Microvascular Complications in Adolescents with Type 1 Diabetes Mellitus

Demirel, Fatma; Tepe, Derya; Kara, Özlem; Esen, İhsan

doi:10.4274/jcrpe.994

Cited by 39 publications

(34 citation statements)

References 24 publications

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“…Some research in children and adolescents with DM done in the USA and Australia found rates of microvascular complication that were similar or even higher than those found here, but these studies used more sensitive diagnostic tests [16,24]. Most research from Western countries showed significantly lower microvascular complication rates, such as one study done in in Ankara, Turkey that found a 16.1% rate of microalbuminuria, 0.6% rate of neuropathy, and no cases of retinopathy [25].…”

Section: Discussionsupporting

confidence: 63%

Diabetic Microvascular Complications Among Children and Adolescents in Northwestern Tanzania: A Cross-Sectional Study

Msanga

Reis

Kayange

et al. 2020

Annals of Global Health

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Background: Africa is experiencing a rapid increase in morbidity and mortality related to diabetes mellitus (DM). Contemporary data are needed to guide efforts to improve prevention and treatment for microvascular complications in children and adolescents in Africa. This study was conducted to assess prevalence of diabetic microvascular complications in northwestern Tanzania, including nephropathy, retinopathy, and neuropathy, as well as associated risk factors. Objectives: 1) To determine the prevalence of microvascular complications and the overlap of nephropathy, retinopathy and neuropathy and 2) to determine factors associated with the development of microvascular complications. Methods: This cross-sectional study included 155 children and adolescents with DM consecutively attending all three health centers providing diabetes care for children in the Mwanza region of Tanzania. Participants were examined for microvascular complications and possible risk factors. Results: Fifty-one of 155 participants (age: 5-19 years) had diabetic nephropathy (32.9%), 16 had diabetic retinopathy (10.3%), and 21 had diabetic neuropathy (13.6%). Risk factors for development of a microvascular complication included age, duration of DM, and poor glycemic control. Of the participants, 107 had poor levels of glycemic control (69%) with HbA1C levels >10%. Conclusion: The prevalence of microvascular complications, especially that of nephropathy, was disturbingly high. Risk factors for microvascular complications were similar to other studies from Africa and included poor glycemic control, older age, and longer duration of DM. Innovative, locally appropriate systems for optimizing glycemic control are urgently needed.

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Section: Discussionsupporting

confidence: 63%

Diabetic Microvascular Complications Among Children and Adolescents in Northwestern Tanzania: A Cross-Sectional Study

Msanga

Reis

Kayange

et al. 2020

Annals of Global Health

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“…This can infl uence negatively the adaptation of the adolescent in relation to diabetes, cooperating or not with the disease control [9][10][11][12][13][14][15] . The family then worry in an exaggerated manner, and to convey feelings of anxiety and fear in relation to immediate and late complications of the disease, not only when the adolescent doesn't follow treatment properly, causing the same feel and think the same way 22 .…”

Section: "The Complications and Some Injury In Some Organ Scare Me" (mentioning

confidence: 99%

“…Healthy habits for the individual with DM1 should be used daily by the capillary blood glucose control, insulin therapy and regular physical activity, which are considered of utmost importance to prevent and delay chronic and acute complications and hospitalizations [12][13] . That's why Marques, Fornés, Stringhini 14 also stress that proper treatment for the control of acute episodes of Hyperglycemia or hypoglycemia can prevent the development of common diseases in those circumstances as Neuropathies, kidney diseases and cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Problems with adherence to treatment among adolescents with diabetes mellitus type 1

Pires¹,

Bani²,

Lima³

et al. 2016

J. Hum. Growth Dev.

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Introduction: Diabetes Mellitus type 1 (DM1) is a chronic degenerative disease with high impact on the lives of children and adolescents. The DM1 affects mainly children and young adults under 30 years old, with a predominance from 10 to 14 years old. As a chronic disease, involves changes in daily habits, being following the recommendations of health professionals one of the main conducts to achieve such changes, however, this follow-up is not easy and can directly infl uence the glycemic control and lead to complications. Objective: Identify the diffi culties of adolescent with DM1 to treatment adherence. The recommendations of this treatment are related to the blood glucose measurements, using a diet plan and insulin application. Methods: The study included 15 adolescent with DM1, of both genders, aged 10-19 years participating in a multidisciplinary group at an outpatient unit in São Paulo, Brazil, aged 13,93 ± 2.4 years, diagnosed with DM1 with an average time of 4.5 years. The following evaluations were employed:1) individual interviews for identifi cation and clinical characterization; 2) characterization of cardiovascular and metabolic parameters; 2) anthropometric assessment and 4) application of a questionnaire with questions about problems of blood glucose measurements, diet plan and insulin application. Data collection was performed before medical appointment with an endocrinologist in a hospital in São Paulo state. Results: The identifi ed diffi culties and cardio-metabolic variables showed the adolescents presented uncontrolled blood glucose levels, doing the rotation of insulin incompletely and face many daily difficulties to perform the appropriate treatment, being the most frequently reported the insulin application and proper nutrition. Conclusion: Adolescents with type 1 diabetes presented diffi culties in adherence to treatment, mainly o follow insulin treatment and proposals for changes in eating habits by following a diet. It is necessary that health professionals offer strategies and orientation to these individuals to improve the handling of their diffi culties that directly affect the course of the disease and leave them more susceptible to developing complications.

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“…Careful glycemic control is challenging and it is well known that hyperglycemia leads to several complications including nephropathy despite existing therapeutic measures [3,4]. Approximately 25 % of patients with type 1 and type 2 diabetes develop renal injury [5,6].…”

Section: Introductionmentioning

confidence: 99%

Adenosine kinase inhibition protects the kidney against streptozotocin-induced diabetes through anti-inflammatory and anti-oxidant mechanisms

Pye

Elsherbiny

Ibrahim

et al. 2014

Pharmacological Research

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Adenosine provides anti-inflammatory effects in cardiovascular disease via the activation of adenosine A2A receptors; however, the physiological effect of adenosine could be limited due to its phosphorylation by adenosine kinase. We hypothesized that inhibition of adenosine kinase exacerbates extracellular adenosine levels to reduce renal inflammation and injury in streptozotocin-induced diabetes. Diabetes was induced in male C57BL/6 mice by daily injection of streptozotocin (50 mg/kg/day, i.p. for 5 days). Control and diabetic mice were then treated with the adenosine kinase inhibitor ABT702 (1.5 mg/kg, i.p two times a week for 8 weeks, n = 7–8/group) or the vehicle (5% DMSO). ABT702 treatment reduced blood glucose level in diabetic mice (~ 20%; p<0.05). ABT702 also reduced albuminuria and markers of glomerular injury, nephrinuria and podocalyxin excretion levels, in diabetic mice. Renal NADPH oxidase activity and urinary thiobarbituric acid reactive substances (TBARS) excretion, indices of oxidative stress, were also elevated in diabetic mice and ABT702 significantly reduced these changes. ABT702 increased renal endothelial nitric oxide synthase expression (eNOS) and nitrate/nitrite excretion levels in diabetic mice. In addition, the diabetic mice displayed an increase in renal macrophage infiltration, in association with increased renal NFB activation. Importantly, treatment with ABT702 significantly reduced all these inflammatory parameters (P< 0.05). Furthermore, ABT702 decreased glomerular permeability and inflammation and restored the decrease in glomerular occludin expression in vitro in high glucose treated human glomerular endothelial cells. Collectively, the results suggest that the reno-protective effects of ABT702 could be attributed to the reduction in renal inflammation and oxidative stress in diabetic mice.

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Microvascular Complications in Adolescents with Type 1 Diabetes Mellitus

Cited by 39 publications

References 24 publications

Diabetic Microvascular Complications Among Children and Adolescents in Northwestern Tanzania: A Cross-Sectional Study

Diabetic Microvascular Complications Among Children and Adolescents in Northwestern Tanzania: A Cross-Sectional Study

Problems with adherence to treatment among adolescents with diabetes mellitus type 1

Adenosine kinase inhibition protects the kidney against streptozotocin-induced diabetes through anti-inflammatory and anti-oxidant mechanisms

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