Positive Family History Of Type Research Articles

Determinants of Type 2 Diabetes Mellitus among Children and Adolescents Attending A Tertiary Specialized Hospital in Bangladesh

Background: Type 2 diabetes in children and adolescents has increased in frequency around the world over the past two decades. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes in children and adolescents. Objective: To observe the determinants of type 2 diabetes mellitus among children and adolescents attending a tertiary specialized hospital in Bangladesh. Methods: This cross-sectional, descriptive study was done on a total of 151 children and adolescents attending the pediatric diabetic outpatient department (OPD) of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine, and Metabolic Disorders (BIRDEM) Hospital, Dhaka, Bangladesh. The sampling technique was purposive. All patients who came to the hospital between July to December 2017 were included. Data was collected through a structured questionnaire. Results: Among 151 respondents, 98 were in the age group of 10-14 years (64.9%), female to male ratio of 1.22:1. The majority belonged to a high used to lead socio-economic class. Regarding food habits, 55.6% had a history of eating fast food regularly and used to lead a sedentary lifestyle with a lack of exercise. 43.7% of children and adolescents were obese 76.8% had high cholesterol and 84.1% had high triglyceride levels. Most of the children had a positive family history of type 2 diabetes mellitus (74.8%). Conclusion: Our study reflects that determinants like obesity, physical inactivity, eating habits, and family history are important factors in the development of type 2 diabetes mellitus in children and adolescents.  Mugda Med Coll J. 2023; 6(2): 51-56

Postprandial And Fasting Lipopolysaccharide Levels In Healthy Hispanic Residents Of Southeast Texas With Positive Family History Of Type 2 Diabetes

Postprandial And Fasting Lipopolysaccharide Levels In Healthy Hispanic Residents Of Southeast Texas With Positive Family History Of Type 2 Diabetes

Idiopathic remitting type 1 diabetes: a case report

AbstractWe describe a case of diabetes remission in a 17‐year‐old male initially diagnosed and treated as having type 1 diabetes, who has since stopped insulin and remained off all diabetes treatments since December 2017.This individual, a Caucasian male, presented aged 17 years with symptoms of polyuria and polydipsia in 2015. His BMI was 23kg/m2. Type 1 diabetes was diagnosed based on a formal laboratory glucose of 32.7mmol/L and an HbA1c of 86mmol/mol (10%). Blood ketones were 2.4mmol/L with a normal venous blood gas and a bicarbonate of 27nmol/L. A positive family history of type 1 diabetes in a maternal aunt was noted.The insulin requirements consistently fell from 21 months post‐diagnosis, with persistent normal range HbA1c (30mmol/mol, 4.9%). At 28 months, insulin was stopped due to increasing frequency of hypoglycaemic events. Initially, a honeymoon period was suspected; however, he has remained off all treatment, for almost five years.To our knowledge this is the first case report meeting the diagnostic criteria for idiopathic remitting diabetes first published in 2014. Further reports of individuals meeting these criteria are essential to provide information about the natural history of idiopathic remitting diabetes and answer questions about rates of relapse and possible underlying aetiology. Copyright © 2023 John Wiley & Sons.

Prevalence of Vitamin B12 Deficiency in Type 2 Diabetes Mellitus Patients on Metformin Therapy.

Background Long-term metformin treatment in individuals with type 2 diabetes mellitus causes vitamin B12 insufficiency, which is typically neglected, undetected, and under-treated. A severe deficit may cause life-threatening neurological problems. This study assessed the prevalence of vitamin B12 deficiencies among T2DM patients and its factors at a tertiary hospital in the Tamil Nadu district of Salem. Materials and Methods This is an analytical cross-sectional study conducted in a tertiary care hospital in the Salem district, Tamil Nadu, India. Patients with type 2 diabetes mellitus who were prescribed metformin at the outpatient department of general medicine took part in the trial. Our research instrument was a structured questionnaire. We used a questionnaire containing information on sociodemographic characteristics, metformin use among diabetic mellitus patients, diabetes mellitus history, lifestyle behaviors, anthropometric measurement, examination findings, and biochemical markers. Prior to administering the interview schedule, each participant's parents provided written informed consent. A thorough medical history, physical exam, and anthropometric examination were performed. Data were entered in Microsoft Excel (Microsoft Corporation, Redmond, WA) and analyzed using SPSS version 23 (IBM Corp., Armonk, NY). Results Among the study participants, we diagnosed nearly 43% of diabetes cases in participants between the ages of 40-50 years, while we diagnosed 39%aged under 40 years. Nearly 51% had diabetes for 5-10 years, while only 14% had diabetes for over 10 years. In addition, 25% of the study sample had a positive family history of type 2 diabetes. Nearly 48% and 13% of the study group had been on metformin for 5-10 years and >10 years, respectively. The majority, 45%, were found to take 1000 mg of metformin per day, whereas just 15% take 2 g per day. In our study, the prevalence of vitamin B12 insufficiency was 27%, and nearly 18% had borderline levels. The duration of diabetes mellitus, the duration of metformin intake, and the dose of metformin were statistically significant (p-value = 0.05) among the variables associated with diabetes mellitus and vitamin B12 deficiency. Conclusion The results of the study show that a deficiency in vitamin B12 increases the likelihood that diabetic neuropathy would worsen. Therefore, individuals with diabetes who take larger dosages of metformin (more than 1000mg)for an extended period must have their vitamin B12 levels monitored often. Preventative or therapeutic vitamin B12 supplementation can mitigate this issue.

LBODP049 Clinical And Biochemical Markers In Early Pregnancy For Prediction Of Gestational Diabetes Mellitus

Abstract Background Early identification of Gestational Diabetes Mellitus (GDM) is pivotal to reduce feto-maternal complications associated with the disease. Current risk prediction models that are based on maternal clinical and biochemical parameters lack a strong predictive value. Objective To evaluate the early trimester maternal parameters for prediction of gestational diabetes mellitus. Methods In this prospective observational study, we screened 581 consecutive healthy women with singleton pregnancy for GDM during their first antenatal visit. After informed consent, fasting blood samples were collected and stored at -800C. GDM was diagnosed as per IADPSG criteria. During prospective follow up, total 55 patients developed GDM. A total of 110 age and BMI matched controls were recruited for comparison. In all women, we measured Oral Glucose Tolerance test (OGTT) with 75 gm anhydrous glucose, fasting insulin, HbA1c, hsCRP, uric acid and Lipid Profile. HOMA-IR, HOMA-β and QUICKI were used to evaluate insulin sensitivity and β-cell function. Results Significant higher proportion of subjects in GDM cohort had presence of acanthosis nigricans and positive family history of Type 2 Diabetes Mellitus in first degree relative. The GDM cohort had significantly higher median waist circumference, 2hr plasma glucose (2hr PPG), HbA1c, fasting insulin, HOMA-IR, uric acid and serum triglyceride levels. The receiver operating characteristic (ROC) curve were as follows: HbA1c - 0.74 (95%CI: 0.661–0.819), Fasting Insulin - 0.748 (95%CI: 0.671–0.826), high sensitivity C-Reactive Protein (hsCRP) - 0.689 (95%CI: 0.605 - 0.773) and Uric acid - 0.718 (95%CI: 0.635–0.802). Multiple regression analysis revealed HbA1c (OR 5.264; p=0. 007), 2hr PPG (OR 1. 026; p=0. 035), QUIKI (OR 1. 057; p=0. 016), uric acid (OR 1. 039; p=0. 013) and neutrophil: lymphocyte ratio (OR 1.545; p=1. 008) to be independently associated with GDM outcome with combined area under the curve (AUC) of 0.850, a sensitivity of 72.7% and a specificity of 87.3%. Conclusions Fasting Insulin, HbA1c, HOMA-IR, hsCRP and Uric acid levels are significantly increased in early pregnancy in individuals who develop GDM subsequently, compared to women who did not develop GDM. Hence utilization of these parameters may identify at risk group in routine clinical care and help in improving feto-maternal outcome. Presentation: No date and time listed

Metabolic determinants of NAFLD in adults with type 1 diabetes

AimTo assess the main metabolic determinants of non-alcoholic fatty liver disease (NAFLD) in adult patients with type 1 diabetes (T1D). Methods115 patients with T1D were divided into 4 groups according to NAFLD grade. NAFLD was diagnosed via transient elastography when CAP > 233 dB/m. Body composition was evaluated by Inbody720, Biospace. Serum lipids, liver enzymes, uric acid, creatinine, hsCRP and HbA1c were evaluated at fasting. ResultsThe overall prevalence of NAFLD was 47% (n = 54). In the subgroup with BMI > 25 kg/m2 NAFLD prevalence was 66%; and positive family history of type 2 diabetes brought the risk up to 76%. 37% of the lean individuals also had NAFLD. HbA1c > 7% doubled the risk of NAFLD. Waist circumference > 82.5 cm was independently related to NAFLD, accounting for 24% of its variation in females. Accumulation of two and three metabolic syndrome (MetS) components, besides hyperglycemia, increased the risk of NAFLD by 14% (p < 0.0001) and 6% (p = 0.024), respectively. Lean NAFLD correlated with total insulin dose; NAFLD in overweight T1D patients correlated with triglycerides. ConclusionsNAFLD is highly prevalent in adults with T1D and obesity or other metabolic derangements and might be independently related to poor long-term glycemic control and waist circumference in females.

Plasma miR-21 as a potential predictor in prediabetic individuals with a positive family history of type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a heritable metabolic perturbation, rapidly growing across the world. Primary recognition of susceptible individuals with a family history of type 2 diabetes (FHD) in the prediabetes stage could delay the onset of T2DM or reduce complications induced by diabetes. This study aims to evaluate the expression levels of miR‐21, miR‐126 as noninvasive predictive biomarkers in individuals with genetic predisposition and investigate the correlation of miRNAs and cardiometabolic risk factors. Our study demonstrated that miR‐21 expression has a notable elevate in both groups of T2DM and pre‐T2DM. miR‐21 expression was distinguished in the pre‐T2DM and T2DM from the nondiabetic individuals by ROC curve analysis with AUC of 0.77 (95% CI 0.65–0.90; p = 0.0004) and AUC of 0.78 (95% CI 0.64–0.92; p = 0.0042), respectively. The relative gene expression of miR‐126 was nearly equal among groups. miR‐21 expression was positively associated with glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and triglyceride (TG) and might have diagnostic value for T2DM and pre‐T2DM. This study has revealed that the expression level of miR‐21 can be considered as a non‐invasive and rapid tool for distinguishing pre‐T2DM and T2DM counterparts from healthy individuals.

Frequency of Metabolic Syndrome in Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangladesh

Background: As a well-established risk factor for coronary heart disease, Metabolic Syndrome was already encountered. But the relationship between Metabolic Syndrome and Type 2 Diabetes Mellitus and the independent contribution of Metabolic Syndrome remained unclear. To evaluate the status of metabolic syndrome in the Type 2 diabetic population and for their ability to predict Type 2 Diabetes Mellitus, in parallel with conventional stroke risk factors, this study was planned. Methods: A hospital-based descriptive observational study was conducted in 100 patients with Type 2 Diabetes Mellitus who were selected by consecutive random sampling techniques. Patients were diagnosed through proper history, clinical examination, and necessary investigations. The outcome values were measured in anthropometric measurements, blood pressure, dyslipidemia, and blood glucose. Results: Among 100 patients with Type 2 Diabetes Mellitus, (64%) were females who were housewives (41%) with significant difference (p &lt; 0.001) and Mean± SD was 58±12.24 yrs ranging from 32-85 years. About 30% had a positive family history of Type 2 Diabetes Mellitus and 28% tobacco abuse. Of the total, 31% of patients had high blood pressure, and 28% had low HDL with a significant difference (p&lt;0.001), but 46% had high triglyceride levels, which was not significant. More than half (53.12%) females showed central obesity, while only 16.67% had central obesity among males, and it showed a significant difference (p=0.04) in both sex. There was a high frequency of Metabolic Syndrome in a patient with Type 2 Diabetes Mellitus (68%) with a significant difference, and 48% were female, and 20 % were male. In patients of Metabolic Syndrome, central obesity was found in 36(52.94%) patients where females were predominantly affected 32(88.89%), hypertension found in 28(4118%) patients where male were predominantly affected 16(57.14%) patients, hypertriglyceridemia found in 44(64.70%) patients where a female was predominantly affected 26(59.09%) patients and low HDL found in 22(32.35%) patients where a female was predominantly affected 16(72.73%). Conclusion: The frequency of Metabolic Syndrome was more than double in women (48%). Central obesity and low HDL were significantly more prevalent in women than men, where hypertension was significant in men. So it would be reasonable to conclude that women are more likely to suffer from Metabolic Syndrome from cardiovascular morbidity and mortality.

Screening for non-invasive risk factors of type 2 diabetes in overweight and obese schoolchildren

IntroductionThe prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. ObjectiveTo explore school children at high-risk for T2DM in Jordan. Materials and methodsA descriptive cross-sectional study was conducted. The children were 10–14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three child́s risk factors were identified. ResultsEight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. ConclusionRisk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.

Challenge of coexisting type 2 diabetes mellitus and insulinoma: a case report

BackgroundInsulinomas are rare clinical entities, but concurrent diabetes mellitus is even more uncommon, and the combination is easily missed. Recurrent hypoglycemia could be misconstrued as improved glycemic control. We present an unusual patient with type 2 diabetes and neuroglycopenia, with apparent improved glycemic control due to an insulinoma.Case presentationA 54-year-old mixed ancestry man with a positive family history of type 2 diabetes mellitus was diagnosed with type 2 diabetes mellitus and hypertension 8 years prior to admission. He presented with episodes of abnormal behavior and hypoglycemia. Inappropriately high insulin and C-peptide concentrations were identified at the time of hypoglycemia. Despite poor adherence to his diabetic treatment, he had no target organ damage relating to diabetes, and his hemoglobin A1c (HbA1c) was 5.3%. A diagnosis of insulinoma was made, and he was started on diazoxide, with endoscopic ultrasound revealing a possible lesion in the pancreatic tail measuring 12 mm × 12 mm. A fine-needle aspiration biopsy could not be performed due to overlying splenic arteries and the risk of vascular perforation. An intraoperative ultrasound confirmed a 15 mm × 10 mm tumor in the pancreatic tail, necessitating a partial pancreatectomy and splenectomy, which were curative. A well-differentiated intermediate grade 2 pancreatic neuroendocrine tumor producing insulin was confirmed on histopathology.ConclusionsRecurrent, progressive hypoglycemia and improved glycemic control in a diabetic, without an alternative explanation, may suggest an insulinoma. Insulinomas that exist with type 1 diabetes mellitus, particularly malignant insulinomas, must have escaped autoimmune attack through lack of autoantigen expression. Computed tomography on its own may be insufficiently sensitive for diagnosis of insulinomas, whereas endoscopic and intraoperative ultrasonography may improve the identification of the culprit lesion.

Impaired postprandial skeletal muscle vascular responses to a mixed meal challenge in normoglycaemic people with a parent with type 2 diabetes.

Microvascular blood flow (MBF) increases in skeletal muscle postprandially to aid in glucose delivery and uptake in muscle. This vascular action is impaired in individuals who are obese or have type 2 diabetes. Whether MBF is impaired in normoglycaemic people at risk of type 2 diabetes is unknown. We aimed to determine whether apparently healthy people at risk of type 2 diabetes display impaired skeletal muscle microvascular responses to a mixed-nutrient meal. In this cross-sectional study, participants with no family history of type 2 diabetes (FH-) for two generations (n = 18), participants with a positive family history of type 2 diabetes (FH+; i.e. a parent with type 2 diabetes; n = 16) and those with type 2 diabetes (n = 12) underwent a mixed meal challenge (MMC). Metabolic responses (blood glucose, plasma insulin and indirect calorimetry) were measured before and during the MMC. Skeletal muscle large artery haemodynamics (2D and Doppler ultrasound, and Mobil-O-graph) and microvascular responses (contrast-enhanced ultrasound) were measured at baseline and 1h post MMC. Despite normal blood glucose concentrations, FH+ individuals displayed impaired metabolic flexibility (reduced ability to switch from fat to carbohydrate oxidation vs FH-; p < 0.05) during the MMC. The MMC increased forearm muscle microvascular blood volume in both the FH- (1.3-fold, p < 0.01) and FH+ (1.3-fold, p < 0.05) groups but not in participants with type 2 diabetes. However, the MMC increased MBF (1.9-fold, p < 0.01), brachial artery diameter (1.1-fold, p < 0.01) and brachial artery blood flow (1.7-fold, p < 0.001) and reduced vascular resistance (0.7-fold, p < 0.001) only in FH- participants, with these changes being absent in FH+ and type 2 diabetes. Participants with type 2 diabetes displayed significantly higher vascular stiffness (p < 0.001) compared with those in the FH- and FH+ groups; however, vascular stiffness did not change during the MMC in any participant group. Normoglycaemic FH+ participants display impaired postprandial skeletal muscle macro- and microvascular responses, suggesting that poor vascular responses to a meal may contribute to their increased risk of type 2 diabetes. We conclude that vascular insulin resistance may be an early precursor to type 2 diabetes in humans, which can be revealed using an MMC.

Repetitiveness of the oral glucose tolerance test in children and adolescents.

BACKGROUNDData regarding the most suitable diagnostic method for the diagnosis of glucose impairment in asymptomatic children and adolescents are inconclusive. Furthermore, limited data are available on the reproducibility of the oral glucose tolerance test (OGTT) in children and adolescents who are obese (OB).AIMTo investigate the usefulness of the OGTT as a screening method for glucose dysregulation in children and adolescents.METHODSEighty-one children and adolescents, 41 females, either overweight (OW), OB or normal weight (NW) but with a strong positive family history of type 2 diabetes mellitus (T2DM), were enrolled in the present observational study from the Outpatient Clinic of Paediatric Endocrinology of the University Hospital of Patras in Greece. One or two 3-h OGTTs were performed and glucose, insulin and C-peptide concentrations were measured at several time points (t = 0 min, t = 15 min, t = 30 min, t = 60 min, t = 90 min, t = 120 min, t = 180 min).RESULTSGood repetitiveness was observed in the OGTT response with regard to T2DM, while low repetitiveness was noted in the OGTT response with regard to impaired glucose tolerance (IGT) and no repetitiveness with regard to impaired fasting glucose (IFG). In addition, no concordance was observed between IFG and IGT. During the 1st and 2nd OGTTs, no significant difference was found in the glucose concentrations between NW, OW and OB patients, whereas insulin and C-peptide concentrations were higher in OW and OB compared to NW patients at several time points during the OGTTs. Also, OW and OB patients showed a worsening insulin and C-peptide response during the 2nd OGTT as compared to the 1st OGTT.CONCLUSIONIn mild or moderate disorders of glucose metabolism, such as IFG and IGT, a diagnosis may not be reached using only one OGTT, and a second test or additional investigations may be needed. When glucose metabolism is profoundly impaired, as in T2DM, one OGTT is probably more reliable and adequate for establishing the diagnosis. Excessive weight and/or a positive family history of T2DM possibly affect the insulin and C-peptide response in the OGTT from a young age.

Screening for non-invasive risk factors of type 2 diabetes in overweight and obese schoolchildren

IntroductionThe prevalence of type 2 diabetes mellitus (T2DM) is increasing among young people worldwide. The American Diabetes Association has defined the risk factors that are associated with this increased risk for developing T2DM in youths. ObjectiveTo explore school children at high-risk for T2DM in Jordan. Materials and methodsA descriptive cross-sectional study was conducted. The children were 10–14.9 years old. Weight, height, and waist circumference were measured, and the body mass index Z score (BMI) was determined. The waist to height ratio (WHtR) was calculated. Blood pressure was measured and three child́s risk factors were identified. ResultsEight hundred and seventy-one schoolchildren were screened; 26.0% were overweight and 19.3% were obese. The most common risk factor among overweight and obese children, accounting for 80.4%, was a positive family history of type 2 diabetes mellitus in first- or second-degree relatives. Children born to mothers with diabetes or gestational diabetes mellitus during the child's gestation represented 17.3%, and around 26.8% were found to have hypertension (stage 1 or 2). In relation to the risk factors, 12.6% presented no risk factors; 54.0% had at least one factor; 29.1% two risk factors and 4.3% had three risk factors. ConclusionRisk factors for T2DM are very common. Around 54% had one risk factor. Strategies aimed at reducing risk factors for T2DM, especially obesity, among Jordanian school children are urgently needed.

High Prevalence of Toxoplasma gondii Infection in Type I Diabetic Patients.

Background Type I diabetes (TΙDM) is a genetic or autoimmune disorder, which may be stimulated by induced immune system components due to the underlying infectious diseases. This study was undertaken to find out any possible association between Toxoplasma gondii infection and TIDM. Materials and Methods One hundred and eighty-two blood samples were taken from individuals who were referred to outpatient clinics in Shiraz city, Southern Iran, during a 6-month period. The age of type I diabetic subjects (n = 91) and the control group (n = 91) was identical, which were less than 30 years. The sera were examined for IgG and IgM antibodies by ELISA and correlated with epidemiological factors such as age, sex, and family history of diabetes. Results Out of 91 diabetic patients, 54 (59.3%) were female and 37 (40.7%) were male. The highest frequency of diabetes belonged to 6-10- and 11-15-year groups (P = 0.17). Toxoplasma infection prevalence in diabetic and control groups was 28.6% and 7.7%, respectively (P = 0.001). A significantly positive family history of diabetes was observed between diabetic patients (31 cases, 34.1%) and the control group (3 cases, 3.3%) (P = 0.01). Interestingly, IgG positivity was seen in 13 cases (41.9%) of patients with positive family history of type I diabetes and 13 cases (21.7%) of subjects with no positive family history of type I diabetes (P = 0.04). Conclusion Our study showed a higher prevalence of Toxoplasma infection in type I diabetes patients. It is likely that the prevalence of TIDM decreases by increasing hygiene and preventing toxoplasmosis.

Dietary intake and anthropometric indices in Mexican medical students, stratified by family history of Type 2 Diabetes

Introduction: Our aim was to evaluate the dietary intake and anthropometric indices in medical students with positive family history of type 2 diabetes (FH-T2D)(+) and without FH-T2D(-).Material and methods: 144 students were analyzed in this cross-sectional, observational study, conducted during the 2017-2018 school year using interviews and 7-day food diary. The participants were characterized anthropometrically. Waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), corrected mid-arm muscle area (MAMA), fat arm index (FAI), and tricipital skinfold (TSF) were calculated. Results: we found that 79.2% (95%CI: 72.5- 85.8) had FH-T2D. BMI was significantly higher in the participants with FH-T2D than without (23.7±3.8 v 25.0±3.7, respectively, p&lt;0.05). No significant differences were determined in the indices based on central fat distribution (WHtR and WHR), peripheral distribution (FAI and TSF), or muscle mass (MAMA), when stratified by FH-T2D. Regarding dietary intake, when comparing participants with and without FH-T2D, respectively, we observed low/none legume consumption [30% (95%CI: 21.4-38.2) vs 23% (95%CI: 8.2-38.5)], diets high in proteins [38.6% (95%CI: 29.7-47.5) vs 46.7% (95%CI: 28.8-64.5)], low in carbohydrates [84.2% (95%CI: 77.5-90.9) vs 83.3% (95%CI: 70.0-96.7)], and insufficient energy intake [64% (95%CI: 55.2-72.8) vs 56.7% (95%CI: 38.9-74.4)], where the alterations in the dietary pattern were more detrimental for the FH-T2D(+) group. Lastly, the participants with FH-T2D consumed mainly late in the day [60% (95%CI: 50.6-68.6) vs 54% (95%CI: 35.5-71.2)].Conclusions: Even though there were minimal significant differences with the consumption by food categories, those students with FH-T2D presented with a poor, little varied and unbalanced dietary pattern with energy consumption mainly at night. These factors, if prolonged, could increase the risk of developing type 2 diabetes.

Family history of type 2 diabetes and characteristics of children with newly diagnosed type 1 diabetes

Aims/hypothesisShared aetiopathogenetic factors have been proposed in type 1 diabetes and type 2 diabetes and both diseases have been shown to cluster in families. Characteristics related to type 2 diabetes have been described in patients with type 1 diabetes with a positive family history of type 2 diabetes. We wanted to characterise the family history of type 2 diabetes and its possible effects on the phenotype and genotype of type 1 diabetes in affected children at diagnosis.MethodsA total of 4993 children under the age of 15 years with newly diagnosed type 1 diabetes from the Finnish Pediatric Diabetes Register were recruited (56.6% boys, median age of 8.2 years) for a cross-sectional, observational, population-based investigation. The family history of diabetes at diagnosis was determined by a structured questionnaire, and markers of metabolic derangement, autoantibodies and HLA class II genetics at diagnosis were analysed.ResultsTwo per cent of the children had an immediate family member and 36% had grandparents with type 2 diabetes. Fathers and grandfathers were affected by type 2 diabetes more often than mothers and grandmothers. The children with a positive family history for type 2 diabetes were older at the diagnosis of type 1 diabetes (p < 0.001), had higher BMI-for-age (p = 0.01) and more often tested negative for all diabetes-related autoantibodies (p = 0.02).Conclusions/interpretationFeatures associated with type 2 diabetes, such as higher body weight, older age at diagnosis and autoantibody negativity, are more frequently already present at the diagnosis of type 1 diabetes in children with a positive family history of type 2 diabetes.Graphical abstract

All things considered, my risk for diabetes is medium: A risk personalization process of familial risk for type 2 diabetes.

BackgroundA positive family history of type 2 diabetes (T2D) has been associated with risk awareness and risk‐reducing behaviours among the unaffected relatives. Yet, little is known about how people with a positive family history for diabetes develop and manage their personal sense of risk.ObjectiveTo characterize two key concepts, salience and vulnerability, within the familial risk perception (FRP) model among unaffected individuals, at increased familial risk for T2D.DesignWe conducted a mixed method study. Descriptions of salience and vulnerability were collected through semi‐structured interviews. Participant's perception of self‐reported risk factors (family history, age, race/ethnicity, medical history, weight and exercise) was measured using the Perceived Risk Factors for T2D Tool and was compared to a clinical evaluation of the same risk factors.ResultsWe identified two components of salience: (a) concern for developing T2D and (b) risk awareness triggers, and two features of vulnerability: (a) statement of risk and (b) risk assessment devices. Although few participants (26%) were concordant between their perceived and clinical overall T2D risk, concordance for individual risk factors was higher, ranging from 42% (medical history) to 90% (family history).Discussion and conclusionBoth familial and non‐familial events lead people to contemplate their T2D risk, even among people who have a positive family history. Participants often downplayed their overall risk and underestimated their overall risk compared to a clinical risk assessment of the same self‐reported risk factors. Clinicians could leverage key components of the FRP process as way to engage patients in risk reduction strategies earlier.

Severe 25(OH)vitamin-D deficiency: A risk factor for development of gestational diabetes mellitus

ObjectiveTo estimate the level of 25 (OH)vitamin D in gestational diabetes mellitus (GDM) and to find the correlation between level of 25(OH)vitamin D and GDM. Materials and methodsThe study was conducted on 50 diagnosed patients of GDM attending antenatal clinic in the obstetrics and gynecology department of Pt. B.D. Sharma PGIMS, Rohtak. 50 age and gestational age matched normoglycemic women were taken as control group. Procedure of study was explained to the participants and informed consent was taken. ResultsGDM women had higher age, BMI, and positive family history of type 2 DM as compared to pregnant women without GDM. The mean vitamin D in GDM women was 32.64 ± 24.33 nmol/L while in controls it was 39.90 ± 21.86 nmol/L(P = 0.033). The prevalence of severe vitamin D deficiency(<25 nmol/L) was found to be 44% among GDM women (22 out of 50 GDM women) and 20% among women with normoglycemia (10 out of 50 normoglycemic controls) with significant p value of 0.010 and odds ratio of 1.833. GDM women with BMI>25 kg/m2 had 1.799 times chances to be severely deficit in vitamin D than women with BMI<25 kg/m2 6 GDM women had mild vitamin D deficiency (>50 but <75 nmol/L) and 16 had moderate deficiency (>25 but <50 nmol/L). Only 6 GDM patients were found to be sufficient for vitamin D(>75 nmol/L). ConclusionSevere vitamin D deficiency in second trimester of pregnancy is significantly associated with elevated risk for GDM.

Insulin Resistance Index and Proatherogenic Lipid Indices in the Offspring of People with Diabetes

Background: Diabetes mellitus and cardiovascular diseases significantly contribute to medical morbidity and mortality worldwide, especially in developing countries like Nigeria. Insulin resistance, a characteristic finding of type 2 diabetics and their offspring, is associated with an abnormal lipid metabolism and cardiovascular disease. Aims: This study therefore aims to determine the pattern of lipid biomarkers of atherogenesis and their relationship with insulin resistance index in young people with a family history of diabetes mellitus. Methods: This is a cross-sectional study carried out among 150 apparently healthy young adults between 18 and 25 years of age, including 76 with a family history of diabetes mellitus in first- and/or second-degree relatives (YWFH) and 74 with no family history of diabetes mellitus (YWoFH). Anthropometric characteristics, insulin resistance index, plasma glucose, fasting lipid profile (plasma total cholesterol, triglycerides [TG], high-density lipoprotein cholesterol, low-density lipoprotein cholesterol), and serum levels of insulin, lipoprotein(a) [Lp(a)], apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA-1), and ApoB/ApoA-1 ratios were compared in the 2 groups. Plasma glucose, total cholesterol, high-density cholesterol, and TG were measured using standard methods. The Friedewald equation was used to calculate low-density cholesterol. Serum insulin, Lp(a) levels, ApoB, and ApoA-1 were also measured using standard assays. The insulin resistance index was determined using homeostatic model assessment (HOMA). Statistical analysis was performed using SPSS version 20.0. Comparisons between variables were performed using the Mann-Whitney U test, and correlations between variables were performed using Spearman rank correlation coefficients. The level of significance was set at p < 0.05. Results: Offspring of diabetics (YWFH) had a significantly higher median BMI (p = 0.015), waist-to-hip ratio (WHR; p = 0.002), insulin resistance index (p = 0.038), total cholesterol (p = 0.017), TG (p = 0.004), Lp(a) (p = 0.045), ApoB (p = 0.002), and ApoB/ApoA-1 ratio (p = 0.001) than the age-matched control group with no family history of diabetes mellitus (YWoFH). There was no correlation between the insulin resistance index and each of the lipid biomarkers of atherogenesis except Lp(a), with which it was negatively correlated. Conclusion: This study demonstrates that a positive family history of type 2 diabetes mellitus is associated with a higher insulin resistance index and elevated atherogenic lipid indices; thus, a positive family history of diabetes mellitus in first or second-degree relatives when the index person is not diabetic confirms a significant cardiovascular risk.

Serum Matrix Metalloproteinase 9 and Macrophage Migration Inhibitory Factor (MIF) Are Increased in Young Healthy Nonobese Subjects with Positive Family History of Type 2 Diabetes.

Insulin resistance increases the risk for cardiovascular disease (CVD) even in the absence of classic risk factors, such as hyperglycemia, hypertension, dyslipidemia, and obesity. Low-grade chronic inflammatory state is associated both with insulin resistance and atherosclerosis. An increased circulating level of proinflammatory proatherogenic factors and biomarkers of endothelial activation was observed in diabetes and CVD. The aim of our study was to assess serum proatherogenic and proinflammatory factors in young healthy nonobese subjects with positive family history of type 2 diabetes. We studied 74 young healthy nonobese subjects with normal glucose tolerance (age < 35 years, BMI < 30 kg/m2), 29 with positive family history of type 2 diabetes (relatives, 25 males and 4 females) and 45 subjects without family history of diabetes (control group, 39 males and 6 females). Hyperinsulinemic-euglycemic clamp was performed, and serum concentrations of monocyte chemoattractant protein-1 (MCP-1), interleukin 18 (IL-18), macrophage inhibitory cytokine 1 (MIC-1), macrophage migration inhibitory factor (MIF), matrix metalloproteinase (MMP-9), and soluble forms of adhesion molecules were measured. Relatives had markedly lower insulin sensitivity (p = 0.019) and higher serum MMP-9 (p < 0.001) and MIF (p = 0.006), but not other chemokines and biomarkers of endothelial function. Insulin sensitivity correlated negatively with serum MMP-9 (r = −0.23, p = 0.045). Our data show that young healthy subjects with positive family history of type 2 diabetes already demonstrate an increase in some nonclassical cardiovascular risk factors.