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https://www.readbyqxmd.com/read/28430872/optimal-screening-schedules-for-disease-progression-with-application-to-diabetic-retinopathy
#1
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
#2
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
#3
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...
April 12, 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
#4
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 with the development of cardiovascular disease (CVD) in patients with type 1 diabetes, among whom these ECG abnormalities are common. RESEARCH DESIGN AND METHODS: 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...
March 16, 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27647854/the-genetic-landscape-of-renal-complications-in-type-1-diabetes
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27509144/lymphoblastoid-cell-lines-as-a-tool-to-study-inter-individual-differences-in-the-response-to-glucose
#15
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
https://www.readbyqxmd.com/read/27508618/-op-2b-01-cigarette-use-alters-assessment-of-glomerular-filtration-rate
#16
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
https://www.readbyqxmd.com/read/27459689/significance-of-epicardial-and-intrathoracic-adipose-tissue-volume-among-type-1-diabetes-patients-in-the-dcct-edic-a-pilot-study
#17
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
https://www.readbyqxmd.com/read/27436274/coprogression-of-cardiovascular-risk-factors-in-type-1-diabetes-during-30-years-of-follow-up-in-the-dcct-edic-study
#18
(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
https://www.readbyqxmd.com/read/27411699/mortality-in-type-1-diabetes-in-the-dcct-edic-versus-the-general-population
#19
(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
https://www.readbyqxmd.com/read/27388466/increased-plasma-levels-of-select-deoxy-ceramide-and-ceramide-species-are-associated-with-increased-odds-of-diabetic-neuropathy-in-type-1-diabetes-a-pilot-study
#20
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...
March 2017: Neuromolecular Medicine
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