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 Convivere con DM1:
Forse questa è la parte più avanzata della ricerca; l'introduzione di nuovi strumenti e insuline ha contribuito al
miglioramento delle condizioni di vita del paziente con diabete.
Molto si può e si deve ancora fare fino a
permettere di dimenticare il diabete.
Anche qui gli studi affrontano una moltitudine di aspetti:
- Migliorare l'autocontrollo - continuando a migliorare gli strumenti e le insuline
- Il pancreas artificiale - che non è la cura ma secondo me poco manca
- Analizzare i rischi e la prevenzione di complicanze
Dose giornaliera di insulina richiesta per bambini e adolescenti con DM1: effetti dell'eta, sesso, peso e modalità di somministrazione.
Daily insulin requirement of children and adolescents with type 1 diabetes: effect of age, gender, body mass index and mode of therapy. | Susanna Wiegand, Klemens Raile, Thomas Reinehr, Sabine Hofer, Andrea Näke, Wolfgang Rabl, Reinhard W Holl on behalf of the DPV-Wiss Study Group
- Universitätsmedizin Berlin, University of Witten-Herdecke, University of Dresden, University of Ulm
2007 - [European Journal of Endocrinology, Vol 158, Issue 4, 543-549]Risultati: La dose varia da 0.67 IU/kg (a 3 anni), 0.93 IU/kg (13 years) e 0.70 IU/kg (23 years). Il valore massimo e' stato osservato a 12 anni per le ragazze (0.94 IU/kg) e a 14 anni per i ragazzi (0.92 IU/kg).
Conclusioni: La dose varia significativamente durante i vari periodi dell'infanzia ed e' modificata dal sesso, peso e schema di somministrazione dell'insulina. | Results: The 50th ID-Perc (P50) varied among 0.67 IU/kg (age 3 years), 0.93 IU/kg (13 years), and 0.70 IU/kg (23 years) increasing from early childhood to adolescence and decreasing toward adulthood. Highest P50 ID was found at 12 years in females (0.94 IU/kg) and at 14 years in males (0.92 IU/kg). Using ICT, the ID was significantly higher compared with CSII (P50: 0.94 IU/kg versus 0.79 IU/kg at 13 years). In multivariate regression analysis, ID was significantly (P>0.001) associated with age, gender, and insulin delivery regime.
Conclusion: The ID-Perc were significantly different during various periods of childhood and were influenced by gender, body weight, and insulin injection regimes. Therefore, the presented data 1) provide evidence to interpret individual ID in children and adolescents with DM1 and 2) more specifically identify children with unusually high (insulin resistance and non-compliance) or low (MODY and persistent remission) insulin requirement. |
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Valutazione clinica a larga scala del sindrome di resistenza all'insulina?
Wide Clinical Implementation of Insulin Resistance Syndrome? | David Virsaladze, M.D.
- Tbilisi State Medical University
2006.09 - Abstract: Metabolic Syndrome and Related Disorders. September 1, 2006, 4(3): 165-171. doi:10.1089/met.2006.4.165.| Conclusioni: Nelle conclusioni si afferma che la diagnosi del syndrome di resistenza all'insulina (IRS) puo' permettere la diagnosi e il trattamento dell'arteriosclerosi in un fase precoce in modo da fermare o eliminare i danni vascolari. | Conclusions: In conclusion, we found that the diagnosis of insulin resistance syndrome (IRS) may allow clinicians to diagnose and treat atherosclerosis at an early stage—to stop or reverse vascular damage. |
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Fattibilita' e sicurezza nel uso di infusori di insulina in bambini di eta compresa tra 2 e 7 anni con DM1: Studio retrospettivo
Feasibility and Safety of Insulin Pump Therapy in Children Aged 2 to 7 Years With Type 1 Diabetes: A Retrospective Study | Tseghai Berhe, MD, MS, FAAP, Daniel Postellon, MD, Bruce Wilson, MD and Roberta Stone, RD, CDE
- Loyola University Medical Center, DeVos Children’s Hospital Diabetes Center
2006.06 - Articolo completo (in inglese): [PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2132-2137]| Risultati: [...] Ad un anno dal introduzione della terapia con microinfusore si osserva un significativo miglioramento dei valori HbA1c (da 8.7 ± 0.6% si passa a 8.0 ± 0.5%) [...] Anche i casi di ipoglicemia subiscono una significativa riduzione [...] | Results: [...]There was a significant reduction in HbA1c level after 1 year of pump therapy compared with the baseline (before pump initiation) (8.0 ± 0.5% vs 8.7 ± 0.6%; P < .001). The greatest improvement in HbA1c level was seen 6 weeks after initiation of insulin pump therapy (7.6 ± 0.4%). Before initiation of pump therapy, 65% of the children had HbA1c levels >8.5%. After initiation of pump therapy, 76% of the patients had HbA1c levels <8.5%. After insulin pump therapy, 40% of the patients demonstrated reduction of >0.8% in HbA1c levels. The rate of severe hypoglycemia was significantly reduced in the insulin pump group (0 vs 17.8 events/100 patient-year; P < .001). [...] |
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Funzionalita' cardiache e vascolari negli adolescenti e giovani con DM1
Cardiac and Vascular Function in Adolescents and Young Adults with Type 1 Diabetes | Elizabeth Berger, Etienne B. Sochett, Alejandro Peirone, Amish Parikh, Denis Daneman
- University of Toronto
2004.01 - Abstract: Diabetes Technology & Therapeutics. April 1, 2004, 6(2): 129-135. doi:10.1089/152091504773731311| Conclusioni: [...] Le analisi effettuate non hanno rilevato differenze significative rispetto al gruppo di confronto se non un aumento della massa e una piccola variazione del diametro diastolico posteriore ventricolare a sinistra. Si e' osservato un miglioramento nella funzionalità carotidiana probailmente dovuto al miglioramento della sensibilità all'insulina avvenuto con la fine della puberta'. | Conclusions: [...]All subjects underwent ultrasonography of the carotid artery to determine distensibility, compliance, and intimal-medial thickness, as well as echocardiographic studies, lipid profile, and measurement of hemoglobin A1c (HbA1c) levels and urinary albumin excretion rate. The diabetes group showed no significant change over the 3-year follow-up in lipid profile, HbA1c level, or albumin excretion rate, but a significant increase in body mass index. The diabetes and control groups were similar in age, lipid profile, and albumin excretion rate. Carotid artery distensibility and compliance in the diabetes group increased significantly from baseline to follow-up but did not differ significantly from controls. The intimal-medial thickness of the diabetes group remained unchanged over time but tended to be higher than controls. Echocardiographic studies showed no difference between the diabetes and control groups, but there was a small change in left ventricular posterior diastolic wall dia |
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DM1: sviluppi recenti
Type 1 diabetes: recent developments | Devasenan Devendra, post doctoral fellow, Edwin Liu, assistant professor of pediatrics, George S Eisenbarth, professor of pediatrics
- Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, 80262 CO, USA
2004 - Articolo completo (in inglese): [BMJ 2004;328:750-754 (27 March)] |
Helicobacter pylori, sintomi gastrointestinali e controllo metabolico nei giovani con DM1
Helicobacter pylori, Gastrointestinal Symptoms, and Metabolic Control in Young Type 1 Diabetes Mellitus Patients | Marcello Candelli, Donato Rigante, Giovanni Marietti, Enrico C. Nista, Francesca Crea, Francesco Bartolozzi, Alessandra Schiavino, Giulia Pignataro, Nicolo' Gentiloni Silveri, Giovanni Gasbarrini, and Antonio Gasbarrini
- Catholic University, Rome
2003.04 - Articolo completo (in inglese): [Pediatrics, Apr 2003; 111: 800 - 803]| Conclusioni: Lo studio non rileva nessuna associzione tra la presenza del H pylori ed il DM1 nei bambini e adolescenti. In aggiunta, la presenza del H pylori non ha modificato l'incidenza di sintomi gastrointestinali negli stessi pazienti. | Conclusions: Our study did not support any association between H pylori and DM1 in children and adolescents. Moreover, the presence of H pylori and cytotoxic strains did not modify the incidence of gastrointestinal symptoms in the same participants. |
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