INTRODUCTION: The long-term prognosis of type 1 diabetes (T1DM) was evaluated in relation to the clinical characteristics at the time of diabetes onset. PATIENTS AND METHODS: We examined retrospectively the clinical and laboratory characteristics present at the time of diagnosis in 301 adult patients (187 men) consecutively admitted to hospital with T1DM onset and evaluated the clinical outcome of T1DM during 6 ± 4.8 years following diagnosis. RESULTS: Women needed a greater insulin dose per kg of body weight over the first 2 years following diagnosis. Younger patients at diagnosis had greater insulin requirements during follow-up. Patients with at least one positive pancreatic antibody needed a greater insulin dose 2 years after diagnosis and developed poorer glycemic control during follow-up than patients with no detectable pancreatic antibodies at onset. Diabetic ketoacidosis at onset was associated with greater insulin requirements over the first 2 years of follow-up and with poorer glycemic control during the course of the illness. C-peptide levels at diagnosis correlated with insulin requirements during the first 2 years of follow-up. Patients with higher HbA1c levels at diagnosis had greater insulin requirements in the first year of follow-up. A correlation was found between the HbA1c levels at the consecutive years of follow-up. CONCLUSIONS: Female sex, younger age, humoral pancreatic autoimmunity, diabetic ketoacidosis, lower pancreatic reserve and higher HbA1c levels at onset could predict a poor long-term clinical outcome of T1DM in terms of insulin requirements and glycemic control.
INTRODUCTION: The long-term prognosis of type 1 diabetes (T1DM) was evaluated in relation to the clinical characteristics at the time of diabetes onset. PATIENTS AND METHODS: We examined retrospectively the clinical and laboratory characteristics present at the time of diagnosis in 301 adult patients (187 men) consecutively admitted to hospital with T1DM onset and evaluated the clinical outcome of T1DM during 6 ± 4.8 years following diagnosis. RESULTS:Women needed a greater insulin dose per kg of body weight over the first 2 years following diagnosis. Younger patients at diagnosis had greater insulin requirements during follow-up. Patients with at least one positive pancreatic antibody needed a greater insulin dose 2 years after diagnosis and developed poorer glycemic control during follow-up than patients with no detectable pancreatic antibodies at onset. Diabetic ketoacidosis at onset was associated with greater insulin requirements over the first 2 years of follow-up and with poorer glycemic control during the course of the illness. C-peptide levels at diagnosis correlated with insulin requirements during the first 2 years of follow-up. Patients with higher HbA1c levels at diagnosis had greater insulin requirements in the first year of follow-up. A correlation was found between the HbA1c levels at the consecutive years of follow-up. CONCLUSIONS: Female sex, younger age, humoral pancreatic autoimmunity, diabetic ketoacidosis, lower pancreatic reserve and higher HbA1c levels at onset could predict a poor long-term clinical outcome of T1DM in terms of insulin requirements and glycemic control.
Authors: Giuseppe Terrazzano; Sara Bruzzaniti; Valentina Rubino; Marianna Santopaolo; Anna Teresa Palatucci; Angela Giovazzino; Claudia La Rocca; Paola de Candia; Annibale Puca; Francesco Perna; Claudio Procaccini; Veronica De Rosa; Chiara Porcellini; Salvatore De Simone; Valentina Fattorusso; Antonio Porcellini; Enza Mozzillo; Riccardo Troncone; Adriana Franzese; Johnny Ludvigsson; Giuseppe Matarese; Giuseppina Ruggiero; Mario Galgani Journal: Nat Metab Date: 2020-02-17
Authors: Dina Khedr; Mona Hafez; Jairo Lumpuy-Castillo; Soha Emam; Antoine Abdel-Massih; Fatma Elmougy; Rasha Elkaffas; Ignacio Mahillo-Fernández; Oscar Lorenzo; Noha Musa Journal: Int J Mol Sci Date: 2020-07-18 Impact factor: 5.923