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Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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Explaining the increased mortality in type 1 diabetes.

Chiara Mameli1, Sara Mazzantini1, Moufida Ben Nasr1

  • 1Chiara Mameli, Sara Mazzantini, Gian Vincenzo Zuccotti, Department of Pediatrics, "Ospedale dei Bambini V. Buzzi", University of Milan, 20154 Milan, Italy.

World Journal of Diabetes
|July 18, 2015
PubMed
Summary

Type 1 diabetes (T1D) patients with good glycated hemoglobin levels still face elevated mortality risks. Long-term glycemic control history, especially from childhood, is crucial for understanding T1D outcomes and developing prevention strategies.

Keywords:
AdolescenceAutonomic neuropathyChildrenDeath ratesEndothelial dysfunctionExerciseHyperglycemiaMetabolic memoryType 1 diabetes

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Area of Science:

  • Endocrinology
  • Diabetology
  • Cardiovascular Medicine

Background:

  • Despite advancements in glucose management and cardiovascular risk factor treatment, mortality rates in type 1 diabetes (T1D) remain high.
  • Recent studies indicate that T1D individuals with glycated hemoglobin (HbA1c) below 6.9% exhibit doubled mortality risk compared to controls.
  • The chronic nature of T1D, often starting in childhood, necessitates considering the entire glycemic control history for accurate mortality correlation.

Purpose of the Study:

  • To discuss the implications of recent findings on T1D mortality rates.
  • To emphasize the impact of early-life glycemic control on long-term outcomes in T1D.
  • To explore factors associated with the chronic progression of T1D and inform preventive strategies.

Main Methods:

  • Review and discussion of recent research on T1D mortality and glycemic control.
  • Analysis of the long-term effects of early-onset T1D and glycemic fluctuations.
  • Exploration of various factors influencing chronic T1D progression and outcomes.

Main Results:

  • Individuals with T1D and HbA1c levels of 6.9% or lower have a significantly higher risk of all-cause and cardiovascular mortality.
  • The transition to a hyperglycemic state in pediatric T1D patients may have lasting effects on mortality.
  • A comprehensive understanding of the entire glycemic control history is essential for accurate risk assessment.

Conclusions:

  • Recent mortality data in T1D highlights the complexity beyond current management strategies.
  • Early-onset T1D and its historical glycemic control significantly influence long-term health outcomes.
  • Further research into early T1D alterations and chronic disease factors is needed for effective preventive strategies.