2019 Guidelines on the management of diabetic patients. A position of Diabetes Poland

Araszkiewicz, Aleksandra; Bandurska-Stankiewicz, Elżbieta; Budzyński, Andrzej; Cypryk, Katarzyna; Czech, Anna; Czupryniak, Leszek; Drzewoski, Józef; Dzida, Grzegorz; Dziedzic, Tomasz; Franek, Edward; Gajewska, Danuta; Górska, Maria; Grzeszczak, W; Gumprecht, Janusz; Idzior−Waluś, Barbara; Jarosz-Chobot, Przemysława; Kalarus, Zbigniew; Klupa, Tomasz; Koblik, Teresa; Kokoszka, Andrzej; Korzon-Burakowska, Anna; Kowalska, Irina; Krętowski, Adam; Majkowska, Lilianna; Małecki, Maciej; Mamcarz, Artur; Mirkiewicz-Sieradzka, B; Młynarski, Wojciech; Moczulski, Dariusz; Myśliwiec, Małgorzata; Narkiewicz, Krzysztof; Noczyńska, Anna; Piątkiewicz, Paweł; Rymaszewska, Joanna; Sieradzki, Jacek; Solnica, Bogdan; Strączkowski, Marek; Strojek, Krzysztof; Szadkowska, Agnieszka; Szelachowska, Małgorzata; Wender-Ożegowska, Ewa; Wierusz‐Wysocka, Bogna; Wolnik, Bogumił; Wyleżoł, Mariusz; Wylęgała, Edward; Zozulińska‐Ziółkiewicz, Dorota

doi:10.5603/dk.2019.0001

Cited by 80 publications

(125 citation statements)

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“…For example, according to the International Society for Paediatric and Adolescent Diabetes (ISPAD), the PR phase is defined by a daily insulin requirement of <0.5 U/kg/day and HbA1c <7% Low dose of insulin requirement accompanied by residual β cell function: according to the guidelines provided by Diabetes Poland, the PR phase is defined as an insulin requirement of <0.3 U/kg/day, C‐peptide values >0.5 ng/mL, and normal glycemic values based on a 24‐hour profile Preserved β cell function: stimulated C‐peptide higher than 300 pmol/L is used as the only indicator for the diagnosis of the PR stage …”

Section: Evolution Of Definitionsmentioning

confidence: 99%

The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno‐metabolic mechanisms

Zhong

Tang

Gong

et al. 2019

Diabetes Metabolism Res

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Type 1 diabetes mellitus (T1DM) is characterized by irreversible islet β cell destruction. During the progression of this disease, some patients with T1DM experience a phase of remission known as honeymoon or partial remission (PR) that is mainly characterized by satisfactory glycemic control and the transient recovery of islet β cell function. This special phase is a good model for studying the mechanism of β cell protection, might serve as a proper intervention period for immunotherapy, and may be related to disease prognosis. This special stage is highly valuable for studies aiming to identify possible targets that may be used to cure T1DM. An in-depth understanding of the diagnosis, epidemiology, and possible mechanisms of the PR phase is highly needed. In general, patients enter the PR phase approximately 3 months after starting insulin therapy, and this phase could be sustained for 6 to 9 months. Current research increasingly focuses on the metabolic and immunological aspects to constantly update our understanding of this phase. This review concentrates on the PR phase of T1DM to provide a comprehensive outlook of its epidemiology, diagnostic criteria, and underlying immune metabolic mechanisms. KEYWORDSimmuno-metabolic mechanism, remission phase, the honeymoon period, type 1 diabetes

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Section: Evolution Of Definitionsmentioning

confidence: 99%

The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno‐metabolic mechanisms

Zhong

Tang

Gong

et al. 2019

Diabetes Metabolism Res

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“…The American Diabetes Association (ADA) suggests the diagnosis of DKD if the urine albumin-to-creatinine ratio (UACR) is ≥ 30 mg/g [3], and the National Kidney Foundation (NKF) diagnosis DKD if UACR is ≥ 30 mg/g only in patients with retinopathy; UACR > 300 mg/g in regardless of this complication [30]. Polish guidelines for the management of diabetes emphasise that screening for increased urinary albumin excretion should be performed annually [31]. In light of the positive GWAS outcomes in relation to the ELMO1 gene and the contradictory outcomes of follow-up studies -as well as the lack of studies performed in a Polish population -this study assessed the association of rs741301 ELMO1 gene variants (reference chloride, and 1% Triton X-100).…”

Section: Snp Genotypingmentioning

confidence: 99%

Association of single nucleotide polymorphism (rs741301) of the ELMO1 gene with diabetic kidney disease in Polish patients with type 2 diabetes: a pilot study

Kwiendacz

Nabrdalik

Adamczyk

et al. 2020

Endokrynologia Polska

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Introduction: Multifactorial pathogenesis of diabetic kidney disease (DKD) consists of a combination of metabolic, environmental, and genetic factors. A genome-wide association study has shown that ELMO1 is a candidate gene for DKD occurrence and progression. The aim of this study was to assess the association of a single nucleotide polymorphism (rs741301) of the ELMO1 gene with DKD in Polish patients with type 2 diabetes (T2DM). Material and methods: This was a case/control study of 272 T2DM patients with or without DKD. Patients were divided into groups depending on DKD definition according to the American Diabetes Association (ADA) and the National Kidney Foundation (NKF). The association of the rs741301 polymorphism with DKD was assessed in the whole study group as well as in the subgroups stratified according to the presence of DKD. Results: There was no association between rs741301 polymorphisms and the presence of DKD in relation to the ADA definition (p = 0.6) or the NKF definition (p = 0.5) of DKD and with estimated glomelural filtration rate (eGFR) value reflecting the stage of the chronic kidney disease (p = 0.8). Conclusions: Even though the results of this study are negative, there is still a great need for larger studies assessing the genetic susceptibility to DKD to identify patients who are particularly prone to this complication.

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“…Children, having CD diagnosed earlier, randomly selected from those remaining under the care of the outpatient's diabetes clinic, were also included to the study. According to ESPGHAN, ISPAD, and Polish Diabetes Recommendations [1,3,12], all patients in our center with symptoms suggestive of CD and/or elevated immune markers underwent small intestine biopsy. CD was diagnosed based on Marsh criteria.…”

Section: Methodsmentioning

confidence: 99%

“…The currently recommended diagnostic scheme of CD in groups of risk with HLA typing is staged mostly in order to rule out the disease, so patients with T1D would not have to perform annually immunological tests. However, due to the high (above 90%) similarity of haplotypes HLA-DQ2/DQ8 in T1D and CD, the real usefulness of HLA typing, as a first-line screening tests, in children with T1D is relatively low, as confirmed by studies conducted in various populations [5,6,11,12]. On the other hand, studies assessing the usefulness of haplotyping in doubtful situations, so common in everyday diabetological practice, e.g., with inconclusive serological and histopathological results in patients without clinical symptoms of disease, or in patients on a gluten-free diet, but without confirmation of villous atrophy, are uncommon.…”

Section: Introductionmentioning

confidence: 99%

The Usefulness of Genotyping of Celiac Disease-Specific HLA among Children with Type 1 Diabetes in Various Clinical Situations

Deja

Sikora

Pyziak-Skupień

et al. 2020

Journal of Diabetes Research

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Aim. The aim of the study was to determine the usefulness of HLA DQ2/DQ8 genotyping in children with T1D in various clinical situations: as a screening test at the diabetes onset, as a verification of the diagnosis in doubtful situations, and as a test estimating the risk of CD in the future. Materials and methods. Three groups of patients with T1D were included: newly diagnosed (n=92), with CD and villous atrophy (n=30), and with potential CD (n=23). Genetic tests were performed (commercial test, PCR, and REX), and clinical data were collected. Results. The results of genetic tests confirmed the presence of DQ2/DQ8 in 94% of children with diabetes (group I) and in 100% of children with diabetes and CD (groups II and III, respectively). Comparative analysis of the HLA DQ2/DQ8 distribution did not show any differences. Allele DRB1∗04 (linked with HLA DQ8) was significantly less common in children with diabetes and CD (group I versus groups II and III, 56.5% vs. 24.5%; p=0.001). The probability of developing CD in DRB1∗04-positive patients was 4 times lower (OR 0.25; 95% CI 0.118-0.529; p=0.001). DRB1∗04 was significantly less frequent in children with villous atrophy compared to potential CD (13% vs. 39%; p=0.03). Conclusions. Genotyping HLA DQ2/DQ8 as a negative screening has limited use in assessing the risk of CD at the diabetes onset and does not allow to verify the diagnosis of CD in doubtful situations. The presence of the DRB1∗04 allele modulates the risk of CD and significantly reduces it and can predict a potential form.

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2019 Guidelines on the management of diabetic patients. A position of Diabetes Poland

Abstract: Clinical Diabetology (ISSN 2450-7458) is published six times a year by "Via Medica sp. z o.o." sp.k.

Cited by 80 publications

References 0 publications

The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno‐metabolic mechanisms

The remission phase in type 1 diabetes: Changing epidemiology, definitions, and emerging immuno‐metabolic mechanisms

Association of single nucleotide polymorphism (rs741301) of the ELMO1 gene with diabetic kidney disease in Polish patients with type 2 diabetes: a pilot study

The Usefulness of Genotyping of Celiac Disease-Specific HLA among Children with Type 1 Diabetes in Various Clinical Situations

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