Publications by authors named "S E Gitelman"
Time to reframe the disease staging system for type 1 diabetes.
Lancet Diabetes Endocrinol
December 2024
Article Synopsis
- A disease staging system introduced in 2015 helps identify and track progression to clinical type 1 diabetes based on islet autoantibodies and dysglycaemia, but it has significant limitations such as combining diverse individuals and lacking high specificity.
- Although the current model suggests a linear progression through stages, real-life progression is often more complex, and factors like age are not considered.
- With the recent FDA approval of teplizumab to delay type 1 diabetes at stage 2, there's a need to refine diabetes staging definitions and develop a risk calculator that considers a wider range of demographic, genetic, and metabolic data, especially in underrepresented groups.
Article Synopsis
- CD4CD25CD127FOXP3 regulatory T cells (T) are crucial in preventing autoimmune conditions, such as type 1 diabetes (T1D), and a study assessed the safety and efficacy of autologous polyclonal T cell treatments in children with new-onset T1D.
- In a randomized clinical trial involving 110 participants, children received either high, low-dose treatments or a placebo, but results showed no significant prevention of beta cell function decline after one year, despite the treatments being safe.
- The study found that while expT showed strong activation in lab settings, the effectiveness in maintaining beta cell function linked more to the quality of T cells rather than the dose administered.
We report the first case of imatinib use in an adolescent with diabetes and suggest that it impacts the natural course of disease. A 14-year-old male patient presented in diabetic ketoacidosis (DKA) and was diagnosed with presumed autoantibody-negative type 1 diabetes (T1D) as well as myeloid neoplasm with platelet-derived growth factor receptor beta (PDGFRB) rearrangement. After starting exogenous insulin and imatinib, he experienced a 1.
View Article and Find Full Text PDFStudy Objective: We aimed to assess and compare the analgesic efficacy and adverse effects of intravenous subdissociative-dose ketamine to nebulized ketamine in emergency department (ED) patients with acute painful conditions.
Methods: We conducted a prospective, randomized, double-blind, double-dummy clinical trial in adult patients (ages 18 and older) with a numerical rating scale pain score of ≥5. We randomized subjects to receive either a single dose of 0.
Teplizumab (TzieldTM, Provention Bio), a monoclonal antibody directed at T-cell marker CD3, is the first medication approved by the FDA to delay progression from stage 2 to stage 3 type 1 diabetes. To date, the overwhelming majority of pediatric endocrinologists do not have experience using immunotherapeutics and seek guidance on the use of teplizumab in clinical practice. To address this need, the Pediatric Endocrine Society (PES) Diabetes Special Interest Group (Diabetes SIG) and Drug and Therapeutics Committee assembled a task force to review clinical trial data and solicit expert recommendations on the approach to teplizumab infusions.
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