Association Between HbA<sub>1c</sub>Variability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes

Virk, Sohaib; Donaghue, Kim C.; Cho, Yoon Hi; Benitez‐Aguirre, Paul; Hing, Stephen; Pryke, Alison; Chan, Albert; Craig, Maria E.

doi:10.1210/jc.2015-3604

Cited by 96 publications

(94 citation statements)

References 36 publications

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“…Studies by other authors did not reveal any difference in hsCRP levels in patients with duration of diabetes up to 1 year versus T1DM patients with history of diabetes longer than 1 year either [47, 48]. On the other hand, lack of difference in hsCRP levels and lack of correlation with serum IL12 levels may suggest “good metabolic memory” and persistence of stable inflammatory state [49, 50]. Chronic hyperglycaemia is accompanied by inflammatory state in patients with longer duration of type 1 diabetes [47, 48].…”

Section: Discussionmentioning

confidence: 99%

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

et al. 2016

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The objective of the research was to investigate serum levels of interleukin-12 (IL12) in relation to percentage of yeast-like fungi colonies residing in the gastrointestinal tract in children and adolescents with type 1 diabetes mellitus (T1DM). The study involved 83 children and adolescents, including 53 T1DM patients and 30 healthy control subjects. In the studied population biochemical tests were performed and yeast-like fungi were identified in the faeces. Moreover, IL12 absorbance was measured and measurements of Candida albicans IgG and IgM antibodies were performed with microplate reader ChroMate 4300 (Awareness Technology, Inc., USA) at wavelength λ = 450 nm. In the group of T1DM children and adolescents with disease duration ≤ 2 years, high levels of IL12 were found with lower percentage of yeast-like fungal colonies versus T1DM patients with disease duration > 2 years and ≤5 years, as well as versus T1DM patients with disease duration > 5 years. Additionally, serum levels of IL12 were found to be decreasing by 18.1 pg/ml with each year of diabetes duration. IL12 serum levels were also found to be decreasing by 52.9 pg/ml with each 1% increase in HbA1c. We suggest that high IL12 levels can inhibit infection with yeast-like fungi colonizing the gastrointestinal tract in children and adolescents with T1DM. Further studies are needed to confirm the antifungal activity of IL12.

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Section: Discussionmentioning

confidence: 99%

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

et al. 2016

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“…As far as DR is concerned, in patients with type 1 diabetes mellitus, Picconi et al have shown that early structural damage of neuroretinal cells was related to glucose fluctuation and suggested that GV should be addressed even in the presence of good metabolic control [13], in line with Virk et al, who found that greater HbA1c variability was a predictor for DR [14]. On the other hand, the DCCT group suggested that within-day GV does not play an apparent role in the development of microvascular complications beyond the influence of the mean glucose [15].…”

Section: Commentarymentioning

confidence: 96%

The Role of Glycemic Control and Variability in Diabetic Retinopathy

Chatziralli

2017

Diabetes Ther

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Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered the leading cause of visual impairment in working-aged adults worldwide. The duration of DM and hyperglycemia have been associated with DR, although the exact role in the pathogenesis of DR and diabetic macular edema remains controversial. As a result, a reasonable question arising is whether control of blood glucose levels may alter the course of DR. Studies have shown that glycemic control remains an important factor for the presence and progression of DR. HbA1c seems to be an indicator which cannot demonstrate exactly the degree of glycemic control, while sudden variations of blood glucose may play an important role in DR; therefore, glycemic variability may be useful to predict DM complications, such as DR.

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“…This difference was attributed to GV. Numerous later studies have further indicated that GV plays an important role in the development and progression of DM complications . Hence, to prevent the occurrence of DR, optimized antidiabetic therapy should focus on not only HbA1c, but also GV.…”

Section: Discussionmentioning

confidence: 99%

Effect of basal insulin supplement therapy on diabetic retinopathy in short‐duration type 2 diabetes: A one‐year randomized parallel‐group trial

Tang

Tan

et al. 2019

Journal of Diabetes

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BackgroundIn this study, we compared the effect on diabetic retinopathy (DR) between oral antidiabetic drugs (OADs) alone and in combination with basal insulin‐supported OADs therapy (BOT). [Correction added on 11 November 2019, after first online publication: In Abstract under Background section, “DR” has been corrected into “diabetic retinopathy (DR)”.]MethodsBetween January 2015 and January 2018, this study enrolled 290 patients (age 18‐65 years) with diabetes duration between 0 and 5 years. Patients were randomly assigned to receive OADs or BOT after 14 days intensive insulin treatment. Examinations were performed at the beginning and end of the study.ResultsFewer patients developed DR in the BOT than OADs group (8 [6.06%] vs 12 [8.3%], respectively), and all cases of DR were non‐proliferative. Blood glucose concentrations were higher in the BOT than OADs group at the 3rd month, but lower in the former at the 6th and 12th month. The rate of reaching target HbA1c ≤7% was lower in the BOT than OADs group at the 3rd month (63.6% vs 72.2%, respectively), similar between the two groups at the 6th month (60.6% vs 66.6%, respectively) and higher in the BOT group at the 12th month (75.0% vs 61.1%, respectively). The SD of fasting blood glucose (FBG), coefficient of variation of FBG, SD of blood glucose (SDBG), and mean amplitude of glycemic excursions were lower in the BOT than OADs group. Changes in the levels of three cytokines (interleukin [IL]‐1β, IL‐6, and IL‐17α) were significantly less in the BOT than OADs group.ConclusionsTwelve months of BOT decreased the incidence of DR in short‐duration type 2 diabetes by reducing glycemia more effectively, stably, and completely than OADs alone.

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Association Between HbA_1cVariability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes

Abstract: Greater HbA1c variability predicts retinopathy, early nephropathy, and CAN, in addition to established risk factors, in adolescents with T1D. Minimizing long term fluctuations in glycemia may provide additional protection against the development of microvascular complications.

Cited by 96 publications

References 36 publications

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

The Role of Glycemic Control and Variability in Diabetic Retinopathy

Effect of basal insulin supplement therapy on diabetic retinopathy in short‐duration type 2 diabetes: A one‐year randomized parallel‐group trial

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Association Between HbA1cVariability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes

Abstract: Greater HbA1c variability predicts retinopathy, early nephropathy, and CAN, in addition to established risk factors, in adolescents with T1D. Minimizing long term fluctuations in glycemia may provide additional protection against the development of microvascular complications.

Cited by 96 publications

References 36 publications

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

High Interleukin-12 Levels May Prevent an Increase in the Amount of Fungi in the Gastrointestinal Tract during the First Years of Diabetes Mellitus Type 1

The Role of Glycemic Control and Variability in Diabetic Retinopathy

Effect of basal insulin supplement therapy on diabetic retinopathy in short‐duration type 2 diabetes: A one‐year randomized parallel‐group trial

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Association Between HbA_1cVariability and Risk of Microvascular Complications in Adolescents With Type 1 Diabetes