BACKGROUND: Advances in paediatric type 1 diabetes management and increased use of diabetes technology have led to improvements in glycaemia, reduced risk of severe hypoglycaemia, and improved quality of life. Since 1993, progressively lower HbA1c targets have been set. The aim of this study was to perform a longitudinal analysis of HbA1c, treatment regimens, and acute complications between 2013 and 2022 using data from eight national and one international paediatric diabetes registries. METHODS: In this longitudinal analysis, we obtained data from the Australasian Diabetes Data Network, Czech National Childhood Diabetes Register, Danish Registry of Childhood and Adolescent Diabetes, Diabetes Prospective Follow-up Registry, Norwegian Childhood Diabetes Registry, England and Wales' National Paediatric Diabetes Audit, Swedish Childhood Diabetes Registry, T1D Exchange Quality Improvement Collaborative, and the SWEET initiative. All children (aged ≤18 years) with type 1 diabetes with a duration of longer than 3 months were included. Investigators compared data from 2013 to 2022; analyses performed on data were pre-defined and conducted separately by each respective registry. Data on demographics, HbA1c, treatment regimen, and event rates of diabetic ketoacidosis and severe hypoglycaemia were collected. ANOVA was performed to compare means between registries and years. Joinpoint regression analysis was used to study significant breakpoints in temporal trends. FINDINGS: In 2022, data were available for 109 494 children from the national registries and 35 590 from SWEET. Between 2013 and 2022, the aggregated mean HbA1c decreased from 8·2% (95% CI 8·1-8·3%; 66·5 mmol/mol [65·2-67·7]) to 7·6% (7·5-7·7; 59·4mmol/mol [58·2-60·5]), and the proportion of participants who had achieved HbA1c targets of less than 7% (<53 mmol/mol) increased from 19·0% to 38·8% (p<0·0001). In 2013, the aggregate event rate of severe hypoglycaemia rate was 3·0 events per 100 person-years (95% CI 2·0-4·9) compared with 1·7 events per 100 person-years (1·0-2·7) in 2022. In 2013, the aggregate event rate of diabetic ketoacidosis was 3·1 events per 100 person-years (95% CI 2·0-4·8) compared with 2·2 events per 100 person-years (1·4-3·4) in 2022. The proportion of participants with insulin pump use increased from 42·9% (95% CI 40·4-45·5) in 2013 to 60·2% (95% CI 57·9-62·6) in 2022 (mean difference 17·3% [13·8-20·7]; p<0·0001), and the proportion of participants using continuous glucose monitoring (CGM) increased from 18·7% (95% CI 9·5-28·0) in 2016 to 81·7% (73·0-90·4) in 2022 (mean difference 63·0% [50·3-75·7]; p<0·0001). INTERPRETATION: Between 2013 and 2022, glycaemic outcomes have improved, parallel to increased use of diabetes technology. Many children had HbA1c higher than the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 target. Reassuringly, despite targeting lower HbA1c, severe hypoglycaemia event rates are decreasing. Even for children with type 1 diabetes who have access to specialised diabetes care and diabetes technology, further advances in diabetes management are required to assist with achieving ISPAD glycaemic targets. FUNDING: None. TRANSLATIONS: For the Norwegian, German, Czech, Danish and Swedish translations of the abstract see Supplementary Materials section.

• MeSH
• Diabetes Mellitus, Type 1 * epidemiology   blood   drug therapy   MeSH
• Child MeSH
• Glycated Hemoglobin * analysis   MeSH
• Hypoglycemia epidemiology   MeSH
• Hypoglycemic Agents * therapeutic use   MeSH
• Infant MeSH
• Blood Glucose * analysis   MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Adolescent MeSH
• Child, Preschool MeSH
• Registries * statistics & numerical data   MeSH
• Glycemic Control statistics & numerical data   methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION: Depression therapy has been linked to negative effects on energy metabolism, which can be attributed to various factors, including an ongoing inflammatory process commonly seen in metabolic disorders. Unhealthy lifestyle choices of patients and the impact of antidepressants on body weight and lipid and glucose metabolism also contribute to these metabolic side effects. Although not as pronounced as other psychopharmaceuticals, the increasing use of antidepressants raises concerns about their potential impact on public health. The study aimed to evaluate the short- and long-term effects of the antidepressant citalopram and its long-term combination with a special diet on metabolic parameters in mice. METHODS: Animals were randomly divided into 5 groups - control, control + special diet, citalopram (10 mg/kg for 35 days), citalopram + special diet (10 mg/kg for 35 days), and citalopram (10 mg/kg for 7 days). After a described time of administration, animals were anesthetized, blood and fat and liver tissues were collected. Biochemical parameters of lipid metabolism (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and glucose were analyzed using spectrophotometry and relevant adipokines and cytokines were evaluated by ELISA. RESULTS: After a week of application of citalopram, we observed dyslipidemia that persisted even at the end of the 5-week experiment. Furthermore, after 5 weeks of citalopram administration, we observed a significant decrease in body weight gain and decreased leptin levels. Changes in lipid metabolism, higher levels of adipokines leptin and PAI-1 were observed due to the special diet after 5 weeks. CONCLUSIONS: Our research suggests that the effects of citalopram and a diet on the metabolism of mice can be significant, both in the short term (1 week) and in the long term (5 weeks).

• MeSH
• Citalopram * adverse effects   administration & dosage   pharmacology   MeSH
• Diet, High-Fat adverse effects   MeSH
• Dyslipidemias * chemically induced   blood   metabolism   MeSH
• Glucose * metabolism   MeSH
• Liver metabolism   drug effects   MeSH
• Blood Glucose metabolism   drug effects   MeSH
• Leptin * blood   metabolism   MeSH
• Lipids * blood   MeSH
• Lipid Metabolism * drug effects   MeSH
• Mice MeSH
• Animals MeSH
• Check Tag
• Male MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH

This report presents a fatal case of a young female Type I diabetic patient who developed convulsions and loss of consciousness after taking methamphetamine and spending some time in a dance club. During the convulsions, she was given sugar and when no response occurred, her boyfriend who was not experienced in the use of insulin administered a dose of insulin to her. The woman lost consciousness and died despite the efforts of the emergency service. A biochemical analysis revealed a high level of insulin (196.67 mU/L) and low levels of glucose (2.96 mmol/L) and C-peptide (26 pmol/L). Toxicological analysis revealed a methamphetamine concentration of 389 ng/mL and an amphetamine concentration of 19 ng/mL. The forensic perspective of the difficult determination of the contribution of each of the factors to the death, i.e., the pre-existing medical condition (Type I diabetes), the use of methamphetamine, the physical exertion at the dance club, and, finally, the non-indicated administration of insulin, is discussed. The ruling of the court is also reported.

• MeSH
• Unconsciousness chemically induced   MeSH
• C-Peptide blood   MeSH
• Diabetes Mellitus, Type 1 * MeSH
• Adult MeSH
• Fatal Outcome MeSH
• Hypoglycemic Agents adverse effects   MeSH
• Insulin * administration & dosage   MeSH
• Blood Glucose analysis   MeSH
• Humans MeSH
• Methamphetamine * adverse effects   MeSH
• Amphetamine-Related Disorders complications   MeSH
• Central Nervous System Stimulants * adverse effects   MeSH
• Dancing MeSH
• Physical Exertion MeSH
• Seizures MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

Stres je často opisovaný ako rizikový faktor pre rozvoj širokého spektra ochorení. Pomerne menej preskúmanou oblasťou je však vplyv stresu na hladinu glukózy, a tým potenciálne na riziko rozvoja ochorenia diabetes mellitus 2. typu u všeobecne zdravých mladých jedincov, ktorí sú stresu vystavovaní na pravidelnej báze. Kazuistika opisuje vývoj glykémie v priebehu 14 dní u 23-ročnej študentky medicíny počas prípravy na skúšku ako aj samotnej skúšky z dermatológie. Hodnoty namerané zariadením FreeStyle Libre 2 sa väčšinu času pohybovali vo fyziologickom rozmedzí s očakávanými zvýšeniami po jedle a fyzickej aktivite. Inak mala glykémia relatívne stabilný vývoj v rámci normálnych hodnôt, až na okamih pár hodín pred skúškou, keď začala stúpať. U pozorovanej študentky došlo k zvýšeniu glykémie až na hodnotu 8,2 mmol/l najpravdepodobnejšie v reakcii na akútny stres.

Stress is often described as a risk factor for developing various diseases. However, a relatively less explored area is the effect of stress on glucose levels, and thus potentially on the risk of developing type 2 diabetes mellitus, in generally healthy young individuals who are exposed to stress regularly. This case report describes the glycaemic trends over 14 days in a 23-year-old medical student while preparing for an exam and the dermatology exam itself. Values measured by the FreeStyle Libre 2 device were within the physiological range most of the time, with expected increases after meals and physical activity. Otherwise, glycaemia had a relatively stable trend within expected values, except for a few hours before the exam when it began to rise. The observed student experienced an increase in glycaemia up to 8,2 mmol/l, most likely in response to acute stress.

• MeSH
• Hyperglycemia * etiology   MeSH
• Blood Glucose analysis   MeSH
• Humans MeSH
• Young Adult MeSH
• Stress, Psychological * MeSH
• Blood Glucose Self-Monitoring MeSH
• Test Anxiety MeSH
• Students, Medical MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Background: Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high. It can cause symptoms relative insulin deficit, whether due to beta-cell damage, insulin resistance. The study of carnitine and LDH levels in diabetic patients is significant because both play important roles in the metabolism of glucose and fatty acids. Carnitine is a compound that transports fatty acids into the mitochondria for energy production, while LDH (lactate dehydrogenase) is an enzyme involved in the conversion of glucose to lactate. Humans with type 2 diabetes develop lipid accumulation due to carnitine depletion. LDH is an essential physiological molecule in the glycolytic pathway, and its concentration may be indicative of the condition of cellular metabolism.Aim: For measuring and evaluating the levels of serum carnitine and LDH in all study groups.Method: A case-control study was done in the Al-Zahraa Teaching Hospital, Kut, Iraq on 150 Iraqi males and females as patients and control between (April 2022 and January 2023). Their ages ranged between 44 and 77 years. Among them were 120 patients divided into 4 groups 30 type 2 diabetes mellitus; 30 diabetic cardiomyopathies; 30 diabetic nephropathies; 30 diabetic retinopathies and 30 control group where control group's age and gender matched those of the patient groups. All patients gave written informed consent to participate in the clinical study. ELISA was used to measure carnitine and LDH.Result: In present study, it was confirmed that carnitine was significantly lower than the control group and that LDH was significantly higher than the control group. the study demonstrated significant differences in fasting blood sugar and HbA1C levels among the control group, DM2, DCM, DNP, and DRP groups.Conclusion: This case-control study revealed significant differences in carnitine levels, LDH, FBS, and HbA1C levels among patients with Type 2 diabetes mellitus (T2DM) and their complications compared to the control group. These findings suggest alterations in energy metabolism and cellular damage in patients, indicating poorer glycemic control, and supporting the presence of uncontrolled diabetes.

• MeSH
• Diabetes Mellitus, Type 2 * diagnosis   complications   blood   MeSH
• Adult MeSH
• Energy Metabolism physiology   MeSH
• Carnitine * blood   MeSH
• Diabetes Complications diagnosis   classification   blood   MeSH
• Blood Glucose metabolism   MeSH
• Lactate Dehydrogenases * blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Fatty Acids metabolism   MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Geographicals
• Iraq MeSH

BACKGROUND: Diabetes mellitus (DM) is a chronic disease with prevalence increasing worldwide. The aim of this study was to investigate satisfaction with the current method of insulin delivery (INS) amongst patient with type 1 diabetes mellitus (T1DM) using multiple daily injection (MDI) or continuous subcutaneous insulin infusion (CSII). Furthermore, a sub-aim was to test the effect of selected variables on patient satisfaction with MDI or CSII using regression analysis. METHODS: A cross-sectional study carried out in the territory of Moravia in the Czech Republic. A quantitative approach using the Insulin Delivery System Rating Questionnaire (IDSRQ) among 197 respondents with T1DM with INS delivery with MDI or CSII for at least 1 year. Statistical methods used were descriptive statistics, Student's t-tests and regression analysis. RESULTS: Highly significant differences were found between CSII and MDI patients in satisfaction with the current method of INS delivery (p < 0.001), in how the current method of delivery helps patients maintain stable blood glucose values, prevent high blood glucose (p < 0.001), and in overall satisfaction with the current method of INS delivery (p < 0.001). The average overall satisfaction score was 56.19 points for MDI and 62.08 points for CSII. Regression analysis revealed predictors of overall satisfaction on the mean score on how the current method of INS delivery helps MDI patients (p < 0.01). The effect of other selected variables was not confirmed. CONCLUSION: The results of the study showed higher overall satisfaction with the method of INS delivery in CSII patients. The current method of INS delivery does not interfere with daily life and activities in most patients.

• MeSH
• Diabetes Mellitus, Type 1 * drug therapy   blood   psychology   MeSH
• Adult MeSH
• Hypoglycemic Agents * administration & dosage   therapeutic use   MeSH
• Injections, Subcutaneous MeSH
• Insulin * administration & dosage   therapeutic use   MeSH
• Insulin Infusion Systems * MeSH
• Blood Glucose MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Cross-Sectional Studies MeSH
• Surveys and Questionnaires MeSH
• Patient Satisfaction * MeSH
• Infusions, Subcutaneous MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Diabetes mellitus (DM) je jedním z výrazně progredujících chronických onemocnění s vysokou celosvětovou prevalencí. Nehledě na typ diabetu je hlavním cílem zdravotnického týmu efektivní kompenzace metabolických abnormalit s cílem zabránit rozvoji pozdních komplikací či zpomalit jejich progresi do stádií výrazně snižujících kvalitu pacientova života. V posledních letech začíná stoupat počet odborných publikací podporujících domněnku, že stabilizace glykemie může mít zdravotní benefity i u zdravých nediabetiků. Tato práce sledovala vliv složení stravy (glykemické nálože) na glykemický profil a subjektivní parametry u mladých zdravých dobrovolníků pomocí kontinuální monitorace glykemie. Dospěli jsme k závěru, že ačkoliv subjektivní dotazníkové hodnocení ukazuje vyšší pocit útlumu po jídle nebo zhoršení dermatologických problémů ve skupině s vyšší glykemickou náloží, objektivní parametry kontinuální glykemické monitorace neukazují žádné významné rozdíly mezi skupinami podle glykemické nálože stravy. Závěrem můžeme předpokládat výraznou kompenzační schopnost regulačních systémů, které udrží glykemii v optimálním rozmezí i při vysoko-glykemické dietě.

Diabetes mellitus (DM) is one of the significantly progressive chronic diseases with high global prevalence. Regardless of the type of diabetes, the primary goal of the healthcare team is the effective management of the patient’s condition. In recent years, the number of scientific publications supporting the assertion that glycemic stabilization can have health benefits even for healthy non-diabetics has been increasing. In this study, we monitored the effect of diet composition (glycemic load) on the glycemic profile and subjective parameters in young healthy non-diabetic patients. We considered the significance of continuous monitoring on the health status of the participants. We concluded that while subjective questionnaire assessments show a higher feeling of postprandial lethargy and worsening of dermatological issues in the group with a higher glycemic load, the objective parameters of continuous glucose monitoring do not indicate any significant differences between the groups based on the glycemic load of their diet. In conclusion, we can assume a significant compensatory ability of regulatory systems to maintain glycemia within an optimal range even with a high-glycemic diet.

• MeSH
• Diet, Carbohydrate-Restricted MeSH
• Adult MeSH
• Clinical Studies as Topic MeSH
• Blood Glucose analysis   MeSH
• Humans MeSH
• Young Adult MeSH
• Surveys and Questionnaires MeSH
• Glycemic Control * MeSH
• Diet, Carbohydrate Loading MeSH
• Blood Glucose Self-Monitoring MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH

OBJECTIVE: Early hypoglycaemia at the time of neonatal intensive care unit (NICU) admission is common in very/extreme preterm infants. This study aimed to determine whether buccal dextrose gel in the delivery room (DR) would improve rates of early hypoglycaemia in this population. DESIGN: Randomised, blinded, placebo-controlled trial. SETTING: Four level-3 and one level-2 neonatal units. PATIENTS: Inborn infants≤32+0 weeks gestational age (GA). INTERVENTIONS: Infants were randomised to 40% dextrose or placebo gel in the DR (≤29+0 GA: 0.5 mL gel, ≥29+1 GA: 1 mL gel). MAIN OUTCOME MEASURE: Hypoglycaemia (<1.8 mmol/L) measured at the time of first intravenous access at NICU admission. RESULTS: Between November 2020 and August 2022, the recruitment rate was slow (impacted by the requirement for antenatal consent). This fact, coupled with finite research resources, led to a decision to end recruitment early. Data analysis of 169 newborns (33% of target sample size) showed no significant difference in the frequency of the primary outcome between dextrose 24/84 (29%) and placebo 25/85 (29%) groups (OR 0.95; 95% CI 0.49 to 1.86; p=0.88). A post-hoc analysis indicated that the trial had a low (47% conditional power) chance of detecting a statistically significant benefit from the intervention (had the target sample been achieved). CONCLUSIONS: This study showed no evidence of benefit of 40% dextrose gel on rates of hypoglycaemia at NICU admission. Management of these vulnerable newborns should continue to focus on vascular access and commencement of dextrose-containing intravenous fluids as early as possible. TRIAL REGISTRATION NUMBER: NCT04353713.

• MeSH
• Administration, Buccal MeSH
• Gels MeSH
• Gestational Age MeSH
• Glucose * administration & dosage   MeSH
• Hypoglycemia * drug therapy   prevention & control   MeSH
• Intensive Care Units, Neonatal MeSH
• Blood Glucose analysis   MeSH
• Humans MeSH
• Infant, Premature, Diseases * drug therapy   MeSH
• Infant, Premature MeSH
• Infant, Newborn MeSH
• Delivery Rooms MeSH
• Sweetening Agents administration & dosage   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

AIM: To determine whether people with type 1 diabetes (T1D) initiating glucose sensor monitoring experience greater improvements in HbA1c when provided with education on carbohydrate counting and flexible insulin dosing than those who do not receive nutrition education. MATERIALS AND METHODS: Our retrospective observational study included 329 people with T1D initiating glucose sensor monitoring between 2015 and 2021. The participants were divided into two groups: one group attended at least one structured educational session with a registered dietitian (n = 126), while the other group did not receive structured education (n = 203). After 12 months of glucose sensor initiation, we compared glycaemic outcomes and CGM metrics between the two groups. RESULTS: At glucose sensor initiation, both groups with and without education had similar HbA1c levels (7.64% [60.0 mmol/mol] vs. 7.66% [60.2 mmol/mol]). After twelve months, the education group demonstrated greater improvement in glycemic outcomes (HbA1c 7.17% [54.9mmol/mol] vs. 7.37% [57.1 mmol/mol], p < 0.05) and spent significantly more time in the target range than did the group without structured education (68.8% vs. 64.1%, p < 0.05). We observed an inverse correlation between the number of completed educational sessions and HbA1c after 12 months, as well as between the number of educational sessions and the change in HbA1c. CONCLUSIONS: People with T1D who initiated glucose sensor monitoring alongside nutrition education showed greater improvements in HbA1c and increased time spent in the target glucose range compared to individuals who did not receive structured education. TRAIL REGISTRATION: ClinicalTrials.gov identifier: NCT06264271.

• MeSH
• Diabetes Mellitus, Type 1 * blood   MeSH
• Adult MeSH
• Glycated Hemoglobin * analysis   metabolism   MeSH
• Hypoglycemic Agents administration & dosage   MeSH
• Insulin administration & dosage   MeSH
• Blood Glucose * analysis   metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Glycemic Control MeSH
• Retrospective Studies MeSH
• Blood Glucose Self-Monitoring * MeSH
• Patient Education as Topic * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

The study focused on the changes in C-peptide, glycemia, insulin concentration, and insulin resistance according to LDL-cholesterol concentration ranges. The metabolic profile of individuals in the Czech Republic (n = 1840) was classified by quartiles of LDL-cholesterol into four groups with the following ranges: 0.46-2.45 (n = 445), 2.46-3.00 (n = 474), 3.01-3.59 (n = 459), and 3.60-7.18 mmol/l (n = 462). The level of glucose, C-peptide, insulin, and area of parameters during OGTT and HOMA IR were compared with a relevant LDL-cholesterol range. The evaluation involved correlations between LDL-cholesterol and the above parameters, F-test and t-test. Generally, mean values of glucose homeostasis-related parameters were higher with increasing LDL-cholesterol levels, except for mean HOMA IR values which rapidly increased (2.7-3.4) between LDL-cholesterol ranges of 3.00-3.59 and 3.60-7.18 mmol/l. Glucose, C-peptide, insulin concentrations, and the area of parameters reached greater changes especially after glucose load during OGTT (p ≤ 0.001). Considerable changes were already observed for the above parameters between groups with LDL-cholesterol ranges of 2.46-3.00 and 3.01-3.59 mmol/l. HOMA IR increased with higher LDL-cholesterol concentrations, but the differences in mean values were not statistically significant. Most important differences appeared in glucose metabolism at LDL-cholesterol concentrations of 3.60-7.18 mmol/l in comparison to LDL-cholesterol lower ranges. In particular, the areas of C-peptide, glucose, and insulin ranges showed statistically significant differences between all groups with growing LDL-cholesterol ranges. The variances of HOMA IR statistically differed between groups created according to LDL-cholesterol concentrations ranges.

• MeSH
• C-Peptide * blood   MeSH
• Adult MeSH
• Glucose Tolerance Test MeSH
• Insulin * blood   MeSH
• Insulin Resistance * MeSH
• Blood Glucose * analysis   metabolism   MeSH
• Cholesterol, LDL * blood   MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH