris 75010, France
| | - L Sablone
- Fondation Francophone Pour la Recherche sur le Diabète, 60 rue Saint Lazare, Paris 75009, France
| | - G Fagherazzi
- Department of Population Health, Deep Digital Phenotyping Research Unit, 1 AB rue Thomas Edison, Strassen, Luxembourg
| | - E Cosson
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, AP-HP, Avicenne Hospital, Paris 13 University, Bobigny, France; UMR 557 INSERM/U11125 INRAE/CNAM / Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Paris 13 University Sorbonne Paris Cité, Bobigny, France
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32
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Diedisheim M, Dancoisne E, Gautier JF, Larger E, Cosson E, Fève B, Chanson P, Czernichow S, Tatulashvili S, Raffin-Sanson ML, Sallah K, Bourgeon M, Ajzenberg C, Hartemann A, Daniel C, Moreau T, Roussel R, Potier L. Response to Letter to the Editor From Woolcott and Castilla-Bancayán: "Diabetes Increases Severe COVID-19 Outcomes Primarily in Younger Adults". J Clin Endocrinol Metab 2021; 106:e5277-e5278. [PMID: 34370033 PMCID: PMC8385935 DOI: 10.1210/clinem/dgab583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Marc Diedisheim
- Cordeliers Research Centre, ImMeDiab team,
INSERM, Université de Paris, 75006 Paris, France
- Hôpital Cochin, APHP, Diabetology
Department, 75014 Paris, France
| | - Etienne Dancoisne
- Assistance Publique-Hôpitaux de Paris, DSI WIND, Web
Innovation Données, 75012 Paris, France
- Hôpital Bichat - Claude-Bernard, APHP, URC
PNVS, CIC-EC 1425, INSERM, 75018 Paris, France
| | - Jean-François Gautier
- Cordeliers Research Centre, ImMeDiab team,
INSERM, Université de Paris, 75006 Paris, France
- GH Lariboisiere Fernand-Widal, APHP, Department of
Diabetes and Endocrinology, 75010 Paris, France
| | - Etienne Larger
- Hôpital Cochin, APHP, Diabetology
Department, 75014 Paris, France
| | - Emmanuel Cosson
- Hospital Avicenne, APHP, Department of
Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000
Bobigny, France
- Université Sorbonne Paris Cité, UMR U557 INSERM/U11125
INRAE, Unité de Recherche Epidémiologique Nutritionnelle, 93000
Bobigny, France
| | - Bruno Fève
- Hôpital Saint-Antoine, APHP, Department of
Endocrinology-Diabetology, 75012 Paris, France
- Institut Hospitalo-Universitaire ICAN, 75013
Paris, France
- Sorbonne Université, INSERM, UMR_S938, CRMR
PRISIS, 75012 Paris, France
| | - Philippe Chanson
- 11Hôpital Bicêtre, APHP, Service d’Endocrinologie et des
Maladies de la Reproduction 94270 Le Kremlin-Bicetre, France
- 12Université Paris-Saclay, INSERM, Physiologie et
Physiopathologie Endocriniennes, 94270 Le Kremlin-Bicetre,
France
| | - Sébastien Czernichow
- Hôpital Européen Georges Pompidou, APHP, Service de
Nutrition, Centre Spécialisé Obésité, 75015 Paris, France
- Université de Paris, INSERM, UMR1153,
Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), 75015 Paris,
France
| | - Sopio Tatulashvili
- Hospital Avicenne, APHP, Department of
Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 93000
Bobigny, France
- Université Sorbonne Paris Cité, UMR U557 INSERM/U11125
INRAE, Unité de Recherche Epidémiologique Nutritionnelle, 93000
Bobigny, France
| | - Marie-Laure Raffin-Sanson
- Hospital Ambroise Paré, APHP, Service d'Endocrinologie
Diabétologie et Nutrition, 92100 Boulogne-Billancourt,
France
- Université de Versailles
Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - Kankoé Sallah
- Hôpital Bichat - Claude-Bernard, APHP, URC
PNVS, CIC-EC 1425, INSERM, 75018 Paris, France
| | - Muriel Bourgeon
- Hôpital Antoine-Béclère, APHP, Service de Médecine
Interne, 92140 Clamart, France
| | | | - Agnès Hartemann
- Hôpital Pitié Salpêtrière, APHP, Diabetology
Department, 75013Paris, France
| | - Christel Daniel
- Assistance Publique-Hôpitaux de Paris, DSI WIND, Web
Innovation Données, 75012 Paris, France
- Sorbonne Université, University Paris 13, Sorbonne Paris
Cité, INSERM UMR_S 1142, 75006 Paris, France
| | - Thomas Moreau
- Université Paris-Saclay, INRIA, CEA, 91120
Palaiseau, France
| | - Ronan Roussel
- Cordeliers Research Centre, ImMeDiab team,
INSERM, Université de Paris, 75006 Paris, France
- Hôpital Bichat - Claude-Bernard, APHP, Department of
Diabetology, 75018 Paris, France
| | - Louis Potier
- Cordeliers Research Centre, ImMeDiab team,
INSERM, Université de Paris, 75006 Paris, France
- Hôpital Bichat - Claude-Bernard, APHP, Department of
Diabetology, 75018 Paris, France
- Corresponding author: Dr Louis Potier, Diabetology, Endocrinology
and Nutrition Department, Bichat Hospital, APHP, 46 rue Henri Huchard 75018
Paris, tel: + 33 (0) 1 40 25 73 01,
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Ouedraogo E, Allard L, Bihan H, Goupil de Bouillé J, Giroux-Leprieur B, Sutton A, Baudry C, Josse C, Didier M, Deutsch D, Rezgani I, Bouchaud O, Cosson E. The association of metabolic syndrome and COVID-19 deterioration. Nutr Metab Cardiovasc Dis 2021; 31:3236-3242. [PMID: 34629251 PMCID: PMC8386103 DOI: 10.1016/j.numecd.2021.08.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/08/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS To evaluate the prevalence and prognostic value of metabolic syndrome (MetS) in patients admitted for coronavirus disease 2019 (COVID-19). METHODS AND RESULTS In this monocentric cohort retrospective study, we consecutively included all adult patients admitted to COVID-19 units between April 9 and May 29, 2020 and between February 1 and March 26, 2021. MetS was defined when at least three of the following components were met: android obesity, high HbA1c, hypertension, hypertriglyceridemia, and low HDL cholesterol. COVID-19 deterioration was defined as the need for nasal oxygen flow ≥6 L/min within 28 days after admission. We included 155 patients (55.5% men, mean age 61.7 years old, mean body mass index 29.8 kg/m2). Fifty-six patients (36.1%) had COVID-19 deterioration. MetS was present in 126 patients (81.3%) and was associated with COVID-19 deterioration (no-MetS vs MetS: 13.7% and 41.2%, respectively, p < 0.01). Logistic regression taking into account MetS, age, gender, ethnicity, period of inclusion, and Charlson Index showed that COVID-19 deterioration was 5.3 times more likely in MetS patients (95% confidence interval 1.3-20.2) than no-MetS patients. CONCLUSIONS Over 81.3% of patients hospitalized in COVID-19 units had MetS. This syndrome appears to be an independent risk factor of COVID-19 deterioration.
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Affiliation(s)
- Elise Ouedraogo
- Department of Infectious Disease, AP-HP, Avicenne Hospital, Bobigny, France
| | - Lucie Allard
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Bobigny, France
| | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Bobigny, France; LEPS (Laboratoire Educations et Pratiques de Santé) EA 3412-Université Sorbonne Paris Nord, Bobigny, France
| | | | | | - Angela Sutton
- Department of Biology Laboratory, AP-HP, Avicenne Hospital, Bobigny, France; Laboratory for Vascular Translational Science (LVTS), Inserm U1148 Groupe Biothérapies et Glycoconjugués, Université Paris 13 - Sorbonne Paris Nord, France
| | - Camille Baudry
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Bobigny, France
| | | | - Morgane Didier
- Department of Respiratory Disease, AP-HP, Avicenne Hospital, Bobigny, France
| | - David Deutsch
- Department of Gastroenterology and Digestive Oncology, AP-HP, Avicenne Hospital, Bobigny, France
| | - Imen Rezgani
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Bobigny, France
| | - Olivier Bouchaud
- Department of Infectious Disease, AP-HP, Avicenne Hospital, Bobigny, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Bobigny, France; Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), UMR U1153 Inserm / U1125 Inrae / Cnam / Université Paris 13 - Sorbonne Paris Nord, Centre de Recherche en Epidémiologie et Statistiques - Université de Paris (CRESS), SMBH PARIS 13, Bobigny, France.
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34
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Rezki A, Cosson E, Fysekidis M, Chiheb S, Vicaut E, Valensi P. Acute and long-term effects of saxagliptin on a set of cardiovascular targets measured at fasting and post-prandially in obese patients with impaired glucose tolerance: A placebo-controlled study. Nutr Metab Cardiovasc Dis 2021; 31:2945-2958. [PMID: 34420816 DOI: 10.1016/j.numecd.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Studies of dipeptidyl peptidase inhibitors (DPP4is) report heterogeneous effects on cardiovascular targets in type 2 diabetes. This study aimed to investigate, in patients with impaired glucose tolerance (IGT), whether saxagliptin, a DPP4i, had beneficial cardiovascular effects at fasting and during the post-prandial state. METHODS AND RESULTS In this randomized, placebo-controlled, double-blind, single-center pilot exploratory study, we included obese individuals with IGT. Twenty-four individuals (BMI 36.8 ± 4.8 kg/m2) were randomized to receive for 12 weeks either saxagliptin 5 mg a day or placebo. They were explored before and after a standardized breakfast for biological markers; microcirculatory blood flow at baseline and after transcutaneous administration of acetylcholine (Periflux System 5000® PERIMED); post-occlusive digital reactive hyperhemia (Endopat2000®); pulse wave velocity, augmentation index, central pulse pressure and subendocardial viability ratio (Sphygmocor®); cardiac hemodynamic parameters and cardiovascular autonomic nervous system activity (Task force monitor®). The results of all the investigations were similar after breakfast in the two groups at Visit 1 (acute post-prandial effects, after the first tablet) and Visit 2 (long-term post-prandial effects), and at fasting at Visit 1 and 2 (long-term effects, after 12 weeks of treatment). Only at Visit 2 the decrease in cardiac vagal activity occurring after breakfast was more sustained in the saxagliptin group than in the placebo group (interaction between treatment and time effect: p = 0.016). CONCLUSION In obese patients with IGT, the effects of saxagliptin on the large set of cardiovascular parameters measured are neutral, except for a more marked post-prandial depression of vagal activity. CLINICAL TRIAL REGISTRATION NUMBER NCT01521312.
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Affiliation(s)
- Amel Rezki
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Emmanuel Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Marinos Fysekidis
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRA/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Sabrina Chiheb
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France
| | - Eric Vicaut
- Université Denis Diderot, AP-HP Unité de Recherche Clinique St-Louis-Lariboisière, Paris, France
| | - Paul Valensi
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Jean Verdier Hospital, Bondy, France.
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Haneef R, Kab S, Hrzic R, Fuentes S, Fosse-Edorh S, Cosson E, Gallay A. Use of artificial intelligence for public health surveillance: a case study to develop a machine Learning-algorithm to estimate the incidence of diabetes mellitus in France. ACTA ACUST UNITED AC 2021; 79:168. [PMID: 34551816 PMCID: PMC8456679 DOI: 10.1186/s13690-021-00687-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 09/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The use of machine learning techniques is increasing in healthcare which allows to estimate and predict health outcomes from large administrative data sets more efficiently. The main objective of this study was to develop a generic machine learning (ML) algorithm to estimate the incidence of diabetes based on the number of reimbursements over the last 2 years. METHODS We selected a final data set from a population-based epidemiological cohort (i.e., CONSTANCES) linked with French National Health Database (i.e., SNDS). To develop this algorithm, we adopted a supervised ML approach. Following steps were performed: i. selection of final data set, ii. target definition, iii. Coding variables for a given window of time, iv. split final data into training and test data sets, v. variables selection, vi. training model, vii. Validation of model with test data set and viii. Selection of the model. We used the area under the receiver operating characteristic curve (AUC) to select the best algorithm. RESULTS The final data set used to develop the algorithm included 44,659 participants from CONSTANCES. Out of 3468 variables from SNDS linked to CONSTANCES cohort were coded, 23 variables were selected to train different algorithms. The final algorithm to estimate the incidence of diabetes was a Linear Discriminant Analysis model based on number of reimbursements of selected variables related to biological tests, drugs, medical acts and hospitalization without a procedure over the last 2 years. This algorithm has a sensitivity of 62%, a specificity of 67% and an accuracy of 67% [95% CI: 0.66-0.68]. CONCLUSIONS Supervised ML is an innovative tool for the development of new methods to exploit large health administrative databases. In context of InfAct project, we have developed and applied the first time a generic ML-algorithm to estimate the incidence of diabetes for public health surveillance. The ML-algorithm we have developed, has a moderate performance. The next step is to apply this algorithm on SNDS to estimate the incidence of type 2 diabetes cases. More research is needed to apply various MLTs to estimate the incidence of various health conditions.
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Affiliation(s)
- Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France.
| | - Sofiane Kab
- Population-Based Epidemiological Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Rok Hrzic
- Department of International Health, Care and Public Health Research Institute - CAPHRI, University of Maastricht University, Maastricht, The Netherlands
| | - Sonsoles Fuentes
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
| | - Sandrine Fosse-Edorh
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France.,Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Anne Gallay
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, 12 rue du Val d'Onse, 94415, Saint-Maurice, France
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Nachtergaele C, Vicaut E, Bihan H, Pinto S, Sal M, Berkane N, Carbillon L, Cosson E. HbA 1c and fasting plasma glucose cannot replace oral glucose tolerance test in order to screen for hyperglycaemia in pregnancy. Diabet Med 2021; 38:e14604. [PMID: 34021631 DOI: 10.1111/dme.14604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 05/18/2021] [Indexed: 12/28/2022]
Affiliation(s)
- Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Sara Pinto
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - Meriem Sal
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Lionel Carbillon
- Department of Obstetrics and Gynecology, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
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Cosson E, Bentounes SA, Nachtergaele C, Berkane N, Pinto S, Sal M, Bihan H, Tatulashvili S, Portal JJ, Carbillon L, Vicaut E. Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy. J Clin Med 2021; 10:3904. [PMID: 34501352 PMCID: PMC8432067 DOI: 10.3390/jcm10173904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022] Open
Abstract
We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01-1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26-9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
- Nutritional Epidemiology Research Unit, UMR U557 INSERM/U11125 INRAE/CNAM, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France
| | - Sid Ahmed Bentounes
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Charlotte Nachtergaele
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Unit of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93143 Bondy, France;
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris Cité, 93000 Bobigny, France; (N.B.); (M.S.); (H.B.); (S.T.)
| | - Jean-Jacques Portal
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Department of Obstetrics and Gynecology, Paris 13 University, Sorbonne Paris Cité, 93143 Bondy, France;
| | - Eric Vicaut
- AP-HP, Clinical Research Unit St-Louis-Lariboisière, Denis Diderot University, 75010 Paris, France; (S.A.B.); (C.N.); (J.-J.P.); (E.V.)
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Diedisheim M, Dancoisne E, Gautier JF, Larger E, Cosson E, Fève B, Chanson P, Czernichow S, Tatulashvili S, Raffin-Sanson ML, Bourgeon M, Ajzenberg C, Hartemann A, Daniel C, Moreau T, Roussel R, Potier L. Diabetes Increases Severe COVID-19 Outcomes Primarily in Younger Adults. J Clin Endocrinol Metab 2021; 106:e3364-e3368. [PMID: 34406396 PMCID: PMC8195170 DOI: 10.1210/clinem/dgab393] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Indexed: 01/24/2023]
Abstract
CONTEXT Diabetes is reported as a risk factor for severe coronavirus disease 2019 (COVID-19), but whether this risk is similar in all categories of age remains unclear. OBJECTIVE To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories. DESIGN SETTING AND PARTICIPANTS We conducted a retrospective observational cohort study of 6314 consecutive patients hospitalized for COVID-19 between February and 30 June 2020 in the Paris metropolitan area, France; follow-up was recorded until 30 September 2020. MAIN OUTCOME MEASURE(S) The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories. RESULTS Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (hazard ratio [HR] 1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 years in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 years and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, P < 0.001), but adjusted HR for diabetes was significant only in patients younger than age 50 years (HR 1.81 [1.14-2.87]). CONCLUSIONS Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
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Affiliation(s)
- Marc Diedisheim
- Cordeliers Research Centre, ImMeDiab team, INSERM, Université de Paris, Paris, France
- Hospital Cochin, APHP, Diabetology Department, Paris, France. Université de Paris, Paris, France
| | - Etienne Dancoisne
- Assistance Publique-Hôpitaux de Paris, DSI WIND, Web Innovation Données, Paris, France
- Hôpital Bichat - Claude-Bernard, Clinical Research Unit, France
| | - Jean-François Gautier
- Cordeliers Research Centre, ImMeDiab team, INSERM, Université de Paris, Paris, France
- GH Lariboisiere Fernand-Widal, AP-HP, Department of Diabetes and Endocrinology, Paris, France. Cordeliers Research Centre, INSERM, ImMeDiab team, Paris, France
| | - Etienne Larger
- Hospital Cochin, APHP, Diabetology Department, Paris, France. Université de Paris, Paris, France
| | - Emmanuel Cosson
- Hospital Avicenne, APHP, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
- Université Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Bruno Fève
- Hôpital Saint-Antoine, Department of Endocrinology-Diabetology, APHP, Institut Hospitalo-Universitaire ICAN, Paris, France. Sorbonne Université, INSERM, UMR_S938, CRMR PRISIS, Paris, France
| | - Philippe Chanson
- Hôpital Bicêtre, APHP, Service d’Endocrinologie et des Maladies de la Reproduction Le Kremlin-Bicetre, France. Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicetre, France
| | - Sébastien Czernichow
- Hôpital Européen Georges Pompidou Cancérologie, Service de Nutrition, Centre Spécialisé Obésité, Paris, France. Université de Paris, INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Paris, France
| | - Sopio Tatulashvili
- Hospital Avicenne, AP-HP, Department of Endocrinology-Diabetology-Nutrition Bobigny, France. Université Sorbonne Paris Cité, Epidemiology and Biostatistics Research Center, Nutritional Epidemiology Research Team (EREN), Inserm U1153, INRA U1125 Bobigny, France
| | - Marie-Laure Raffin-Sanson
- Hospital Ambroise Paré, APHP, Service d'Endocrinologie Diabétologie et Nutrition, Boulogne-Billancourt, France. Université de Versailles Saint-Quentin-en-Yvelines Versailles, France
| | - Muriel Bourgeon
- Hôpital Antoine-Béclère, APHP, Service de Médecine Interne, Clamart, France
| | | | - Agnès Hartemann
- Sorbonne Université, Institute of Cardiometabolism and Nutrition ICAN, Paris, France. University Hospital Pitié Salpêtrière, APHP, Diabetes Department, Paris, France
| | - Christel Daniel
- Assistance Publique-Hôpitaux de Paris, DSI WIND, Web Innovation Données, Paris, France
- Sorbonne Université, University Paris 13, Sorbonne Paris Cité, INSERM UMR_S 1142, Paris, France
| | - Thomas Moreau
- Université Paris-Saclay, Inria, CEA, Palaiseau, France
| | - Ronan Roussel
- Cordeliers Research Centre, ImMeDiab team, INSERM, Université de Paris, Paris, France
- Hôpital Bichat - Claude-Bernard, APHP, Department of Diabetology, Paris, France
| | - Louis Potier
- Cordeliers Research Centre, ImMeDiab team, INSERM, Université de Paris, Paris, France
- Hôpital Bichat - Claude-Bernard, APHP, Department of Diabetology, Paris, France
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39
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Tramunt B, Smati S, Coudol S, Wargny M, Pichelin M, Guyomarch B, Al-Salameh A, Amadou C, Barraud S, Bigot E, Bordier L, Borot S, Bourgeon M, Bourron O, Charrière S, Chevalier N, Cosson E, Fève B, Flaus-Furmaniuk A, Fontaine P, Galioot A, Gonfroy-Leymarie C, Guerci B, Lablanche S, Lalau JD, Larger E, Lasbleiz A, Laviolle B, Marre M, Munch M, Potier L, Prevost G, Renard E, Reznik Y, Seret-Bégué D, Sibilia P, Thuillier P, Vergès B, Gautier JF, Hadjadj S, Cariou B, Mauvais-Jarvis F, Gourdy P. Sex disparities in COVID-19 outcomes of inpatients with diabetes: insights from the CORONADO study. Eur J Endocrinol 2021; 185:299-311. [PMID: 34085949 PMCID: PMC9494335 DOI: 10.1530/eje-21-0068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/03/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Male sex is one of the determinants of severe coronavirus diseas-e-2019 (COVID-19). We aimed to characterize sex differences in severe outcomes in adults with diabetes hospitalized for COVID-19. METHODS We performed a sex-stratified analysis of clinical and biological features and outcomes (i.e. invasive mechanical ventilation (IMV), death, intensive care unit (ICU) admission and home discharge at day 7 (D7) or day 28 (D28)) in 2380 patients with diabetes hospitalized for COVID-19 and included in the nationwide CORONADO observational study (NCT04324736). RESULTS The study population was predominantly male (63.5%). After multiple adjustments, female sex was negatively associated with the primary outcome (IMV and/or death, OR: 0.66 (0.49-0.88)), death (OR: 0.49 (0.30-0.79)) and ICU admission (OR: 0.57 (0.43-0.77)) at D7 but only with ICU admission (OR: 0.58 (0.43-0.77)) at D28. Older age and a history of microvascular complications were predictors of death at D28 in both sexes, while chronic obstructive pulmonary disease (COPD) was predictive of death in women only. At admission, C-reactive protein (CRP), aspartate amino transferase (AST) and estimated glomerular filtration rate (eGFR), according to the CKD-EPI formula predicted death in both sexes. Lymphocytopenia was an independent predictor of death in women only, while thrombocytopenia and elevated plasma glucose concentration were predictors of death in men only. CONCLUSIONS In patients with diabetes admitted for COVID-19, female sex was associated with lower incidence of early severe outcomes, but did not influence the overall in-hospital mortality, suggesting that diabetes mitigates the female protection from COVID-19 severity. Sex-associated biological determinants may be useful to optimize COVID-19 prevention and management in women and men.
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Affiliation(s)
- Blandine Tramunt
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
| | - Sarra Smati
- Nantes University, Nantes University Hospital, CNRS, INSERM, L’Institut du Thorax, Nantes, France
| | | | - Matthieu Wargny
- Nantes University, Nantes University Hospital, CNRS, INSERM, L’Institut du Thorax, Nantes, France
- CIC-EC 1413, Data Clinic, France
| | - Matthieu Pichelin
- Nantes University, Nantes University Hospital, CNRS, INSERM, L’Institut du Thorax, Nantes, France
| | - Béatrice Guyomarch
- Research Department, Methodology and Biostatistics Platform, Nantes University Hospital, Nantes, France
| | - Abdallah Al-Salameh
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France
- PériTox=UMR_I 01, University of Picardie Jules Verne, Amiens, France
| | - Coralie Amadou
- Department of Diabetology, Sud Francilien Hospital Center, Corbeil Essonne, France
| | - Sara Barraud
- CRESTIC EA 3804, University of Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la Housse, Reims, France
- Department of Endocrinology-Diabetes-Nutrition, Reims University Hospital, Avenue du Général Koenig, Reims, France
| | - Edith Bigot
- Department of Biochemistry, Nantes University Hospital, G et R Laënnec Hospital, Bd Jacques Monod, Nantes, France
| | - Lyse Bordier
- Department of Endocrinology, Bégin Hospital, Saint-Mandé, France
| | - Sophie Borot
- Department of Endocrinology, Diabetology and Nutrition, Besançon University Hospital, Besançon, France
| | - Muriel Bourgeon
- Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Antoine Béclère Hospital, Clamart, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Olivier Bourron
- Department of Diabetology, Sorbonne University, Assistance Publique Hôpitaux de Paris, La Pitié Salpêtrière-Charles Foix University Hospital, Inserm, UMR_S 1138, Cordeliers Research Center, Paris 06, Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - Sybil Charrière
- Federation of Endocrinology – Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, INSERM UMR 1060 Carmen, Claude Bernard Lyon 1 University, Lyon, France
| | - Nicolas Chevalier
- University of Côte d’Azur, University Hospital, Inserm U1065, C3M, Nice, France
| | - Emmanuel Cosson
- Department of Endocrinology, Diabetology and Nutrition, Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm/U11125 INRAE/CNAM/Paris13 University, Nutritional Epidemiological Research Unit, Bobigny, France
| | - Bruno Fève
- Department of Endocrinology, Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Paris, France
- Sorbonne University, Inserm UMRS 938, Saint-Antoine Research Center, Paris, France
| | - Anna Flaus-Furmaniuk
- Department of Endocrinology-Diabetology, Felix Guyon Site, University Hospital of la Réunion, Saint-Denis de la Réunion, France
| | - Pierre Fontaine
- Department of Endocrinology, Diabetology and Nutrition, Hospital of Huriez, Lille University Hospital, Lille, France
| | - Amandine Galioot
- Department of Endocrinology, Diabetology and Nutrition, Bordeaux University Hospital and University of Bordeaux, Bordeaux, France
| | | | - Bruno Guerci
- Lorraine University and Endocrinology, Diabetology, Metabolic Diseases and Nutrition, Nancy University Hospital, Nancy, France
| | - Sandrine Lablanche
- Grenoble Alpes University, INSERM U1055, LBFA, Endocrinology, Grenoble Alpes University Hospital, France
| | - Jean-Daniel Lalau
- Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France
- PériTox=UMR_I 01, University of Picardie Jules Verne, Amiens, France
| | - Etienne Larger
- Department of Diabetology, Cochin Hospital, AP-HP, Paris University, Paris, France
| | - Adèle Lasbleiz
- Department of Endocrinology, Diabetology and Nutrition, Hospital of la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- Aix Marseille University, INSERM, INRA, C2VN, Marseille, France
| | - Bruno Laviolle
- Rennes University, Rennes University Hospital, Inserm, CIC 1414 (Clinical Investigation Center), Rennes, France
| | - Michel Marre
- Ambroise Paré Neuilly-sur-Seine Hospital, Cordeliers Research Center, Paris Diderot University, Paris, France
| | - Marion Munch
- Department of Endocrinology, Diabetology and Nutrition, Strasbourg University Hospitals, Strasbourg, France
| | - Louis Potier
- Department of Endocrinology, Diabetology and Nutrition, Bichat Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- Cordeliers Research Center, Inserm, U-1138, Paris University, Paris, France
| | - Gaëtan Prevost
- Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie University, UNIROUEN, Rouen University Hospital, Rouen, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, INSERM Clinical Investigation Centre, Institute of Functional Genomics, CNRS, INSERM, University of Montpellier, Montpellier, France
| | - Yves Reznik
- Department of Endocrinology and Diabetology, University Hospital of Côte de Nacre, Caen Cedex, France
| | | | - Paul Sibilia
- Department of Endocrinology, Diabetology and Nutrition, Angers University Hospital, Angers, France
| | - Philippe Thuillier
- Department of Endocrinology, Brest University Hospital, EA 3878 GETBO, Brest, France
| | - Bruno Vergès
- Department of Endocrinology, Diabetology and Metabolic Diseases, Hospital of Bocage, Dijon, France
| | - Jean-François Gautier
- Department of Diabetology and Endocrinology, Lariboisière Hospital, APHP, Paris, France
- INSERM UMRS 1138, Paris Diderot-Paris VII University, Sorbonne Paris Cité, Paris, France
| | - Samy Hadjadj
- Nantes University, Nantes University Hospital, CNRS, INSERM, L’Institut du Thorax, Nantes, France
| | - Bertrand Cariou
- Nantes University, Nantes University Hospital, CNRS, INSERM, L’Institut du Thorax, Nantes, France
| | - Franck Mauvais-Jarvis
- Section of Endocrinology, John W Deming Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Southeast Louisiana Veterans Health Care System Medical Center, New Orleans, Louisiana, USA
- Tulane Center of Excellence in Sex-Based Biology and Medicine, New Orleans, Louisiana, USA
- Correspondence should be addressed to F Mauvais-Jarvis;
| | - Pierre Gourdy
- Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France
- Correspondence should be addressed to P Gourdy;
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Roussel R, Darmon P, Pichelin M, Goronflot T, Abouleka Y, Ait Bachir L, Allix I, Ancelle D, Barraud S, Bordier L, Carlier A, Chevalier N, Coffin‐Boutreux C, Cosson E, Dorange A, Dupuy O, Fontaine P, Fremy B, Galtier F, Germain N, Guedj A, Larger E, Laugier‐Robiolle S, Laviolle B, Ludwig L, Monier A, Montanier N, Moulin P, Moura I, Prevost G, Reznik Y, Sabbah N, Saulnier P, Serusclat P, Vatier C, Wargny M, Hadjadj S, Gourdy P, Cariou B. Use of dipeptidyl peptidase-4 inhibitors and prognosis of COVID-19 in hospitalized patients with type 2 diabetes: A propensity score analysis from the CORONADO study. Diabetes Obes Metab 2021; 23:1162-1172. [PMID: 33528920 PMCID: PMC8013481 DOI: 10.1111/dom.14324] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/06/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023]
Abstract
AIM To investigate the association between routine use of dipeptidyl peptidase-4 (DPP-4) inhibitors and the severity of coronavirus disease 2019 (COVID-19) infection in patient with type 2 diabetes in a large multicentric study. MATERIALS AND METHODS This study was a secondary analysis of the CORONADO study on 2449 patients with type 2 diabetes (T2D) hospitalized for COVID-19 in 68 French centres. The composite primary endpoint combined tracheal intubation for mechanical ventilation and death within 7 days of admission. Stabilized weights were computed for patients based on propensity score (DPP-4 inhibitors users vs. non-users) and were used in multivariable logistic regression models to estimate the average treatment effect in the treated as inverse probability of treatment weighting (IPTW). RESULTS Five hundred and ninety-six participants were under DPP-4 inhibitors before admission to hospital (24.3%). The primary outcome occurred at similar rates in users and non-users of DPP-4 inhibitors (27.7% vs. 28.6%; p = .68). In propensity analysis, the IPTW-adjusted models showed no significant association between the use of DPP-4 inhibitors and the primary outcome by Day 7 (OR [95% CI]: 0.95 [0.77-1.17]) or Day 28 (OR [95% CI]: 0.96 [0.78-1.17]). Similar neutral findings were found between use of DPP-4 inhibitors and the risk of tracheal intubation and death. CONCLUSIONS These data support the safety of DPP-4 inhibitors for diabetes management during the COVID-19 pandemic and they should not be discontinued.
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Affiliation(s)
- Ronan Roussel
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique‐Hôpitaux de ParisCentre de Recherche des Cordeliers, INSERMParisFrance
| | - Patrice Darmon
- Service d'Endocrinologie, Maladies Métaboliques et Nutrition, Hôpital de la Conception, Assistance Publique‐Hôpitaux de MarseilleINSERM, INRA, C2VN, Aix‐Marseille UniversityMarseilleFrance
| | - Matthieu Pichelin
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thoraxINSERM, CNRS, UNIV Nantes, CHU NantesNantesFrance
| | | | - Yawa Abouleka
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique‐Hôpitaux de ParisCentre de Recherche des Cordeliers, INSERMParisFrance
| | - Leila Ait Bachir
- Département d'Endocrinologie, Diabétologie, NutritionHôpital Franco‐britanniqueLevallois‐PerretFrance
| | - Ingrid Allix
- Département d'Endocrinologie, Diabétologie, NutritionCHU de AngersAngersFrance
| | - Deborah Ancelle
- Département d'Endocrinologie, Diabétologie, NutritionCH Le HavreLe HavreFrance
| | - Sara Barraud
- CRESTIC EA 3804, Université de Reims Champagne Ardenne, UFR Sciences Exactes et Naturelles, Moulin de la HousseReimsFrance
- Service d'Endocrinologie ‐ Diabète – NutritionCentre Hospitalier Universitaire de ReimsReimsFrance
| | - Lyse Bordier
- Département d'Endocrinologie, Maladies Métaboliques, Service de Santé des ArméesHôpital d'instruction des Armées BéginSaint MandéFrance
| | - Aurélie Carlier
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique‐Hôpitaux de ParisCentre de Recherche des Cordeliers, INSERMParisFrance
| | - Nicolas Chevalier
- Service d'endocrinologie, diabétologie et médecine de la reproduction, hôpital de l'Archet 2Université Côte d'Azur, CHU de NiceNiceFrance
- INSERM, UMR U1065/UNS; Université Côte d'Azur, CHU de NiceNiceFrance
| | | | - Emmanuel Cosson
- Département d'Endocrinologie, Diabétologie et NutritionCRNH‐IdF, CINFO Hôpital Avicenne, Assistance Publique Hôpitaux de Paris; INSERM, UMR U557; Université Paris 13, Sorbonne Paris CitéBobignyFrance
| | - Anne Dorange
- Département de Diabétologie, EndocrinologieCH Le MansLe MansFrance
| | - Olivier Dupuy
- Département d'Endocrinologie, DiabétologieParis Hôpital Saint‐JosephParisFrance
| | - Pierre Fontaine
- Département d'endocrinologie, Diabète et maladies métaboliquesHôpital Huriez, Université de LilleLilleFrance
| | - Bénédicte Fremy
- Département d'Endocrinologie, Diabétologie, NutritionCH de Agen‐NeracAgenFrance
| | - Florence Galtier
- Centre d'Investigation Clinique et Département des Maladies EndocriniennesINSERM, CIC 1411, Hôpital St Éloi, CHU MontpellierMontpellierFrance
| | - Natacha Germain
- Département d'EndocrinologieCHU de Saint‐EtienneSaint‐EtienneFrance
- TAPE Research Group EA 7423, Université Jean MonnetSaint‐EtienneFrance
| | - Anne‐Marie Guedj
- Département Maladies Métaboliques et EndocriniennesCHU NîmesNîmesFrance
| | - Etienne Larger
- Service de diabétologie, Hôpital Cochin, AP‐HP, Centre‐Université de ParisParisFrance
| | | | - Bruno Laviolle
- Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes)RennesFrance
| | - Lisa Ludwig
- CHRU Nancy, hôpital BrahoisUniversité de LorraineNancyFrance
| | - Arnaud Monier
- Département de Diabétologie, Endocrinologie, NutritionCH de CHARTRESChartresFrance
| | | | - Philippe Moulin
- Fédération d'endocrinologie, maladies métaboliques, diabète et nutritionINSERM UMR 1060 CARMEN Hospices Civils de Lyon, Université Lyon 1LyonFrance
| | - Isabelle Moura
- Unité transversale Diabétologie – EndocrinologieCH de AlbiAlbiFrance
| | - Gaëtan Prevost
- Département d'Endocrinologie, Diabétologie et Maladies MétaboliquesCHU de Rouen, Université de RouenRouenFrance
| | - Yves Reznik
- Département de DiabétologieCHU de CaenCaenFrance
| | - Nadia Sabbah
- Département d'Endocrinologie, Diabétologie, NutritionCH de CayenneCayenneFrance
| | - Pierre‐Jean Saulnier
- Centre d'Investigation Clinique CIC 1402Université de Poitiers, Inserm, CHU de PoitiersPoitiersFrance
| | - Pierre Serusclat
- Département d'Endocrinologie, Diabétologie et NutritionGroupe Hospitalier Mutualiste Les Portes du SudVénissieuxFrance
| | - Camille Vatier
- Département d'EndocrinologieAssistance Publique Hôpitaux de Paris, Saint‐Antoine Hospital, Centre de Référence: Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS)ParisFrance
- Sorbonne Université, Inserm UMRS 938, Centre de Recherche Saint‐AntoineParisFrance
| | - Matthieu Wargny
- CIC‐EC 1413, Clinique des Données, CHU de NantesNantesFrance
| | - Samy Hadjadj
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thoraxINSERM, CNRS, UNIV Nantes, CHU NantesNantesFrance
| | - Pierre Gourdy
- Département d'Endocrinologie, Diabétologie et NutritionCHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 INSERM/UPS, Université de ToulouseToulouseFrance
| | - Bertrand Cariou
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thoraxINSERM, CNRS, UNIV Nantes, CHU NantesNantesFrance
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Oikonomidi T, Ravaud P, James A, Cosson E, Montori V, Tran VT. An International, Mixed-Methods Study of the Perceived Intrusiveness of Remote Digital Diabetes Monitoring. Mayo Clin Proc 2021; 96:1236-1247. [PMID: 33487438 DOI: 10.1016/j.mayocp.2020.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/06/2020] [Accepted: 07/23/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess the relationship between remote digital monitoring (RDM) modalities for diabetes and intrusiveness in patients' lives. PATIENTS AND METHODS Online vignette-based survey (February 1 through July 1, 2019). Adults with diabetes (type 1, 2, or subtypes such as latent autoimmune diabetes of adulthood) assessed three randomly selected vignettes among 36 that combined different modalities for monitoring tools (three options: glucose- and physical activity [PA]-monitoring only, or glucose- and PA-monitoring with occasional or regular food monitoring), duration/feedback loops (six options: monitoring for a week before all vs before specific consultations with feedback given in consultation, vs monitoring permanently, with real-time feedback by one's physician vs by anoter caregiver, vs monitoring permanently, with real-time, artificial intelligence-generated treatment feedback vs treatment and lifestyle feedback), and data handling (two options: by the public vs private sector). We compared intrusiveness (assessed on a 5-point scale) across vignettes and used linear mixed models to identify intrusiveness determinants. We collected qualitative data to identify aspects that drove participants' perception of intrusiveness. RESULTS Overall, 1010 participants from 30 countries provided 2860 vignette-assessments (52% were type 1 diabetes). The monitoring modalities associated with increased intrusiveness were food monitoring compared with glucose- and PA-monitoring alone (β=0.34; 95% CI, 0.26 to 0.42; P<.001) and permanent monitoring with real-time physician-generated feedback compared with monitoring for a week with feedback in consultation (β=0.25; 95% CI, 0.16 to 0.34, P<.001). Public-sector data handling was associated with decreased intrusiveness as compared with private-sector (β=-0.15; 95% CI, -0.22 to -0.09; P<.001). Four drivers of intrusiveness emerged from the qualitative analysis: practical/psychosocial burden (eg, RDM attracting attention in public), control, data safety/misuse, and dehumanization of care. CONCLUSION RDM is intrusive when it includes food monitoring, real-time human feedback, and private-sector data handling.
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Affiliation(s)
- Theodora Oikonomidi
- Université de Paris, CRESS, INSERM, INRA, Paris, France; Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Philippe Ravaud
- Université de Paris, CRESS, INSERM, INRA, Paris, France; Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Arthur James
- Université de Paris, CRESS, INSERM, INRA, Paris, France; Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Cosson
- Sorbonne Paris Nord, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, Department of Endocrinology, CRNH-IdF, CINFO, Bobigny, France; Sorbonne Paris Nord, CRESS, UMR 1153 INSERM/U1125 INRA/CNAM, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Victor Montori
- Department of Health and Human Services, Center for Evidence and Practice Improvement of the Agency for Healthcare Research and Quality, Rockville, MD; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN
| | - Viet-Thi Tran
- Université de Paris, CRESS, INSERM, INRA, Paris, France; Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Rezki A, Fysekidis M, Chiheb S, Vicaut E, Cosson E, Valensi P. Acute and long-term effects of saxagliptin on post-prandial glycemic response in obese patients with impaired glucose tolerance. Nutr Metab Cardiovasc Dis 2021; 31:1257-1266. [PMID: 33618922 DOI: 10.1016/j.numecd.2020.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/25/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Dipeptidyl-peptidase inhibitors might be useful in type 2 diabetes prevention. ACCES (ACute and Chronic Effects of Saxagliptin) was a randomized, placebo-controlled, double-blind, controlled phase 2, pilot study aiming to examine in obese patients with impaired glucose tolerance (IGT) the acute effects and the effects after 12 weeks of treatment by saxagliptin on glucose levels at fasting and postprandially after a standard breakfast, and on glucose tolerance. METHODS AND RESULTS We included 24 obese patients with IGT. Patients were randomized to receive saxagliptin 5 mg or placebo in the morning. The treatment was taken on Visit 1 before breakfast, then continued for 12 weeks. Biochemical measurements were performed before, one, two and three hours after a standard breakfast including 75 g of carbohydrates, during Visit 1 and Visit 2 (12 weeks). Glucose variability (GV) was evaluated at Visit 1 from 24-h continuous glucose monitoring including the breakfast. A second OGTT was performed at Visit 3 (3-5 days after Visit 2). Compared with placebo-treated patients, saxagliptin-treated patients had lower 1 h and 2 h post-meal plasma glucose levels at Visit 1 and similar changes at Visit 2 (p < 0.01 to p < 0.004), with lower GV indexes after breakfast at Visit 1. At Visit 3, all patients but one in saxagliptin group and only 4 patients in placebo group turned to normal glucose tolerance. Lower glucose response to breakfast at Visit 1 was predictive of recovery of glucose tolerance. CONCLUSION Saxagliptin has metabolically beneficial effects in glucose-intolerant obese patients by significantly lowering postprandial blood glucose levels. CLINICAL TRIAL REGISTRATION NUMBER NCT01521312: https://clinicaltrials.gov/ct2/show/NCT01521312.
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Affiliation(s)
- Amel Rezki
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Marinos Fysekidis
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Sabrina Chiheb
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France
| | - Eric Vicaut
- Clinical Research Unit, Lariboisière-St Louis, Fernand Widal Hospital, APHP, Paris, France
| | - Emmanuel Cosson
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France; Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - Paul Valensi
- Department of Endocrinology, Diabetology, Nutrition, Jean Verdier Hospital, AP-HP, CRNH-IdF, CINFO, Paris Nord University, Sorbonne Paris Cité, Bondy, France.
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Tatulashvili S, Gusto G, Cosson E, Balkau B, Gourdy P, Bonnet F, Bihan H, Fagherazzi G. Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22-year follow-up of 83 799 women from the E3N cohort study. J Diabetes 2021; 13:330-338. [PMID: 33145935 DOI: 10.1111/1753-0407.13129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/12/2020] [Accepted: 11/01/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In many populations the incidence of type 2 diabetes is higher in men than in women. This may be explained by exposure to female gonadal hormones, but so far, there is no consensus on their role over the life course in type 2 diabetes etiology. METHODS Data are from 83 799 French women from the E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale) cohort study, followed for 22 years. Multivariable Cox models including classical risk factors were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between gonadal hormonal factors and incident type 2 diabetes. RESULTS Older age at menarche, more menstrual cycles, older age at menopause, longer duration of exposure to gonadal hormones and breastfeeding were inversely associated with incident type 2 diabetes cases (n = 4806). While a longer duration of menstrual cycles (HR = 1.23 [95% CI: 1.07-1.41] comparing ≥32 vs ≤24 days) and use of contraceptive pills (HR = 1.33 [1.25-1.42]) were associated with a greater risk of type 2 diabetes. CONCLUSIONS In women, a longer exposure to endogenous gonadal hormones with a later menopause as well as breastfeeding were associated with a lower risk of developing type 2 diabetes, independently of classical diabetes risk factors. In contrast, the use of contraceptive agents was associated with incident diabetes, but the influence of each type of contraception and of exposure duration remain to be investigated.
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Affiliation(s)
- Sopio Tatulashvili
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
| | - Gaelle Gusto
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
| | - Emmanuel Cosson
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Beverley Balkau
- Clinical Epidemiology, Université Paris-Saclay, UVSQ, Inserm u1018, CESP, Villejuif, France
| | - Pierre Gourdy
- Diabetology Department, CHU Toulouse, Institute of Metabolic and Cardiovascular Diseases (I2MC, UMR1048 Inserm/UPS), University of Toulouse, Toulouse, France
| | - Fabrice Bonnet
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Endocrinology, Diabetology and Nutrition, CHU Rennes, Université de Rennes 1, Rennes, France
| | - Hélène Bihan
- AP-HP, Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, Bobigny, France
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Paris Nord, Inserm U1153, Inra U1125, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Guy Fagherazzi
- Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP) "Health Across Generations" Team, Université Paris-Saclay, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
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Cosson E, Nguyen MT, Rezgani I, Tatulashvili S, Sal M, Berkane N, Allard L, Brillet PY, Bihan H. Epicardial adipose tissue volume and coronary calcification among people living with diabetes: a cross-sectional study. Cardiovasc Diabetol 2021; 20:35. [PMID: 33546697 PMCID: PMC7863354 DOI: 10.1186/s12933-021-01225-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/22/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epicardial adipose tissue (EAT) has anatomic and functional proximity to the heart and is considered a novel diagnostic marker and therapeutic target in cardiometabolic diseases. The aim of this study was to evaluate whether EAT volume was associated with coronary artery calcification (CAC) in people living with diabetes, independently of confounding factors. METHODS We included all consecutive patients with diabetes whose EAT volume and CAC score were measured using computed tomography between January 1, 2019 and September 30, 2020 in the Department of Diabetology-Endocrinology-Nutrition at Avicenne Hospital, France. Determinants of EAT volume and a CAC score ≥ 100 Agatston units (AU) were evaluated. RESULTS The study population comprised 409 patients (218 men). Mean (± standard deviation) age was 57 ± 12 years, and 318, 56 and 35 had type 2 (T2D), type 1 (T1D), or another type of diabetes, respectively. Mean body mass index (BMI) was 29 ± 6 kg/m2, mean AET volume 93 ± 38 cm3. EAT volume was positively correlated with age, BMI, pack-year smoking history and triglyceridaemia, but negatively correlated with HDL-cholesterol level. Furthermore, it was lower in people with retinopathy, but higher in men, in Caucasian people, in patients on antihypertensive and lipid-lowering medication, in people with nephropathy, and finally in individuals with a CAC ≥ 100 AU (CAC < 100 vs CAC ≥ 100: 89 ± 35 vs 109 ± 41 cm3, respectively, p < 0.05). In addition to EAT volume, other determinants of CAC ≥ 100 AU (n = 89, 22%) were age, T2D, ethnicity, antihypertensive and lipid-lowering medication, cumulative tobacco consumption, retinopathy, macular edema and macrovascular disease. Multivariable analysis considering all these determinants as well as gender and BMI showed that EAT volume was independently associated with CAC ≥ 100 AU (per 10 cm3 increase: OR 1.11 [1.02-1.20]). CONCLUSIONS EAT volume was independently associated with CAC. As it may play a role in coronary atherosclerosis in patients with diabetes, reducing EAT volume through physical exercise, improved diet and pharmaceutical interventions may improve future cardiovascular risk outcomes in this population.
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Affiliation(s)
- Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France. .,Unité de Recherche Epidémiologique Nutritionnelle, UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Bobigny, France.
| | - Minh Tuan Nguyen
- Department of Functional Explorations, AP-HP, Jean Verdier Hospital, Université Paris 13, Bondy, France
| | - Imen Rezgani
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Sopio Tatulashvili
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Meriem Sal
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | - Lucie Allard
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
| | | | - Hélène Bihan
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France.,Laboratoire Educations et Pratiques de Santé UR 3412, UFR Santé, Médecine, Biologie Humaine, Université Paris Sorbonne Paris Nord, 74, rue Marcel Cachin, 93017, Bobigny Cedex, France
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Nachtergaele C, Vicaut E, Pinto S, Tatulashvili S, Bihan H, Sal M, Berkane N, Allard L, Baudry C, Carbillon L, Cosson E. COVID-19 pandemic: Can fasting plasma glucose and HbA1c replace the oral glucose tolerance test to screen for hyperglycaemia in pregnancy? Diabetes Res Clin Pract 2021; 172:108640. [PMID: 33359083 PMCID: PMC7834431 DOI: 10.1016/j.diabres.2020.108640] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 12/22/2022]
Abstract
AIMS To evaluate proposals considering HbA1c and fasting plasma glucose (FPG) measurement as a substitute for oral glucose tolerance test (OGTT) to diagnose hyperglycaemia in pregnancy (HIP) during COVID-19 pandemic. METHODS Of the 7,334 women who underwent the OGTT between 22 and 30 weeks gestation, 966 had HIP (WHO diagnostic criteria, reference standard). The 467 women who had an available HbA1c were used for analysis. French-speaking Society of Diabetes (SFD) proposal to diagnose HIP during COVID-19 pandemic was retrospectively applied: HbA1c ≥5.7% (39 mmol/mol) and/or FPG level ≥5.1 mmol/l. SFD proposal sensitivity for HIP diagnosis and the occurrence of HIP-related events (preeclampsia, large for gestational age infant, shoulder dystocia or neonatal hypoglycaemia) in women with false negative (FN) and true positive (TP) HIP-diagnoses were evaluated. RESULTS The sensitivity was 57% [95% confidence interval 52-62]. FN women had globally lower plasma glucose levels during OGTT, lower HbA1c and body mass index than those TP. The percentage of HIP-related events was similar in FN (who were cared) and TP cases, respectively 19.5 and 16.9% (p = 0.48). We observed similar results when women at high risk for HIP only were considered. CONCLUSION The SFD proposal has a poor sensitivity to detect HIP. Furthermore, it fails to have any advantages in predicting adverse outcomes.
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Affiliation(s)
- Charlotte Nachtergaele
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, Paris, France
| | - Sara Pinto
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bondy, France
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Narimane Berkane
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Lucie Allard
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Camille Baudry
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Bondy, France
| | - Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
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Oikonomidi T, Ravaud P, Cosson E, Montori V, Tran VT. Evaluation of Patient Willingness to Adopt Remote Digital Monitoring for Diabetes Management. JAMA Netw Open 2021; 4:e2033115. [PMID: 33439263 PMCID: PMC7807289 DOI: 10.1001/jamanetworkopen.2020.33115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/18/2020] [Indexed: 01/21/2023] Open
Abstract
Importance Patients will decide whether to adopt remote digital monitoring (RDM) for diabetes by weighing its health benefits against the inconvenience it may cause. Objective To identify the minimum effectiveness patients report they require to adopt 36 different RDM scenarios. Design, Setting, and Participants This survey study was conducted among adults with type 1 or type 2 diabetes living in 30 countries from February to July 2019. Exposures Survey participants assessed 3 randomly selected scenarios from a total of 36. Scenarios described different combinations of digital monitoring tools (glucose, physical activity, food monitoring), duration and feedback loops (feedback in consultation vs real-time telefeedback by a health care professional or by artificial intelligence), and data handling modalities (by a public vs private company), reflecting different degrees of RDM intrusiveness in patients' personal lives. Main Outcomes and Measures Participants assessed the minimum effectiveness for 2 diabetes-related outcomes (reducing hypoglycemic episodes and preventing ophthalmologic complications) for which they would adopt each RDM (from much less effective to much more effective than their current monitoring). Results Of 1577 individuals who consented to participate, 1010 (64%; 572 [57%] women, median [interquartile range] age, 51 [37-63] years, 524 [52%] with type 1 diabetes) assessed at least 1 vignette. Overall, 2860 vignette assessments were collected. In 1025 vignette assessments (36%), participants would adopt RDM only if it was much more effective at reducing hypoglycemic episodes compared with their current monitoring; in 1835 assessments (65%), participants would adopt RDM if was just as or somewhat more effective. The main factors associated with required effectiveness were food monitoring (β = 0.32; SE, 0.12; P = .009), real-time telefeedback by a health care professional (β = 0.49; SE, 0.15; P = .001), and perceived intrusiveness (β = 0.36; SE, 0.06; P < .001). Minimum required effectiveness varied among participants; 34 of 36 RDM scenarios (94%) were simultaneously required to be just as or less effective by at least 25% of participants and much more effective by at least 25% of participants. Results were similar for participant assessments of scenarios regarding the prevention of ophthalmologic complications. Conclusions and Relevance The findings of this study suggest that patients require greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. Patient monitoring devices should be designed to be minimally intrusive. The variability in patients' requirements points to a need for shared decision-making.
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Affiliation(s)
- Theodora Oikonomidi
- Université de Paris, Centre of Research in Epidemiology and Statistics, French National Institute of Health and Medical Research, National Institute for Agricultural Research, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- Université de Paris, Centre of Research in Epidemiology and Statistics, French National Institute of Health and Medical Research, National Institute for Agricultural Research, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Emmanuel Cosson
- Sorbonne Paris Nord, Sorbonne Paris Cité, Assistance Publique–Hôpitaux de Paris, Avicenne Hospital, Department of Endocrinology, Research Centre in Human Nutrition–Ile de France, North Ile-de-France Integrated Obesity Centre, Bobigny, France
- Sorbonne Paris Nord, Centre of Research in Epidemiology and Statistics, Research Unit 1153, French National Institute of Health and Medical Research, U1125 National Institute for Agricultural Research, National Conservatory of Arts and Crafts, Bobigny, France
| | - Victor Montori
- Department of Health and Human Services, Center for Evidence and Practice Improvement of the Agency for Healthcare Research and Quality, Rockville, Maryland
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Viet Thi Tran
- Université de Paris, Centre of Research in Epidemiology and Statistics, French National Institute of Health and Medical Research, National Institute for Agricultural Research, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
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Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I, Amadou C, Arnault G, Baudoux F, Bauduceau B, Borot S, Bourgeon-Ghittori M, Bourron O, Boutoille D, Cazenave-Roblot F, Chaumeil C, Cosson E, Coudol S, Darmon P, Disse E, Ducet-Boiffard A, Gaborit B, Joubert M, Kerlan V, Laviolle B, Marchand L, Meyer L, Potier L, Prevost G, Riveline JP, Robert R, Saulnier PJ, Sultan A, Thébaut JF, Thivolet C, Tramunt B, Vatier C, Roussel R, Gautier JF, Gourdy P. Blood glucose levels and COVID-19. Reply to Sardu C, D'Onofrio N, Balestrieri ML et al [letter] and Lepper PM, Bals R, Jüni P et al [letter]. Diabetologia 2020; 63:2491-2494. [PMID: 32816095 PMCID: PMC7438680 DOI: 10.1007/s00125-020-05255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/02/2022]
Affiliation(s)
- Bertrand Cariou
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France
| | - Samy Hadjadj
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France.
| | - Matthieu Wargny
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France
- CIC-EC 1413, Clinique des Données, CHU Nantes, Nantes, France
| | - Matthieu Pichelin
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France
| | - Abdallah Al-Salameh
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Amiens, PeriToxUMR_I 01, Université de Picardie, Amiens, France
| | - Ingrid Allix
- Département d'Endocrinologie, Diabétologie, Nutrition, CHU de Angers, Angers, France
| | - Coralie Amadou
- Département de Diabétologie, Centre Hospitalier Sud Francilien, Corbeil Essonne, France
| | - Gwénaëlle Arnault
- Département d'Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Florence Baudoux
- Clinique d'Endocrinologique Marc-Linquette, Hôpital Claude-Huriez, CHRU de Lille, Lille, France
| | - Bernard Bauduceau
- Département de Diabétologie, H.I.A. Begin, Saint Mandé, France
- Fondation Francophone pour la Recherche sur le Diabète (FFRD), Paris, France
| | - Sophie Borot
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU de Besançon, Besançon, France
| | - Muriel Bourgeon-Ghittori
- Département d'Endocrinologie, Diabétologie et Nutrition, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Hôpital Antoine Béclère, Clamart, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Olivier Bourron
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié Salpêtrière-Charles Foix, Inserm, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - David Boutoille
- Département des Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France
| | - France Cazenave-Roblot
- Département des Maladies Infectieuses et Tropicales, CHU de Poitiers, INSERM U1070, Poitiers, France
- Société de Pathologie Infectieuse de langue Française (SPILF), Paris, France
| | | | - Emmanuel Cosson
- Assistance Publique Hôpitaux de Paris, Hôpital Avicenne, Université Paris 13, Sorbonne Paris Cité, Département d'Endocrinologie, Diabétologie et Nutrition, CRNH-IdF, CINFO, Bobigny, France
- Université Paris 13, Sorbonne Paris Cité, UMR U557 Inserm / U11125 INRAE / CNAM / Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Sandrine Coudol
- CIC-EC 1413, Clinique des Données, CHU Nantes, Nantes, France
| | - Patrice Darmon
- Département d'Endocrinologie et de Diabétologie, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Emmanuel Disse
- Département d'Endocrinologie, Diabétologie et Nutrition, Hospices Civils de Lyon, CarMeN Laboratory, Inserm 1060, Lyon, France, Université Claude Bernard Lyon 1, Lyon, France
| | - Amélie Ducet-Boiffard
- Département d'Endocrinologie et de Diabétologie, Centre Hospitalier Départemental de Vendée, La Roche sur Yon, France
| | - Bénédicte Gaborit
- Département d'Endocrinologie et de Diabétologie, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Véronique Kerlan
- Département d'Endocrinologie, CHU de Brest, EA 3878 GETBO, Brest, France
| | - Bruno Laviolle
- CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Université de Rennes, Rennes, France
| | - Lucien Marchand
- Département d'Endocrinologie et de Diabétologie, Centre Hospitalier St. Joseph - St. Luc, Lyon, France
| | - Laurent Meyer
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Louis Potier
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Centre de Recherche des Cordeliers, Inserm, Université de Paris, U-1138, Paris, France
| | - Gaëtan Prevost
- Département d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU de Rouen, Université de Rouen, Rouen, France
| | - Jean-Pierre Riveline
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Paris Diderot-Paris VII Université, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - René Robert
- Université de Poitiers, CIC Inserm 1402, Poitiers, Médecine Intensive Réanimation, Poitiers, France
| | - Pierre-Jean Saulnier
- Centre d'Investigation Clinique CIC 1402, Université de Poitiers, Inserm, CHU de Poitiers, Poitiers, France
| | - Ariane Sultan
- Département d'Endocrinologie, Diabète, Nutrition et CIC Inserm 1411, CHU de Montpellier, Montpellier, France
| | | | - Charles Thivolet
- Centre du Diabète DIAB-eCARE, Hospices Civils de Lyon et Laboratoire CarMeN, Inserm, INRA, INSA, Université Claude Bernard Lyon 1, Lyon, France
- Société Francophone du Diabète (SFD), Paris, France
| | - Blandine Tramunt
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 Inserm/UPS, Université de Toulouse, Toulouse, France
| | - Camille Vatier
- Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Department of Endocrinology, Paris, France
- Inserm UMRS 938, Saint-Antoine Research Center, Sorbonne University, Paris, France
| | - Ronan Roussel
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Centre de Recherche des Cordeliers, Inserm, Université de Paris, U-1138, Paris, France
| | - Jean-François Gautier
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Pierre Gourdy
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 Inserm/UPS, Université de Toulouse, Toulouse, France
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Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I, Amadou C, Arnault G, Baudoux F, Bauduceau B, Borot S, Bourgeon-Ghittori M, Bourron O, Boutoille D, Cazenave-Roblot F, Chaumeil C, Cosson E, Coudol S, Darmon P, Disse E, Ducet-Boiffard A, Gaborit B, Joubert M, Kerlan V, Laviolle B, Marchand L, Meyer L, Potier L, Prevost G, Riveline JP, Robert R, Saulnier PJ, Sultan A, Thébaut JF, Thivolet C, Tramunt B, Vatier C, Roussel R, Gautier JF, Gourdy P. Correction to: Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia 2020; 63:1953-1957. [PMID: 32617649 PMCID: PMC7330254 DOI: 10.1007/s00125-020-05207-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The authors regret a mistake in Table 1.
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Affiliation(s)
- Bertrand Cariou
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France.
| | - Samy Hadjadj
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France.
| | - Matthieu Wargny
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France
- CIC-EC 1413, Clinique des Données, CHU Nantes, Nantes, France
| | - Matthieu Pichelin
- Département d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093, Nantes Cedex 01, France
| | - Abdallah Al-Salameh
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Amiens, PeriToxUMR_I 01, Université de Picardie, Amiens, France
| | - Ingrid Allix
- Département d'Endocrinologie, Diabétologie, Nutrition, CHU de Angers, Angers, France
| | - Coralie Amadou
- Département de Diabétologie, Centre Hospitalier Sud Francilien, Corbeil Essonne, France
| | - Gwénaëlle Arnault
- Département d'Endocrinologie, Diabétologie et Maladies Métaboliques, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Florence Baudoux
- Clinique d'Endocrinologique Marc-Linquette, Hôpital ClaudeHuriez, CHRU de Lille, Lille, France
| | - Bernard Bauduceau
- Département de Diabétologie, H.I.A. Begin, Saint Mandé, France
- Fondation Francophone pour la Recherche sur le Diabète (FFRD), Paris, France
| | - Sophie Borot
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU de Besançon, Besançon, France
| | - Muriel Bourgeon-Ghittori
- Département d'Endocrinologie, Diabétologie et Nutrition, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Hôpital Antoine Béclère, Clamart, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Olivier Bourron
- Sorbonne Université, Assistance Publique Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié Salpêtrière-Charles Foix, Inserm, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, Institute of Cardiometabolism and Nutrition ICAN, Paris, France
| | - David Boutoille
- Département des Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France
| | - France Cazenave-Roblot
- Département des Maladies Infectieuses et Tropicales, CHU de Poitiers, INSERM U1070, Poitiers, France
- Société de Pathologie Infectieuse de langue Française (SPILF), Paris, France
| | | | - Emmanuel Cosson
- Assistance Publique Hôpitaux de Paris, Hôpital Avicenne, Université Paris 13, Sorbonne Paris Cité, Département d'Endocrinologie, Diabétologie et Nutrition, CRNH-IdF, CINFO, Bobigny, France
- Université Paris 13, Sorbonne Paris Cité, UMR U557 Inserm / U11125 INRAE / CNAM / Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Sandrine Coudol
- CIC-EC 1413, Clinique des Données, CHU Nantes, Nantes, France
| | - Patrice Darmon
- Département d'Endocrinologie et de Diabétologie, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Emmanuel Disse
- Département d'Endocrinologie, Diabétologie et Nutrition, Hospices Civils de Lyon, CarMeN Laboratory, Inserm 1060, Lyon, France, Université Claude Bernard Lyon 1, Lyon, France
| | - Amélie Ducet-Boiffard
- Département d'Endocrinologie et de Diabétologie, Centre Hospitalier Départemental de Vendée, La Roche sur Yon, France
| | - Bénédicte Gaborit
- Département d'Endocrinologie et de Diabétologie, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Véronique Kerlan
- Département d'Endocrinologie, CHU de Brest, EA 3878 GETBO, Brest, France
| | - Bruno Laviolle
- Université de Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Rennes, France
| | - Lucien Marchand
- Département d'Endocrinologie et de Diabétologie, Centre Hospitalier St. Joseph - St. Luc, Lyon, France
| | - Laurent Meyer
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Louis Potier
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Centre de Recherche des Cordeliers, Inserm, U-1138, Université de Paris, Paris, France
| | - Gaëtan Prevost
- Département d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU de Rouen, Université de Rouen, Rouen, France
| | - Jean-Pierre Riveline
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Paris Diderot-Paris VII Université, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - René Robert
- Université de Poitiers, CIC Inserm 1402, Poitiers, Médecine Intensive Réanimation, Poitiers, France
| | - Pierre-Jean Saulnier
- Centre d'Investigation Clinique CIC 1402, Université de Poitiers, Inserm, CHU de Poitiers, Poitiers, France
| | - Ariane Sultan
- Département d'Endocrinologie, Diabète, Nutrition et CIC Inserm 1411, CHU de Montpellier, Montpellier, France
| | | | - Charles Thivolet
- Centre du Diabète DIAB-eCARE, Hospices Civils de Lyon et Laboratoire CarMeN, Inserm, INRA, INSA, Université Claude Bernard Lyon 1, Lyon, France
- Société Francophone du Diabète (SFD), Paris, France
| | - Blandine Tramunt
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 Inserm/UPS, Université de Toulouse, Toulouse, France
| | - Camille Vatier
- Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Department of Endocrinology, Paris, France
- Sorbonne University, Inserm UMRS 938, Saint-Antoine Research Center, Paris, France
| | - Ronan Roussel
- Département d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Centre de Recherche des Cordeliers, Inserm, U-1138, Université de Paris, Paris, France
| | - Jean-François Gautier
- Département Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France
- Inserm UMRS 1138, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, Paris, France
| | - Pierre Gourdy
- Département d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 Inserm/UPS, Université de Toulouse, Toulouse, France
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Cosson E, Vicaut E, Sandre-Banon D, Gary F, Pharisien I, Portal JJ, Baudry C, Cussac-Pillegand C, Costeniuc D, Valensi P, Carbillon L. Performance of a selective screening strategy for diagnosis of hyperglycaemia in pregnancy as defined by IADPSG/WHO criteria. Diabetes & Metabolism 2020; 46:311-318. [DOI: 10.1016/j.diabet.2019.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/12/2019] [Accepted: 09/29/2019] [Indexed: 12/20/2022]
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Oikonomidi T, Ravaud P, James A, Cosson E, Montori V, Tran VT. What makes digital health intrusive? Qualitative findings from an international study on diabetes. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Remote digital monitoring (RDM, i.e., using digital devices to monitor patients' health and behavior) is a novel care model that can improve health outcomes for people with chronic conditions. However, it could be intrusive to patients' lives. We sought to understand which aspects of RDM make it intrusive to patients and why.
Methods
We performed content analysis of qualitative data collected by using open-ended questions in an international, online survey with a convenience sample of adults with type 1 or 2 diabetes (February-July 2019). Participants were first shown scenarios describing possible RDM features (i.e. different RDM tools [for glucose or food monitoring], feedback loops [receiving feedback in consultation, or remotely by a physician, or by artificial intelligence], and data handling options [by the public or private sector]).
Results
We analyzed data from 709 participants from 24 countries (38% men, median age 38, 54% type 1). Participants found RDM burdensome (n = 468). Burden arose from RDM features that caused disruption in daily life (e.g., alerts), features that may invite undesirable attention in public (e.g., visible wearable sensors may invite questions about one's health), or from having to adapt one's life to fit in RDM (e.g., adapt one's mealtime routine around food monitoring). Participants wanted control, particularly over sharing food-monitoring data with health care professionals in real-time to receive feedback (n = 440). They felt RDM could expose a delicate topic to 'surveillance' by authority figures (i.e., their data may 'reveal' poor dietary habits, leading to criticism by physicians). Intrusion could take the form of RDM eroding the patient-physician relationship (n = 34), or fear of data misuse (n = 206), which was associated with private-sector financial interests.
Conclusions
Our findings offer directions for minimally intrusive RDM design and show that digital health may cause concerns about stigma and treatment burden.
Key messages
Remote digital monitoring is intrusive when it increases treatment burden and limits patients’ control over their own health. “Minimally intrusive” digital health design could increase patient acceptability and, ultimately, foster scalability.
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Affiliation(s)
- T Oikonomidi
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Ravaud
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, France
| | - A James
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - E Cosson
- U 1125, Sorbonne Paris Nord, INRA/CNAM, Bobigny, France
- Department of Endocrinology, Sorbonne Paris Nord, Sorbonne Paris Cité, AP-HP, Avicenne Hospital, CRNH-IdF, CINFO, Bobigny, France
| | - V Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, USA
- Department of Health and Human Services, Center for Evidence and Practice Improvement of the Agency for Healthcare Research and Quality, Rockville, USA
| | - V T Tran
- UMR 1153, Université de Paris, CRESS, INSERM, INRA, Paris, France
- Clinical Epidemiology Unit, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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