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Tina Costacou
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. Despite these significant advancements in knowledge regarding the management of this chronic disease, however, individuals with type 1 diabetes continue to experience increased morbidity and mortality compared to the general population. 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...
September 27, 2016: Current Diabetes Reviews
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, Jaakko Tuomilehto, Valeriya Lyssenko, Paul M McKeigue, Stephen S Rich, Mary Julia Brosnan, Eric Fauman, Riccardo Bellazzi, Peter Rossing, Samy Hadjadj, Andrzej Krolewski, Andrew D Paterson, Jose C Florez, Joel N Hirschhorn, Alexander P Maxwell, David Dunger, 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...
September 19, 2016: Journal of the American Society of Nephrology: JASN
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
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
Michael A Grassi, Vidhya R Rao, Siquan Chen, Dingcai Cao, Xiaoyu Gao, Patricia A Cleary, R Stephanie Huang, Andrew D Paterson, Rama Natarajan, Jalees Rehman, Timothy S Kern
BACKGROUND: White blood cells have been shown in animal studies to play a central role in the pathogenesis of diabetic retinopathy. Lymphoblastoid cells are immortalized EBV-transformed primary B-cell leukocytes that have been extensively used as a model for conditions in which white blood cells play a primary role. The purpose of this study was to investigate whether lymphoblastoid cell lines, by retaining many of the key features of primary leukocytes, can be induced with glucose to demonstrate relevant biological responses to those found in diabetic retinopathy...
2016: PloS One
J Tian, Y Xie, K Ren, T Chen, P Brewster, C Drummond, W He, D Kennedy, S Haller, C Cooper
OBJECTIVE: Accurate assessment of glomerular filtration rate (GFR) is important in ascertaining health status, especially in older individuals and in populations at risk of chronic kidney disease. Recently we observed that smokers with renal artery stenosis and renovascular hypertension had lower GFR when estimated by cystatin-C, than with creatinine-based estimates. We sought to resolve this issue. DESIGN AND METHOD: Data from the Diabetes Control and Complications Trial (DCCT) were used to estimate GFR in individuals with diabetes...
September 2016: Journal of Hypertension
Sirous Darabian, Jye-Yu C Backlund, Patricia A Cleary, Nasim Sheidaee, Ionut Bebu, John M Lachin, Matthew J Budoff
INTRODUCTION: Type 1 diabetes (T1DM) patients are at increased risk of coronary artery disease (CAD). This pilot study sought to evaluate the relationship between epicardial adipose tissue (EAT) and intra-thoracic adipose tissue (IAT) volumes and cardio-metabolic risk factors in T1DM. METHOD: EAT/IAT volumes in 100 patients, underwent non-contrast cardiac computed tomography in the Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were measured by a certified reader...
2016: PloS One
(no author information available yet)
OBJECTIVE: The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study has demonstrated the beneficial effect of intensive therapy on atherosclerosis and clinical cardiovascular outcomes, while identifying hyperglycemia as a dominant risk factor for type 1 diabetes. The current analyses evaluate the extent to which glycemic exposure influences long-term changes in established risk factors for cardiovascular disease (CVD) among patients with type 1 diabetes...
September 2016: Diabetes Care
(no author information available yet)
OBJECTIVE: Historically, mortality in type 1 diabetes has exceeded that in the general population. We compared mortality in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study cohort to that of the current general U.S. RESEARCH DESIGN AND METHODS: The DCCT (1983-1993) compared intensive versus conventional therapy, with HbA1c levels of ∼7 vs. 9%, respectively, over an average of 6.5 years of treatment...
August 2016: Diabetes Care
Samar M Hammad, Nathaniel L Baker, Jad M El Abiad, Stefanka D Spassieva, Jason S Pierce, Barbara Rembiesa, Jacek Bielawski, Maria F Lopes-Virella, Richard L Klein
Plasma deoxy-sphingoid bases are elevated in type 2 diabetes patients and correlate with the stage of diabetic distal sensorimotor polyneuropathy; however, associations between deoxy-sphingolipids (DSL) and neuropathy in type 1 diabetes have not been examined. The primary aim of this exploratory pilot study was to assess the associations between multiple sphingolipid species including DSL and free amino acids and the presence of symptomatic neuropathy in a DCCT/EDIC type 1 diabetes subcohort. Using mass spectroscopy, plasma levels of DSL and free amino acids in DCCT/EDIC type 1 diabetes participants (n = 80), with and without symptoms of neuropathy, were investigated...
July 7, 2016: Neuromolecular Medicine
Ilkka Penttilä, Karri Penttilä, Päivi Holm, Harri Laitinen, Päivi Ranta, Jukka Törrönen, Rainer Rauramaa
The formation of glycohemoglobin, especially the hemoglobin A1c (HbA1c) fraction, occurs when glucose becomes coupled with the amino acid valine in the β-chain of Hb; this reaction is dependent on the plasma concentration of glucose. Since the early 1970s it has been known that diabetics display higher values OF HbA1C because they have elevated blood glucose concentrations. Thus HbA1c has acquired a very important role in the treatment and diagnosis of diabetes mellitus. After the introduction of the first quantitative measurement OF HbA1C, numerous methods for glycohemoglobin have been introduced with different assay principles: From a simple mini-column technique to the very accurate automated high-pressure chromatography and lastly to many automated immunochemical or enzymatic assays...
June 26, 2016: World Journal of Methodology
James M Hotaling, Aruna V Sarma, Darshan P Patel, Barbara H Braffett, Patricia A Cleary, Eva Feldman, William H Herman, Catherine L Martin, Alan M Jacobson, Hunter Wessells, Rodica Pop-Busui
OBJECTIVE: This study evaluated associations among cardiovascular autonomic neuropathy (CAN), female sexual dysfunction (FSD), and urinary incontinence (UI) in women with type I diabetes mellitus (T1DM). RESEARCH DESIGN AND METHODS: We studied 580 women with T1DM in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC). CAN was defined as: 1) R-R variation <15 with deep breathing or 2) R-R variation of 15-19...
September 2016: Diabetes Care
Takeshi Nishikawa, Eiichi Araki
The series of reports by the DCCT Skin Collagen Ancillary Study Group are very interesting and informative. The hypothesis from these reports clearly indicates that AGEs are a strong candidate for the mechanism of the 'hyperglycemic memory.'
May 2016: Journal of Diabetes Investigation
J Roth, N Müller, T Lehmann, L Heinemann, G Wolf, U A Müller
Objective: Target HbA1c values given in the most National Therapeutic Guidelines for patients with diabetes and cut-off HbA1c values for diabetes diagnosis are usually not taking the age of the respective patients into account; despite the fact that an increase in HbA1c in subjects without diabetes with age is known for some time. In order to further quantify the association between age and HbA1c in non-diabetic subjects an analysis of one German register was performed. Methods: In this cross-sectional study we analyzed data from 7 699 visits of 2 921 patients without diabetes (age 46...
May 24, 2016: Experimental and Clinical Endocrinology & Diabetes
Delnaz Roshandel, Ronald Klein, Barbara E K Klein, Bruce H R Wolffenbuttel, Melanie M van der Klauw, Jana V van Vliet-Ostaptchouk, Gil Atzmon, Danny Ben-Avraham, Jill P Crandall, Nir Barzilai, Shelley B Bull, Angelo J Canty, S Mohsen Hosseini, Linda T Hiraki, John Maynard, David R Sell, Vincent M Monnier, Patricia A Cleary, Barbara H Braffett, Andrew D Paterson
Skin fluorescence (SF) noninvasively measures advanced glycation end products (AGEs) in the skin and is a risk indicator for diabetes complications. N-acetyltransferase 2 (NAT2) is the only known locus influencing SF. We aimed to identify additional genetic loci influencing SF in type 1 diabetes (T1D) through a meta-analysis of genome-wide association studies (N = 1,359) including Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) and Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR)...
July 2016: Diabetes
Zhuo Chen, Feng Miao, Andrew D Paterson, John M Lachin, Lingxiao Zhang, Dustin E Schones, Xiwei Wu, Jinhui Wang, Joshua D Tompkins, Saul Genuth, Barbara H Braffett, Arthur D Riggs, Rama Natarajan
We examined whether persistence of epigenetic DNA methylation (DNA-me) alterations at specific loci over two different time points in people with diabetes are associated with metabolic memory, the prolonged beneficial effects of intensive vs. conventional therapy during the Diabetes Control and Complications Trial (DCCT) on the progression of microvascular outcomes in the long-term follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) Study. We compared DNA-me profiles in genomic DNA of whole blood (WB) isolated at EDIC Study baseline from 32 cases (DCCT conventional therapy group subjects showing retinopathy or albuminuria progression by EDIC Study year 10) vs...
May 24, 2016: Proceedings of the National Academy of Sciences of the United States of America
R Pop-Busui, C Martin
The Diabetes Control and Complications Trial (DCCT) and its epidemiological follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) provide important insight on the natural history of distal symmetrical polyneuropathy and cardiovascular autonomic neuropathy in patients with type 1 diabetes and on the impact of intensive treatment of hyperglycemia on disease progression. This chapter summarizes the design and methods used for neuropathy evaluations both in the DCCT and in EDIC, the characteristics of the DCCT/EDIC patient population, and summarizes the findings of the DCCT/EDIC relative to neuropathic complications of type 1 diabetes...
2016: International Review of Neurobiology
Sara M Lenherr, J Quentin Clemens, Barbara H Braffett, Patricia A Cleary, Rodney L Dunn, James M Hotaling, Alan M Jacobson, Catherine Kim, William Herman, Jeanette S Brown, Hunter Wessells, Aruna V Sarma
PURPOSE: We examined the relationship between glycemic control and urinary tract infections in women with type 1 diabetes mellitus. MATERIALS AND METHODS: Women enrolled in the Epidemiology of Diabetes Interventions and Complications study, the observational followup of the Diabetes Control and Complications Trial, were surveyed to assess the rate of physician diagnosed urinary tract infections in the preceding 12 months. The relationship between glycated hemoglobin levels and number of urinary tract infections in the previous 12 months was assessed using a multivariable Poisson regression model...
October 2016: Journal of Urology
Lars Rydén, Bahira Shahim, Linda Mellbin
Cardiovascular disease is a major threat to people with diabetes. Attempts have long been made to lower cardiovascular risk by means of glucose-lowering treatment. Initially, it seemed that was an option, but subsequent trials could not verify the original observations and there was concern that some glucose-lowering drugs can actually cause cardiovascular harm. This led medical product agencies in the United States and Europe to require major outcomes trials before accepting new glucose-lowering drugs. The least requirement was noninferiority compared with existing treatment modalities...
June 2016: Clinical Therapeutics
S M Lenherr, J Q Clemens, B H Braffett, R L Dunn, P A Cleary, C Kim, W H Herman, J M Hotaling, A M Jacobson, J S Brown, H Wessells, A V Sarma
AIMS: To study the impact of glycaemic control on urinary incontinence in women who participated in the Diabetes Control and Complications Trial (DCCT; 1983-1993) and its observational follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC; 1994- present). METHODS: Study participants were women who completed, at both years 10 (2003) and 17 (2010) of the EDIC follow-up, the urological assessment questionnaire (UroEDIC). Urinary incontinence was defined as self-reported involuntary leakage of urine that occurred at least weekly...
March 30, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
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