Metabolic Control Parameters Research Articles

Spanish Validation of the Problem Area in Diabetes-Pediatric Version Survey and Its Weak Association with Metabolic Control Parameters in Pediatric Diabetes: A Cross-Sectional Multicenter Study

Background: Type 1 diabetes mellitus (T1DM) in pediatric patients often leads to emotional distress, impacting self-management. The PAID-Peds survey measures diabetes-related emotional burden but lacks a validated Spanish version. This study aimed to validate the Spanish PAID-Peds survey in children and adolescents with T1DM and correlate it with diabetic metabolic control parameters. Methods: A cross-sectional study was conducted from October 2022 to December 2023, recruiting 636 patients aged 8–17 years from three Spanish hospitals. Psychometric properties were assessed using Cronbach’s alpha for reliability and confirmatory factor analysis for construct validity. Associations between PAID-Peds scores and clinical measures, such as HbA1c, were examined. Results: The final sample consisted of 538 participants (84.59% response rate). The PAID-Peds survey showed high internal consistency (Cronbach’s alpha = 0.90). The confirmatory factor analysis indicated a satisfactory model fit (χ2 = 812.28, p < 0.001; RMSEA = 0.08). Weak correlations were found between PAID-Peds scores and HbA1c (r = 0.14, p < 0.001). Conclusions: The Spanish PAID-Peds survey is a reliable tool for assessing emotional burden in pediatric T1DM patients. Integrating it into clinical practice may improve early identification of emotional distress, aiding in better diabetes management. Further research should explore its application over time and in intervention studies.

Association of plasma endocan levels with metabolic parameters and predictive value of endocan for the development of complications in patients with type 2 diabetes mellitus: An observational study

The aim of the current research was to investigate the association between plasma endocan levels and metabolic control parameters, as well as to evaluate its predictive value for clinical complications in patients with type 2 diabetes mellitus (DMT2). A total of 100 DMT2 patients participated in this prospective observational study. Plasma endocan levels were significantly elevated in DMT2 patients with HbA1c>7% (1.38±0.33 vs. 0.68±0.23 ng/mL; p<0.0001), compared to patients with HbA1c ≤7%. Patients with plasma endocan concentrations >1.10 ng/mL (median value of 1.10 ng/mL) demonstrated significantly higher levels of metabolic parameters: body mass index (BMI), HbA1c%, fasting glucose level, LDL cholesterol, total cholesterol, triglycerides, along with significantly lower HDL cholesterol levels. Furthermore, patients with plasma endocan levels >1.10 ng/mL were found to have an increased risk for the following complications: retinopathy (RR: 2.7500; 95% CI: 1.2150 to 6.2244; p= 0.0152, nephropathy (RR: 2.0952; 95% CI: 1.2294 to 3.5710; p=0.0065), neuropathy (RR: 1.9945; 95% CI: 1.2025 to 3.3081); p=0.0075 ), angina pectoris (RR: 2.4881; 95% CI 1.0865 to 5.6979; p=0.0311, hypertension (RR: 1.1372; 95% CI 1.0060 to 1.2856; p=0.0398), cardiomyopathy (RR: 2.6190; 95% CI 1.1507 to 5.9612; p=0.0218), myocardial infarction (RR: 9.4286; 95% CI 1.2742 to 69.7697; p=0.0280) and stroke (RR: 4.4638; 95% CI 1.3765 to 14.4758; p=0.0127). Correlation analysis revealed that plasma endocan levels were positively correlated with HbA1c% (r=0.856, p<0.0001), fasting glucose level (r=0.631, p<0.0001), LDL (r=0.347, p=0.0004), cholesterol (r=0.282, p=0.0045) and triglycerides (r=0.366, p=0.0002). Conversely, plasma endocan levels were negatively correlated with HDL cholesterol (r= - 0.429, p<0.0001). In conclusion, higher plasma endocan levels were strongly associated with poor metabolic control in DMT2 patients and exhibited significant predictive value for both microvascular and macrovascular complications.

Impact of a therapeutic educational intervention using a gamification method aimed at adolescents with type 1 diabetes mellitus.

ntroduction : Autoimmune type 1 diabetes mellitus (T1D) is one of the most prevalent chronic diseases in the paediatric age group. Gamification in diabetes education may have the potential to change health behaviours by creating an innovative, engaging and interactive learning environment. Material and methods : A 6-month prospective quasiexperimental pilot study aimed at evaluating the impact of a gamified educational intervention (own kahoot ®, face-to-face, in 2 sessions, with immediate feedback) on diabetes knowledge, metabolic control and quality of life of adolescents with T1D. Variables recorded : knowledge using the Diabetes Knowledge Questionnaire Test (DKQ2) and own Diabethoc questionnaire, metabolic control parameters through glycosylated haemoglobin, main parameters established according to the recommendations of the Advanced Technologies & Treatments for Diabetes (for sensor use >70%) and quality of life in diabetes with the PedsQL test. Results : Twenty-one patients (61.9% boys) with a mean age of 13.8±0.81SD years on multi-dose insulin therapy 71.4% (n=15) and the insulin pump 28.6% (n=6) were included. Assessment by DKQ2 showed a 38.7% increase in knowledge post-intervention. The Diabet-hoc test showed an increase of 65.3% throughout the study. Changes in metabolic control and the quality-of-life test were not statistically significant. Conclusions : Our tool demonstrated an improvement in diabetes knowledge maintained at 6 months after the study

Impact on Glycemia Risk Index and other metrics in type 1 adult patients switching to Advanced Hybrid Closed-Loop systems: a one-year real-life experience

BackgroundAdvanced Hybrid Closed-Loop system (AHCL) has profoundly changed type 1 diabetes therapy. This study primarily aimed to assess the impact on Glycemia Risk Index (GRI) and other continuous glucose monitoring (CGM) metrics when switching from one of four insulin strategies to AHCL in type 1 adult patients.MethodsA single-center, retrospective pre/post observational study; 198 patients (age 44.4 ± 12.7 years, 115 females/83 males, diabetes duration 24.7 ± 11.6 years, HbA1c 7.4 ± 1%), treated with different insulin therapies (MDI, CSII, SAP with PLGS, HCL) were assessed before and after switching to an AHCL (MiniMed 780G, Diabeloop Roche, Tandem Control-IQ) at 1, 3, 6, and 12 months. Mixed-effects multivariable regression models were used to estimate the mean pre/post variations at different time points, adjusted for potential confounders.ResultsA month after the switch, there was an improvement in CGM metrics and HbA1c for all patients: GRI −10.7, GMI −0.27%, CV −2.1%, TAR>250 −3.7%, TAR180-250 −5.6%, TIR + 9.7%, HbA1c −0.54% (all p < 0.001). This improvement was maintained throughout the observational period (at 3, 6, and 12 months, with all p-values < 0.001). When improvements across the 780, Diabeloop, and Tandem CIQ devices were compared: Diabeloop demonstrated significantly better performance in terms of GRI, GMI, CV, TAR>250 at T1 (for all p < 0.01); 780 recorded highest average decrease in TAR180-250 (p = 0.020), while Tandem achieved the most significant reduction in TBR54-69 (p = 0.004).ConclusionsAdopting an AHCL leads to a rapid and sustained improvement in GRI and other parameters of metabolic control for up to a year, regardless of prior insulin therapies, baseline conditions or brands.

The impact of new glucose monitoring systems on parameters of diabetes metabolic control. Literature review

Introduction In recent years, there has been tremendous development in medicine, including diabetology. A significant portion of these achievements pertains to pharmacological treatment. However, one should not overlook the advancement of devices necessary for monitoring glucose levels, such as glucometers or CGM and FGM systems. In this paper, I want to focus on how the use of glucose monitoring systems affects the course of diabetes. Aim of the study The aim of this study was to determine the impact of glucose monitoring systems (CGM and FGM) on parameters of metabolic control in diabetes. Materials and methods The article was created based on the PubMed and Scholar databases. The literature was analyzed using the following keywords: Continuous glucose monitor, CGM, flash glucose monitoring, FGM, type 1 diabetes, type 2 diabetes, diabetes mellitus, Metrics of Glycemic. Results Research has confirmed that the use of continuous glucose monitoring systems lowers HbA1c in patients with both type 1 and type 2 diabetes regardless of age and treatment modality. Furthermore, the use of CGM and FGM reduces the number of hypoglycemic episodes and increases time in range (TIR). Conclusions Thanks to the results obtained from numerous studies, it can be assumed that the use of continuous glucose monitoring systems is not only an adjunct to diabetes therapy but also an important component of it. With this technology combined with modern medications, we can achieve better glycemic control and, consequently, improve the quality of life of patients with diabetes.

High Fat Diet and Polycystic Ovary Syndrome (PCOS) in Adolescence: An Overview of Nutritional Strategies.

Polycystic ovary syndrome (PCOS) is a multifaceted and heterogeneous disorder, linked with notable reproductive, metabolic, and psychological outcomes. During adolescence, key components of PCOS treatment involve weight loss achieved through lifestyle and dietary interventions, subsequently pursued by pharmacological or surgical therapies. Nutritional interventions represent the first-line therapeutic approach in adolescents affected by PCOS, but different kinds of dietary protocols exist, so it is necessary to clarify the effectiveness and benefits of the most well-known nutritional approaches. We provided a comprehensive review of the current literature concerning PCOS definition, pathophysiology, and treatment options, highlighting nutritional strategies, particularly those related to high-fat diets. The high-fat nutritional protocols proposed in the literature, such as the ketogenic diet (KD), appear to provide benefits to patients with PCOS in terms of weight loss and control of metabolic parameters. Among the different types of KD studies, very low-calorie ketogenic diets (VLCKD), can be considered an effective dietary intervention for the short-term treatment of patients with PCOS. It rapidly leads to weight loss alongside improvements in body composition and metabolic profile. Even though extremely advantageous, long-term adherence to the KD is a limiting factor. Indeed, this dietary regimen could become unsustainable due to the important restrictions required for ketosis development. Thus, a combination of high-fat diets with more nutrient-rich nutritional regimens, such as the Mediterranean diet, can amplify positive effects for individuals with PCOS.

Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease

BackgroundPreliminary evidence demonstrates some parameters of metabolic control, including glycaemic control, lipid control and insulin resistance, vary across the menstrual cycle. However, the literature is inconsistent, and the underlying mechanisms remain uncertain. This study aimed to investigate the association between the menstrual cycle phase and metabolites and to explore potential mediators and moderators of these associations.MethodsWe undertook a cross-sectional cohort study using UK Biobank. The outcome variables were glucose; triglyceride; triglyceride to glucose index (TyG index); total, HDL and LDL cholesterol; and total to HDL cholesterol ratio. Generalised additive models (GAM) were used to investigate non-linear associations between the menstrual cycle phase and outcome variables. Anthropometric, lifestyle, fitness and inflammatory markers were explored as potential mediators and moderators of the associations between the menstrual cycle phase and outcome variables.ResultsData from 8694 regularly menstruating women in UK Biobank were analysed. Non-linear associations were observed between the menstrual cycle phase and total (p < 0.001), HDL (p < 0.001), LDL (p = 0.012) and total to HDL cholesterol (p < 0.001), but not glucose (p = 0.072), triglyceride (p = 0.066) or TyG index (p = 0.100). Neither anthropometric, physical fitness, physical activity, nor inflammatory markers mediated the associations between the menstrual cycle phase and metabolites. Moderator analysis demonstrated a greater magnitude of variation for all metabolites across the menstrual cycle in the highest and lowest two quartiles of fat mass and physical activity, respectively.ConclusionsCholesterol profiles exhibit a non-linear relationship with the menstrual cycle phase. Physical activity, anthropometric and fitness variables moderate the associations between the menstrual cycle phase and metabolite concentration. These findings indicate the potential importance of physical activity and fat mass as modifiable risk factors of the intra-individual variation in metabolic control across the menstrual cycle in pre-menopausal women.

Impact of the COVID-19 pandemic on the outcomes of Indonesian chronic disease management program

&lt;b&gt;Background: &lt;/b&gt;The&lt;i&gt; &lt;/i&gt;Indonesian Government launched chronic disease management program (PROLANIS) with the aim of improving clinical outcomes and preventing disease complications of patients with type 2 diabetes (T2D). During the coronavirus disease 2019 (COVID-19) pandemic, the overwhelmed healthcare system shifted resources away from non-communicable diseases in the attempt to mitigate it. Thus, the implementation of PROLANIS during the COVID-19 pandemic might not be as optimal as before the pandemic era, leading to worse clinical outcomes. This pilot study aims to evaluate the impact of the COVID-19 pandemic on PROLANIS in rural areas by analyzing the changes of metabolic control and renal function parameters.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; This study used data from three PROLANIS groups report in rural areas in East Java Province, Indonesia. Study population was PROLANIS participants who came for six-month-evaluation in December 2019 (T0), June 2020 (T1), and December 2020 (T2). Evaluated metabolic control parameters were body mass index (BMI), blood pressure, hemoglobin A1C (HbA1C), total cholesterol (TC), high-density lipid, low-density lipid, and triglyceride (TG), whereas evaluated renal function parameters were blood urea nitrogen, serum creatinine, and urinary albumin. Independent t-test and Wilcoxon signed-rank test were used for statistical analyses. p-value &amp;lt;0.05 was considered statistically significant.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; Among 52 PROLANIS participants included in the analyses, four metabolic control parameters (BMI, blood pressure, TC, and TG) and all renal function parameters significantly worsened right after the pandemic started but improved 6 months afterwards. Meanwhile, HbA1C continuously worsened throughout the study period, albeit statistically insignificant.&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;The metabolic control and renal function parameters in our study population deteriorates especially in the beginning of the COVID-19 pandemic.

Children-Dietary Inflammatory Index and Adherence to the Mediterranean Diet in Children with Overweight and Obesity: Are They Associated with Cardiometabolic Risk Parameters?

Purpose: This study was planned to assess the relationship between the children’s dietary inflammatory index (cDII), adherence to the Mediterranean diet (AMD), and metabolic control parameters in children with overweight and obesity.&#x0D; Methods: This cross-sectional was conducted in children with overweight and obesity aged 7-18 years. Sociodemographic, biochemical, dietary, and lifestyle data were collected using a questionnaire. Mediterranean Diet Quality Index (KIDMED) was used to evaluate AMD. Body weight, height, neck, waist, and hip circumference were measured. Dietary intake and cDII were assessed with a three-day food consumption record. &#x0D; Results: The mean cDII score was 2.2∓0.94 (range from -0.43 to 4.39). Of the total participants, 12% had high and 38.7% had low AMD. There were no significant differences between cDII and biochemical and anthropometric parameters. The proportion of participants with high insulin levels (53.4%) was higher in participants with low AMD group than in those with high AMD (32.6%) (p=0.011). The proportion of participants with insulin resistance was higher in the low AMD group than in the medium/high adherence group (53.4% vs. 37.0%, p=0.047). There was no significant relationship between AMD and lipid profile. Logistic regression analysis showed that participants with low AMD had high insulin levels to be 2.055 times (95% CI= 1.009-4.186. OR=2.055) compared to participants with moderate/high AMD (p=0.047). cDII scores and AMD were not associated with insulin resistance.&#x0D; Conclusion: This study showed that low AMD was associated with high insulin levels, but cDII was not associated with cardiometabolic risk factors in children with overweight and obesity.

Plasma leucine-rich α-2-glycoprotein 1 - a novel marker of diabetic kidney disease in children and adolescents with type 1 diabetes mellitus?

Glomerular endothelial dysfunction and neoangiogenesis play a significant role in the pathogenesis of diabetic kidney disease (DKD). Leucine-rich α-2 glycoprotein 1 (LRG1) is a recently discovered protein that participates in the molecular pathway of inflammation and angiogenesis. We aimed to investigate efficacy of LRG1 to predict estimated glomerular filtration rate (eGFR) decrease in children and adolescents with type 1 diabetes mellitus (T1DM). The study comprised 72 participants with diabetes duration for ≥ 2years. At study initiation, LRG1, urine albumin, eGFR (cystatin C-based, and Schwartz), HbA1c, and lipid values were evaluated and diabetes-related clinical features and anthropometric measurements were collected. These results were compared with final control values after ≥ 1year. Patients were divided into subgroups according to presence of albuminuria progression, eGFR decrease, and metabolic control parameters. There was positive correlation between LRG1 level and Schwartz and cystatin C-based eGFR decline (r = 0.360, p = 0.003; r = 0.447, p = 0.001, respectively), and negative correlation between final cystatin C-based eGFR and LRG1 (p = 0.01, r = -0.345). Patients with cystatin C-based eGFR decrease > 10% had significantly higher LRG1 levels (p = 0.03), however, LRG1 was not different between albuminuria progression subgroups. A 0.282μg/ml increase in LRG1 correlated with a 1% decrease in eGFR in simple linear regression analysis (β = 0.282, %CI 0.11-0.45, p = 0.001) and LRG1 was an independent predictor of GFR decline even in the presence of covariates. Our study supports the relationship between plasma LRG1 and eGFR decline and suggests LRG1 may be an early marker of DKD progression in children with T1DM. A higher resolution version of the Graphical abstract is available as Supplementary information.

Metabolic Disturbance of High-Saturated Fatty Acid Diet in Cognitive Preservation.

Aging continues to be the main cause of the development of Alzheimer's, although it has been described that certain chronic inflammatory pathologies can negatively influence the progress of dementia, including obesity and hyperlipidemia. In this sense, previous studies have shown a relationship between low-density lipoprotein receptor (LDLR) and the amyloid-beta (Aβ) binding activity, one of the main neuropathological features of Alzheimer's disease (AD). LDLR is involved in several processes, including lipid transport, regulation of inflammatory response and lipid metabolism. From this perspective, LDLR-/- mice are a widely accepted animal model for the study of pathologies associated with alterations in lipid metabolism, such as familial hypercholesterolemia, cardiovascular diseases, metabolic syndrome, or early cognitive decline. In this context, we induced hyperlipidemia in LDLR-/- mice after feeding with a high-saturated fatty acid diet (HFD) for 44 weeks. LDLR-/--HFD mice exhibited obesity, hypertriglyceridemia, higher glucose levels, and early hepatic steatosis. In addition, HFD increased plasmatic APOE and ubiquitin 60S levels. These proteins are related to neuronal integrity and health maintenance. In agreement, we detected mild cognitive dysfunctions in mice fed with HFD, whereas LDLR-/--HFD mice showed a more severe and evident affectation. Our data suggest central nervous system dysfunction is associated with a well-established metabolic syndrome. As a late consequence, metabolic syndrome boots many behavioral and pathological alterations recognized in dementia, supporting that the control of metabolic parameters could improve cognitive preservation and prognosis.

Hba1c Level is Not Always a Reliable Parameter of Metabolic Control of Diabetes

Hba1c Level is Not Always a Reliable Parameter of Metabolic Control of Diabetes

Metabolic control of diabetic patients assisted by private and public health care systems during the COVID-19 pandemic: A retrospective cohort study

AimsWe sought to analyze the impacts of social restriction measures imposed by the pandemic COVID-19 on the control of metabolic parameters in diabetic patients. MethodsWe accessed the medical records of patients who underwent clinical follow-up in the public and private health systems between July 2019 and June 2021. The sample consisted of 288 patients (111 adults and 177 older individuals). A two-way ANOVA mixed model was used to test the effects of intra- (time: baseline and after 24 months) and inter-subject factors. Linear regression analysis was used to predict the difference in body weight considering age, sex, HbA1c, health care system and insulin use. ResultsAmong adults, we observed an increase in body weight and LDL-c levels, especially for insulin users (p ≤ 0.05). Adults assisted by the public health care system showed higher HbA1c levels (p = 0.001). Among older individuals using insulin, blood glucose levels decreased (p = 0.019). Body weight decreased in those assisted by the private system (p = 0.005), while glycemia decreased for patients assisted by both health care systems (p = 0.043). The linear regression model confirmed that the increase in body weight was more pronounced in adults than in older individuals. ConclusionThe social restriction measures imposed by the pandemic affected the metabolic control of diabetic patients, especially adults assisted by the public health care system.

Metabolic control during the first two years of the COVID-19 pandemic in pediatric patients with type 1 diabetes: results from the German DPV initiative

AimTo assess effects of the SARS-CoV2 pandemic on metabolic control in youth with type 1 diabetes (T1D) in Germany in a population-based analysis.MethodsData from 33,372 pediatric T1D patients from the Diabetes Prospective Follow-up (DPV) registry, with face-to-face visits or telemedicine contacts in the years 2019–2021, were available. Datasets from eight time periods between March 15, 2020, and December 31, 2021, according to SARS-CoV2 incidence waves, were compared to those from five control time periods. Parameters of metabolic control were assessed with adjustment for sex, age, diabetes duration, and repeated measurements. Laboratory-measured HbA1c values and those estimated from CGM were aggregated into a combined glucose indicator (CGI).ResultsThere was no clinically relevant difference in metabolic control between pandemic and control time periods with adjusted CGI values ranging from 7.61% [7.60–7.63] (mean [95% confidence interval (CI)]) in the third quarter of 2019 to 7.83% [7.82–7.85] in the time period from January 1 to March 15 2020, in the other control periods, and during the pandemic, CGI values lay between these values. BMI-SDS rose during the pandemic from 0.29 [0.28–0.30] (mean [95% CI]) in the third quarter of 2019 to 0.40 [0.39–0.41] during the fourth wave. Adjusted insulin dose rose during the pandemic. Event rates for hypoglycemic coma and diabetic ketoacidosis remained unchanged.ConclusionsWe found no clinically relevant change of glycemic control or incidence of acute diabetes complications during the pandemic. The observed BMI increase may represent an important health risk for youth with T1D.

Diabetes and thyroid through the prism of some metabolic abnormalities

Introduction: Thyroid dysfunction (TD) and diabetes mellitus (DM) are the two most common chronic endocrine disorders with variable prevalence among different populations. Both insulin and thyroid hormones are affected by autoimmune pathology and they do affect cellular metabolism, being a part of the metabolic syndrome. However, the correlations between T2DM and TD have not yet been sufficiently defined, followed by ambivalent results from previous studies.Objectives: The study was conducted to compare the metabolic parameters of patients with T2DM with and those without AITD so as to determine the existence of a correlation between these and hormonal parameters (TSH, FT4).Design and methods: This are documented observational case-control study that included 31 subjects with T2DM and AITD and 25 with T2DM without AITD. Sessions were conducted at the Clinic for Internal Medicine of the University Clinical Center in Tuzla. Individual metabolic parameters were analyzed, and in a broad evaluation, the values of hormonal and immune parameters were monitored and documented.Results: There were no differences in age, gender and BMI of the examined groups. There was a statistically significant difference between the values related to OS, SKT, DKT, PGN, 2h ppPG, and HbA1c. A statistically significant correlation was found between TSH and females, FT4 and BMI (rS = 0.375 pvalue = 0.045) as wellas a correlation between TSH and HbA1c (rS = 0.313 pvalue = 0.019) and TSH and 2x ppPG (rS = 0.281, pvalue = 0.036).Conclusion: The expression of metabolic control parameters is strongest in the group of patients with diabetes and AITD. Their identification as a risk factor and the detection of their subclinical signs are extremely important for the early implementation of preventive and therapeutic strategies, which could change the course of diabetic complications and significantly improve prognosis of diabetes.

Relationships between serum and dietary magnesium, calcium, and metabolic parameters in women with type 2 diabetes mellitus

Magnesium and calcium are essential minerals in several enzymatic activities that modulate essential biological functions. Hypomagnesemia occurs in patients with type 2 diabetes mellitus (T2DM), especially those with poor metabolic control. Dietary magnesium and calcium intake play a protective role in the development of T2DM. This research aimed to investigate the association of dietary and serum magnesium and calcium with metabolic control parameters in diabetic women. This case-control study was conducted on 80 women, including 40 patients diagnosed with T2DM and 40 healthy controls aged 35-60 years. Some anthropometric measurements of the individuals were taken, and their body mass index was calculated. In addition, some biochemical parameters, serum magnesium, and calcium were analyzed. A validated 96-item quantitative food frequency questionnaire was used to obtain dietary magnesium and calcium intake data. Serum magnesium levels were lower in subjects with diabetes than in controls, and there was a similar incidence of hypomagnesemia in T2DM patients and controls, but not statistically significant (p>0.05). In T2DM patients, there was a statistically significant inverse association between HbA1c and serum magnesium (p<0.05). Dietary magnesium intake was inversely associated with HOMA-IR scores (p<0.05) but had a positive association with serum magnesium levels in patients with T2DM (p<0.05). There were no significant differences in the calcium/magnesium ratio between T2DM patients and healthy controls (p>0.05). In a multiple linear regression analysis, dietary magnesium intake and HbA1c were found to be significantly related to altered serum magnesium in T2DM patients. The present findings suggest that lower serum magnesium levels were associated with higher HbA1c levels in subjects with T2DM. Increased dietary magnesium intake in T2DM may enhance HOMA-IR scores and serum magnesium levels.

Evaluation of the Relationship between Emotional Appetite, Adherence to the Mediterranean Diet, and Metabolic Control Parameters in Individiuals with Type 2 Diabetes

Amaç: Sağlıklı diyet modellerinden biri olarak kabul edilen Akdeniz diyetinin ve duygusal iştah kontrolünün diyabet yönetimini kolaylaştıracağı düşünülmektedir. Bu çalışmada, tip 2 diabetes mellitus (T2DM) hastalarında Akdeniz diyetine uyum, duygusal iştah ve metabolik kontrol parametreleri arasındaki ilişkinin incelenmesi amaçlanmıştır. Örneklem ve Yöntem: Çalışma en az bir yıl önce tanı alan 19-64 yaş arası gönüllü 101 T2DM hastası ile yürütülmüştür. Hastalara demografik özellikler, sağlık durumları, antropometrik ölçümler ve hastalık ile ilişkili biyokimyasal parametreleri kapsayan bir anket formuna ek olarak Akdeniz Diyeti Uyum Ölçeği, Duygusal İştah Anketi (DİA) ve Uluslararası Fiziksel Aktivite Anketi uygulanmıştır. İstatistiksel anlamlılık düzeyi p&amp;lt;0.05 olarak alınmıştır. Bulgular: Akdeniz diyetine uyumu yüksek olan hastalarda metabolik kontrolün göstergesi olan hemoglobin A1c (HbA1c), açlık kan glukozu ve beden kütle indeksi (BKİ) düzeyleri, uyumsuz olanlara göre anlamlı düzeyde düşük bulunmuştur (p&amp;lt;0.05). Akdeniz diyetine yüksek uyumlu hastaların bel çevresi ise kabul edilebilir düzeyde uyumlu olanlara göre düşük bulunmuştur (p&amp;lt;0.05). Erkek hastaların duygusal yemek yeme pozitif durum ortalamaları ve toplam pozitif puan ortalamaları kadın hastalardan daha yüksektir (p&amp;lt;0.05). DİA pozitif toplam puan ile HbA1c ve açlık kan glukozu arasında pozitif yönlü ve yine pozitif toplam puan ile BKİ ve bel çevresi arasında negatif yönlü zayıf ve orta düzey ilişkiler saptanmıştır (p&amp;lt;0.05). Sonuç: Duygulara karşılık olarak gelişen ve aşırı yemeye neden olan duygusal iştah, T2DM hastalarında vücut ağırlığı kaybını zorlaştırmakta ve obezite riskini arttırmaktadır. Bu nedenle T2DM’li bireylerde, beslenmenin psikolojik yönü de dikkate alınarak, duygusal iştah durumları sorgulanmalıdır. Ayrıca Akdeniz diyetine uyum ile T2DM’nin biyobelirteçleri ve antropometrik ölçümler üzerine olumlu etkiler gözlenmektedir. Bu nedenle T2DM’li bireylerin tıbbi beslenme tedavisinde Akdeniz diyetine uyum arttırmalıdır.

Effect of Inulin Intervention on Metabolic Control and Methylation of INS and IRS1 Genes in Patients with Type 2 Diabetes Mellitus

Currently, treatments are being sought to improve the control of type II diabetes mellitus (T2DM), and inulin has been shown to be effective in reducing glucose levels and other metabolic control parameters. These effects on metabolic control may be associated with changes in the epigenetic modulation of genes of the insulin pathway. Therefore, our objective is to determine the effect of agave inulin in metabolic control parameters and in INS and IRS1 genes' methylation in T2DM patients. This was a longitudinal experimental study with 67 Mexican participants who received an intervention of inulin agave (10 g daily) for 2 months. The methylation of the INS and IRS1 genes was determined by MSP. For the INS gene, we found a significant decrease in the proportions of T2DM patients with methylated DNA after inulin intervention (p = 0.0001). In contrast, the difference in the proportions of the unmethylated IRS1 gene before and after the inulin intervention was not significant (p = 0.79). On the other hand, we observed changes in the number of T2DM patients' recommended categories for metabolic control depending on the methylation of INS and IRS1 genes before and after treatment with inulin. For the first time, we report the modification in the methylation of two genes, INS and IRS1, of the insulin pathway and provide information on the possible relevant role of epigenetics as a key factor in positive changes in metabolic control parameters by inulin intake in T2DM patients.

RF34 | PMON263 Study of Testosterone Replacement in Hypogonadal Men With Uncontrolled Type 2 Diabetes – a Randomised Double Blinded Placebo Controlled Trial (STRIDE Study)

Abstract Objective This RCT set out to test the effect of testosterone on glycaemic control, parameters of metabolic control and quality of life(QoL) in a cohort of people with poorly-controlled type 2 diabetes and hypogonadism. Research design and methods: This is a randomised double-blinded placebo-controlled add-on trial of intramuscular testosterone undecanoate (Nebido®) administered every 12 weeks in 65 hypogonadal men with poorly-controlled type 2 diabetes. Phase 1 patients were randomly assigned to either treatment or placebo arm for 6 months of TRT. Phase 2 was an open-labelled phase for 6 months and patients on placebo moved on to the treatment group wherein patients in the treatment group continued. Anthropometric measurements, questionnaires and biochemical parameters were recorded at baseline and every three months for a year. Results Mean age of the cohort was 59±8.98 years(mean±SD). Mean duration since diagnosis of diabetes was 8.6 years. 17(26%) were on insulin. Baseline cohorts were comparable. There was no improvement in mean HbA1c or fasting plasma glucose(FBG) between the active and placebo groups after 6 months of TRT. No difference was found in HbA1c or FBG at 12 months compared to baseline in the active group either. Our study also showed a significant decrease in serum triglycerides (-0.497±0.213mmol/l, p=0.023) and improvement in left hand grip strength (p=0.025) at 6 months post treatment in the active group compared to placebo group. There was no significant difference in the mean weight, BMI, WC, WHR, fat mass, fat percentage or fat free mass between the groups. Our study is the first ever RCT to show a significant improvement in total AMS (aging male symptom) scores from baseline after 6 months of TU treatment compared to placebo group (p&amp;lt;0.05) in a cohort with poorly-controlled type 2 diabetes and hypogonadism. Another key finding from our study substantiating the clinical argument of treatment of patients with hypogonadism in diabetes cohort is that the proportion of patients with severe symptoms moving to a less severe category (low/mild/moderate severity) was 46% in the active vs only 28% in placebo group(p=0.0024). Conclusions Our study concludes that testosterone therapy did not have a significant improvement in glycaemic control at 6 months between the active and placebo groups and at 12 months within the in the active group and may need longer duration to see the positive effects especially in cohort of people who have had long duration of diabetes. There was a significant reduction in triglyceride levels and increase muscular strength after 6 months of TRT. STRIDE study is the first ever RCT to show a significant improvement in clinical symptoms and symptom severity following testosterone treatment in patients with hypogonadism and type 2 diabetes after 6 months of testosterone treatment. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 12:42 p.m. - 12:47 p.m.

Weight gain in type 1 diabetes during the SARS-CoV-2 pandemic. Does lockdown affect the metabolic control of pediatric patients?

Background and aimsDue to the severe acute respiratory syndrome coronavirus 2 pandemic, governments of many countries decided to implement lockdowns, which included school closures. This major lifestyle change also applied to people with diabetes. The aim of this paper was to analyze how the COVID-19 pandemic and related restrictions influenced the metabolic compensation of diabetes in the pediatric population.MethodsPatients with type 1 diabetes (T1D), treated by one therapeutic team, who in 2020 and 2021 paid at least two in-person visits in the outpatient clinic, were included in the study. The time in range (TIR) and HbA1c, as well as the total daily dose (TDD) of insulin and BMI from the visit before the announcement of the pandemic restrictions (March 2020) and during the lockdown (second visit after 6 months) and within the period of loosened restrictions (two visits in 2021) were analyzed.ResultsA total of 185 patients with T1D were included in the study (96 boys), aged 2–18 years (11.5 ± 3.5); 135 of them (72.9%) use CSII and 142 (76.8%) use CGM or FGM. During the first months of the studied period, despite comparable (p>0.05) TIR (57.5 ± 21.4% vs. 59.9 ± 20.5%), improvement of HbA1c was noticed (7.9 ± 1.6% vs. 7.5 ± 1.4%, p=0.0336), whereas in the following months, both HbA1c and TIR were comparable. Also, the TDD increased significantly (from 37.3 ± 18.9 units/day on the first visit up to 46.8 ± 22.7 units/day on the last visit, p=0.0003); however, TDD/kg remained constant (p>0.05) (0.8 ± 0.2 units/kg/day vs. 0.8 ± 0.3 units/kg/day) possibly due to an increased BMI (19.1 ± 3.7 kg/m2 vs. 20.9 ± 4.1 kg/m2, p=0.0001). The percentage of basal insulin in the TDD remained stable (p>0.05) (39.7 ± 11.3% vs. 39.3 ± 13.6%). Furthermore, a significant (p=0.0001) change in the BMI percentile was noticed [from 58.9 ± 26.2 percentiles (%iles) before lockdown vs. 64.6 ± 26.0%iles on the second visit]. However, the BMI percentile returned to baseline (58.1 ± 28.4%iles) at the visit at the end of the observation period.ConclusionsThe parameters of metabolic control in pediatric patients with T1D during the pandemic period remained stable; however, weight gain and an increase in daily insulin dose have been observed, possibly due to reduced physical activity.