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Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version).
J Diabetes Investig
January 2025
Department of Endocrinology, Metabolism and Diabetes, Kindai University Faculty of Medicine, Osaka, Japan.
Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non-insulin-dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase.
View Article and Find Full Text PDFPoor mid-term functional patency and post-operative outcomes in diabetic patients who undergo arteriovenous graft creation.
J Vasc Access
November 2024
Division of Vascular and Endovascular Surgery, University of Connecticut School of Medicine, Farmington, CT, USA.
Article Synopsis
- Diabetes mellitus is a major factor in causing renal failure and leads to worse outcomes in diabetic patients even after receiving dialysis treatments.
- The study analyzed diabetic patients undergoing their first arteriovenous access creation, comparing those with AV fistulas to those with AV grafts to assess differences in access durability and outcomes.
- Results showed that while AV grafts allowed quicker access for hemodialysis, AV fistulas offered longer functional use, indicating that patients with diabetes may face worse clinical outcomes with grafts compared to fistulas.
Brain Defense of Glycemia in Health and Diabetes.
Diabetes
December 2024
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.
The brain coordinates the homeostatic defense of multiple metabolic variables, including blood glucose levels, in the context of ever-changing external and internal environments. The biologically defended level of glycemia (BDLG) is the net result of brain modulation of insulin-dependent mechanisms in cooperation with the islet, and insulin-independent mechanisms through direct innervation and neuroendocrine control of glucose effector tissues. In this article, we highlight evidence from animal and human studies to develop a framework for the brain's core homeostatic functions-sensory/afferent, integration/processing, and motor/efferent-that contribute to the normal BDLG in health and its elevation in diabetes.
View Article and Find Full Text PDFRandom C-Peptide and Islet Antibodies at Onset Predict β Cell Function Trajectory and Insulin Dependence in Pediatric Diabetes.
Endocr Pract
December 2024
Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, Texas.
Objective: Identification of prognostic biomarkers in pediatric diabetes is important for precision medicine. We assessed whether C-peptide and islet autoantibodies are useful to predict the natural history of children with new-onset diabetes.
Methods: We prospectively studied 72 children with new-onset diabetes (median follow-up: 8 months) by applying the Aβ classification system ("A+": islet autoantibody positive, "β+": random serum C-peptide ≥1.
Unlabelled: Current treatments for type 1 diabetes (T1D) focus on insulin replacement. We demonstrate the therapeutic potential of a secreted protein fraction from embryonic brown adipose tissue (BAT), independent of insulin. The large molecular weight secreted fraction mediates insulin receptor-dependent recovery of euglycemia in a T1D animal model, nonobese diabetic (NOD) mice, by suppressing glucagon secretion.
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