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https://www.readbyqxmd.com/read/29138273/impact-of-excessive-weight-gain-on-cardiovascular-outcomes-in-type-1-diabetes-results-from-the-diabetes-control-and-complications-trial-epidemiology-of-diabetes-interventions-and-complications-dcct-edic-study
#1
Jonathan Q Purnell, Barbara H Braffett, Bernard Zinman, Rose A Gubitosi-Klug, William Sivitz, John P Bantle, Georgia Ziegler, Patricia A Cleary, John D Brunzell
OBJECTIVE: Intensive treatment (INT) of type 1 diabetes reduces the incidence of cardiovascular disease (CVD) events compared with conventional treatment (CONV), but it also results in more weight gain. Our objective was to examine whether excessive weight gain from INT of type 1 diabetes is independently associated with subsequent CVD events. RESEARCH DESIGN AND METHODS: Quartiles (Q) of weight gain in 1,213 participants aged 18 years and older at enrollment in the Diabetes Control and Complications Trial (DCCT) were determined within randomized treatment groups (INT vs...
November 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29118060/association-between-inflammatory-markers-and-progression-to-kidney-dysfunction-examining-different-assessment-windows-in-patients-with-type-1-diabetes
#2
Nathaniel L Baker, Kelly J Hunt, Danielle R Stevens, Gabor Jarai, Glenn D Rosen, Richard L Klein, Gabriel Virella, Maria F Lopes-Virella
OBJECTIVE: To determine whether biomarkers of inflammation and endothelial dysfunction are associated with the development of kidney dysfunction and the time frame of their association. RESEARCH DESIGN AND METHODS: Biomarkers were measured at four time points during 28 years of treatment and follow-up in patients with type 1 diabetes in the DCCT/EDIC cohort. In addition to traditional biomarkers of inflammation (C-reactive protein and fibrinogen), we measured interleukin-6 (IL-6) and soluble tumor necrosis factor receptors 1 and 2 (sTNFR-1/2), markers of endothelial dysfunction (soluble intracellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin [sE-selectin]), and fibrinolysis (total and active plasminogen activator inhibitor-1 [PAI-1])...
November 8, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29078730/barriers-to-engagement-in-collaborative-care-treatment-of-uncontrolled-diabetes-in-a-safety-net-clinic
#3
Brittaney Belyeu, Lydia Chwastiak, Joan Russo, Meghan Kiefer, Kathy Mertens, Lisa Chew, Sara L Jackson
Purpose The purpose of the study was to evaluate patient factors associated with nonengagement in a Diabetes Collaborative Care Team (DCCT) program in a safety-net clinic. Methods The first 18 months of a multidisciplinary care, team-based diabetes care management program in a safety-net primary care clinic were studied. Nonengagement was defined as fewer than 2 visits with a team member during the 18 months of the program. Patients who did not engage in the program were compared with those who did engage on demographics, comorbid medical and psychiatric diagnoses, and cardiovascular risk factors, using univariate and multivariable analyses...
December 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#4
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28711972/the-relationship-of-blood-glucose-with-cardiovascular-disease-is-mediated-over-time-by-traditional-risk-factors-in-type-1-diabetes-the-dcct-edic-study
#5
Ionut Bebu, Barbara H Braffett, Rodica Pop-Busui, Trevor J Orchard, David M Nathan, John M Lachin
AIMS/HYPOTHESIS: Chronic hyperglycaemia, as measured by HbA1c levels, is a major risk factor for atherosclerosis and cardiovascular disease (CVD) in type 1 diabetes. Our aim was to describe the degree to which the effect of HbA1c on the risk of CVD is mediated by its effect on traditional risk factors over time, and how these mediation pathways change over time. METHODS: The DCCT and its observational follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC), followed 1441 participants for a mean of 27 years, with periodic measurement of HbA1c and risk factors over time...
October 2017: Diabetologia
https://www.readbyqxmd.com/read/28550194/risk-of-severe-hypoglycemia-in-type-1-diabetes-over-30-years-of-follow-up-in-the-dcct-edic-study
#6
Rose A Gubitosi-Klug, Barbara H Braffett, Neil H White, Robert S Sherwin, F John Service, John M Lachin, William V Tamborlane
OBJECTIVE: During the Diabetes Control and Complications Trial (DCCT), intensive diabetes therapy achieving a mean HbA1c of ∼7% was associated with a threefold increase in the rate of severe hypoglycemia (defined as requiring assistance) compared with conventional diabetes therapy with a mean HbA1c of 9% (61.2 vs. 18.7 per 100 patient-years). After ∼30 years of follow-up, we investigated the rates of severe hypoglycemia in the DCCT/Epidemiology of Diabetes Inverventions and Complications (EDIC) cohort...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28430872/optimal-screening-schedules-for-disease-progression-with-application-to-diabetic-retinopathy
#7
Ionut Bebu, John M Lachin
Clinical management of chronic diseases requires periodic evaluations. Subjects transition between various levels of severity of a disease over time, one of which may trigger an intervention that requires treatment. For example, in diabetic retinopathy, patients with type 1 diabetes are evaluated yearly for either the onset of proliferative diabetic retinopathy (PDR) or clinically significant macular edema (CSME) that would require immediate treatment to preserve vision. Herein, we investigate methods for the selection of personalized cost-effective screening schedules and compare them with a fixed visit schedule (e...
April 20, 2017: Biostatistics
https://www.readbyqxmd.com/read/28423305/frequency-of-evidence-based-screening-for-retinopathy-in-type-1-diabetes
#8
RANDOMIZED CONTROLLED TRIAL
David M Nathan, Ionut Bebu, Dean Hainsworth, Ronald Klein, William Tamborlane, Gayle Lorenzi, Rose Gubitosi-Klug, John M Lachin
BACKGROUND: In patients who have had type 1 diabetes for 5 years, current recommendations regarding screening for diabetic retinopathy include annual dilated retinal examinations to detect proliferative retinopathy or clinically significant macular edema, both of which require timely intervention to preserve vision. During 30 years of the Diabetes Control and Complications Trial (DCCT) and its longitudinal follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study, retinal photography was performed at intervals of 6 months to 4 years...
April 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28404658/association-of-glycemic-variability-in-type-1-diabetes-with-progression-of-microvascular-outcomes-in-the-diabetes-control-and-complications-trial
#9
John M Lachin, Ionut Bebu, Richard M Bergenstal, Rodica Pop-Busui, F John Service, Bernard Zinman, David M Nathan
OBJECTIVE: The Diabetes Control and Complications Trial (DCCT) demonstrated the beneficial effects of intensive versus conventional therapy on the development and progression of microvascular complications of type 1 diabetes. These beneficial effects were almost completely explained by the difference between groups in the levels of HbA1c, which in turn were associated with the risk of these complications. We assessed the association of glucose variability within and between quarterly 7-point glucose profiles with the development and progression of retinopathy, nephropathy, and cardiovascular autonomic neuropathy during the DCCT...
June 2017: Diabetes Care
https://www.readbyqxmd.com/read/28302651/electrocardiographic-abnormalities-and-cardiovascular-disease-risk-in-type-1-diabetes-the-epidemiology-of-diabetes-interventions-and-complications-edic-study
#10
Elsayed Z Soliman, Jye-Yu C Backlund, Ionut Bebu, Trevor J Orchard, Bernard Zinman, John M Lachin
OBJECTIVE: We examined the association between the prevalence and incidence of electrocardiographic (ECG) abnormalities and the development of cardiovascular disease (CVD) in patients with type 1 diabetes, among whom these ECG abnormalities are common. RESEARCH DESIGN AND METHODS: We conducted a longitudinal cohort study involving 1,306 patients with type 1 diabetes (mean age 35.5 ± 6.9 years; 47.7% female) from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study...
June 2017: Diabetes Care
https://www.readbyqxmd.com/read/28197833/auxiliendo-primum-non-nocere-a-preliminary-view-of-the-devote-trial-comparing-cardiovascular-safety-of-insulin-degludec-versus-insulin-glargine-in-type-2-diabetes
#11
Sanjay Kalra
A demonstration of cardiovascular safety is mandatory for all newly developed glucose-lowering agents, including insulin analogues. The vascular benefit of insulin is evident from the Diabetes Control and Complication Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS), and the cardiovascular safety of insulin glargine has been demonstrated in individuals with newly diagnosed diabetes or prediabetes in the ORIGIN trial (Outcome Reduction with an Initial Glargine Intervention). The top-line results of DEVOTE (Trial Comparing Cardiovascular Safety of Insulin Degludec vs...
April 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27986796/association-of-cardiovascular-risk-factors-and-myocardial-fibrosis-with-early-cardiac-dysfunction-in-type-1-diabetes-the-diabetes-control-and-complications-trial-epidemiology-of-diabetes-interventions-and-complications-study
#12
Anderson C Armstrong, Bharath Ambale-Venkatesh, Evrim Turkbey, Sirisha Donekal, Elzbieta Chamera, Jye-Yu Backlund, Patricia Cleary, John Lachin, David A Bluemke, João A C Lima
OBJECTIVE: We investigated the association of cardiovascular risk factors and myocardial fibrosis with early cardiac dysfunction in type 1 diabetes. RESEARCH DESIGN AND METHODS: Participants with type 1 diabetes aged 13-39 years without a known history of cardiovascular disease (CVD) (n = 1,441) were recruited into the Diabetes Control and Complications Trial (1983-1993) and subsequently followed in the Epidemiology of Diabetes Interventions and Complications study (1994 to present)...
March 2017: Diabetes Care
https://www.readbyqxmd.com/read/27872156/association-between-blood-pressure-and-adverse-renal-events-in-type-1-diabetes
#13
RANDOMIZED CONTROLLED TRIAL
Elaine Ku, Charles E McCulloch, Michael Mauer, Stephen E Gitelman, Barbara A Grimes, Chi-Yuan Hsu
OBJECTIVE: To compare different blood pressure (BP) levels in their association with the risk of renal outcomes in type 1 diabetes and to determine whether an intensive glycemic control strategy modifies this association. RESEARCH DESIGN AND METHODS: We included 1,441 participants with type 1 diabetes between the ages of 13 and 39 years who had previously been randomized to receive intensive versus conventional glycemic control in the Diabetes Control and Complications Trial (DCCT)...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27803120/cardiovascular-autonomic-neuropathy-and-cardiovascular-outcomes-in-the-diabetes-control-and-complications-trial-epidemiology-of-diabetes-interventions-and-complications-dcct-edic-study
#14
RANDOMIZED CONTROLLED TRIAL
Rodica Pop-Busui, Barbara H Braffett, Bernie Zinman, Catherine Martin, Neil H White, William H Herman, Saul Genuth, Rose Gubitosi-Klug
OBJECTIVE: To examine whether cardiovascular autonomic neuropathy (CAN) is an independent risk factor of cardiovascular disease (CVD) events during DCCT/EDIC. RESEARCH DESIGN AND METHODS: Standardized cardiovascular autonomic reflex tests (R-R response to paced breathing, Valsalva maneuver, postural changes in blood pressure) were performed at DCCT baseline, every 2 years throughout DCCT, and at two time points in EDIC. CVD events were ascertained throughout the study and adjudicated by a review committee...
January 2017: Diabetes Care
https://www.readbyqxmd.com/read/27797889/albuminuria-changes-and-cardiovascular-and-renal-outcomes-in-type-1-diabetes-the-dcct-edic-study
#15
Ian H de Boer, Xiaoyu Gao, Patricia A Cleary, Ionut Bebu, John M Lachin, Mark E Molitch, Trevor Orchard, Andrew D Paterson, Bruce A Perkins, Michael W Steffes, Bernard Zinman
BACKGROUND AND OBJECTIVES: In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27766580/urogenital-autonomic-dysfunction-in-diabetes
#16
REVIEW
Barbara H Braffett, Hunter Wessells, Aruna V Sarma
This review details the epidemiology, possible mechanisms, and risk factors associated with urogenital autonomic dysfunction in diabetes. Autonomic neuropathy in diabetes is associated with various urological complications including bladder and sexual dysfunction. Several studies have reported the high prevalence of bladder and sexual dysfunction in both men and women. The DCCT/EDIC UroEDIC study examined the association between cardiovascular autonomic neuropathy and bladder and sexual dysfunction in a large cohort of participants with type 1 diabetes and was the first to report significant associations...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27678065/the-epidemiology-of-cardiovascular-disease-in-adults-with-type-1-diabetes
#17
Tina Costacou
BACKGROUND: In the era following the publication of results from the Diabetes Control and Complications Trial / Epidemiology of Diabetes Complications (DCCT/EDIC) study, care for patients with type 1 diabetes has dramatically improved. OBJECTIVE/METHODS: The present review specifically focused on the epidemiology of cardiovascular complications among adults with type 1 diabetes, summarizing evidence on the prevalence, incidence, mortality, as well as on predictors of cardiovascular disease in this population...
2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27647854/the-genetic-landscape-of-renal-complications-in-type-1-diabetes
#18
Niina Sandholm, Natalie Van Zuydam, Emma Ahlqvist, Thorhildur Juliusdottir, Harshal A Deshmukh, N William Rayner, Barbara Di Camillo, Carol Forsblom, Joao Fadista, Daniel Ziemek, Rany M Salem, Linda T Hiraki, Marcus Pezzolesi, David Trégouët, Emma Dahlström, Erkka Valo, Nikolay Oskolkov, Claes Ladenvall, M Loredana Marcovecchio, Jason Cooper, Francesco Sambo, Alberto Malovini, Marco Manfrini, Amy Jayne McKnight, Maria Lajer, Valma Harjutsalo, Daniel Gordin, Maija Parkkonen, Valeriya Lyssenko, Paul M McKeigue, Stephen S Rich, Mary Julia Brosnan, Eric Fauman, Riccardo Bellazzi, Peter Rossing, Samy Hadjadj, Andrzej Krolewski, Andrew D Paterson, Joel N Hirschhorn, Alexander P Maxwell, Claudio Cobelli, Helen M Colhoun, Leif Groop, Mark I McCarthy, Per-Henrik Groop
Diabetes is the leading cause of ESRD. Despite evidence for a substantial heritability of diabetic kidney disease, efforts to identify genetic susceptibility variants have had limited success. We extended previous efforts in three dimensions, examining a more comprehensive set of genetic variants in larger numbers of subjects with type 1 diabetes characterized for a wider range of cross-sectional diabetic kidney disease phenotypes. In 2843 subjects, we estimated that the heritability of diabetic kidney disease was 35% (P=6...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27632534/the-health-economic-value-of-changes-in-glycaemic-control-weight-and-rates-of-hypoglycaemia-in-type-1-diabetes-mellitus
#19
Phil McEwan, Hayley Bennett, Jonathan Fellows, Jennifer Priaulx, Klas Bergenheim
AIMS: Therapy-related consequences of treatment for type 1 diabetes mellitus (T1DM), such as weight gain and hypoglycaemia, act as a barrier to attaining optimal glycaemic control, indirectly influencing the incidence of vascular complications and associated morbidity and mortality. This study quantifies the individual and combined contribution of changes in hypoglycaemia frequency, weight and HbA1c to predicted quality-adjusted life-years (QALYs) within a T1DM population. MATERIALS AND METHODS: We describe the Cardiff Type 1 Diabetes (CT1DM) Model, originally informed by the Diabetes Control and Complications Trial (DCCT) and updated with the Epidemiology of Diabetes Interventions and Complications (EDIC) study and Swedish National Diabetes Registry for microvascular and cardiovascular complications respectively...
2016: PloS One
https://www.readbyqxmd.com/read/27539884/haptoglobin-2-2-genotype-and-the-risk-of-coronary-artery-disease-in-the-diabetes-control-and-complications-trial-epidemiology-of-diabetes-interventions-and-complications-study-dcct-edic
#20
Trevor J Orchard, Jye-Yu C Backlund, Tina Costacou, Patricia Cleary, Maria Lopes-Virella, Andrew P Levy, John M Lachin
AIMS/HYPOTHESIS: Haptoglobin(Hp) 2-2 genotype has been shown to increase coronary artery disease (CAD) risk in numerous type 2 diabetes studies but in only one type 1 diabetes cohort. We assessed the association of Hp2-2 with incident CAD over 26years of follow-up in 1303 Caucasian participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. METHODS: DCCT randomized volunteers with type 1 diabetes to intensive versus conventional therapy within two cohorts: 'primary prevention' with 1-5years diabetes duration and 'secondary intervention' with 1-15years diabetes duration and early retinopathy, with or without albuminuria, but no advanced complications...
November 2016: Journal of Diabetes and its Complications
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