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A 1-year randomized study to evaluate the effects of a dose reduction in oral contraceptives on lipids and carbohydrate metabolism: 20 microg ethinyl estradiol combined with 100 microg levonorgestrel.

https://arctichealth.org/en/permalink/ahliterature176202
Source
Contraception. 2005 Feb;71(2):111-7
Publication Type
Article
Date
Feb-2005
Author
Sven O Skouby
Jan Endrikat
Bernd Düsterberg
Werner Schmidt
Christoph Gerlinger
Jens Wessel
Henri Goldstein
Joergen Jespersen
Author Affiliation
Department of Obstetrics and Gynecology, Frederiksberg Hospital, University of Copenhagen, DK 2000 Copenhagen F, Denmark. sven.skouby@fh.hosp.dk
Source
Contraception. 2005 Feb;71(2):111-7
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Adult
Blood Glucose - metabolism
C-Peptide - blood
Carbohydrate Metabolism - drug effects
Cholesterol, HDL - blood
Cholesterol, LDL - blood
Contraceptive Agents, Female - administration & dosage - pharmacology
Contraceptives, Oral, Combined - administration & dosage - pharmacology
Denmark
Dose-Response Relationship, Drug
Ethinyl Estradiol - administration & dosage - pharmacology
Fatty Acids, Nonesterified - blood
Female
Humans
Insulin - blood
Levonorgestrel - administration & dosage - pharmacology
Lipid Metabolism - drug effects
Prospective Studies
Time Factors
Treatment Outcome
Triglycerides - blood
Abstract
To evaluate the impact on lipid and carbohydrate variables of a combined one-third ethinyl estradiol (EE)/levonorgestrel (LNG) dose reduction in oral contraceptives.
In an open-label, randomized study, a dose-reduced oral contraceptive containing 20 microg EE and 100 microg LNG (20 EE/100 LNG) was compared with a reference preparation containing 30 microg EE and 150 microg LNG (30 EE/150 LNG). One-year data from 48 volunteers were obtained.
We found a decrease of HDL2 cholesterol and increases of low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and total triglycerides in both treatment groups from baseline to the 13th treatment cycle. Although for four of six variables, the changes in the 20 EE group were lower compared with the 30 EE group, none of the differences between the two treatments were statistically significant. The median values for the fasting levels of insulin, C-peptide and free fatty acids slightly increased or remained unchanged while the fasting glucose levels slightly decreased after 13 treatment cycles. While the glucose area under the curve (AUC) (0-3 h) was similar in both groups during the OGTT, the insulin AUC(0-3 h) was less increased in the 20 EE/100 LNG group compared with the 30 EE/150 LNG group. None of the differences between the treatment groups for any of the carbohydrate metabolism variables were statistically significant at any time point. Both study treatments were safe and well tolerated by the volunteers.
Similar effects on the lipid and carbohydrate profiles were found for both preparations. The balanced one-third EE dose reduction in this new oral contraceptive caused slightly lower, but insignificant, changes in the lipid and carbohydrate variables compared with the reference treatment.
PubMed ID
15707560 View in PubMed
Less detail

Adult glucose metabolism in extremely birthweight-discordant monozygotic twins.

https://arctichealth.org/en/permalink/ahliterature120924
Source
Diabetologia. 2012 Dec;55(12):3204-12
Publication Type
Article
Date
Dec-2012
Author
M. Frost
I. Petersen
K. Brixen
H. Beck-Nielsen
J J Holst
L. Christiansen
K. Højlund
K. Christensen
Author Affiliation
The Danish Twin Registry, Department of Epidemiology, University of Southern Denmark, JB Winsløvsvej 9, Odense C, Denmark. frostnielsen@yahoo.com
Source
Diabetologia. 2012 Dec;55(12):3204-12
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Birth weight
Blood Glucose - metabolism
C-Peptide - blood
Denmark - epidemiology
Diabetes Mellitus, Type 2 - blood - epidemiology
Disease Susceptibility - blood - epidemiology
Female
Glucagon-Like Peptide 1 - blood
Glucose Intolerance
Glucose Tolerance Test
Humans
Infant, Low Birth Weight
Infant, Newborn
Insulin Resistance
Logistic Models
Male
Middle Aged
Questionnaires
Risk factors
Twins, Monozygotic
Abstract
Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment.
Among 77,885 twins in the Danish Twin Registry, 155 of the most BW-discordant MZ twin pairs (median BW difference 0.5 kg) were assessed using a 2 h oral glucose tolerance test with sampling of plasma (p-)glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. HOMA for beta cell function (HOMA-ß) and insulin resistance (HOMA-IR), and also insulin sensitivity index (BIGTT-SI) and acute insulin response (BIGTT-AIR), were calculated. Subgroup analyses were performed in those with: (1) double verification of BW difference; (2) difference in BW >0.5 kg; and (3) no overt metabolic disease (type 2 diabetes, hyperlipidaemia or thyroid disease).
No intra-pair differences in p-glucose, insulin, C-peptide, incretin hormones, HOMA-ß, HOMA-IR or BIGTT-SI were identified. p-Glucose at 120 min was higher in the twins with the highest BW without metabolic disease, and BIGTT-AIR was higher in those with the highest BW although not in pairs with a BW difference of >0.5 kg.
BW-discordant MZ twins provide no evidence for a detrimental effect of low BW on glucose metabolism in adulthood once genetic factors and rearing environment are controlled for.
PubMed ID
22955993 View in PubMed
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Adverse effects of psychosocial stress on gonadal function and insulin levels in middle-aged males.

https://arctichealth.org/en/permalink/ahliterature11406
Source
J Intern Med. 1995 May;237(5):479-86
Publication Type
Article
Date
May-1995
Author
P M Nilsson
L. Møller
K. Solstad
Author Affiliation
Health Sciences Centre, University of Lund, Sweden.
Source
J Intern Med. 1995 May;237(5):479-86
Date
May-1995
Language
English
Publication Type
Article
Keywords
Blood Pressure - physiology
Body mass index
C-Peptide - blood
Cohort Studies
Cross-Sectional Studies
Denmark
Genitalia, Male - physiopathology
Gonadal Steroid Hormones - blood
Humans
Insulin - blood
Insulin Resistance
Male
Middle Aged
Questionnaires
Regression Analysis
Research Support, Non-U.S. Gov't
Respiratory Function Tests
Stress, Psychological - blood - physiopathology
Abstract
OBJECTIVES. To investigate the relationship between gonadal function, insulin and psychosocial stress in middle-aged men. DESIGN. A population-based, cross-sectional, observational study. SETTING. Glostrup Hospital, Copenhagen, Denmark. SUBJECTS. Four hundred and thirty-nine males, all aged 51 years. MAIN VARIABLES. Body-mass index (BMI), waist-to-hip ratio (WHR), insulin, C-peptide, free testosterone, luteinizing hormone (LH), lipids, fibrinogen, lung function tests (FVC, FEV1, PEF), blood pressure, a self-administered questionnaire with questions on psychosocial variables, lifestyle and self-rated health. RESULTS. Free testosterone correlated inversely (P
PubMed ID
7738488 View in PubMed
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Amino acid polymorphisms in the ATP-regulatable inward rectifier Kir6.2 and their relationships to glucose- and tolbutamide-induced insulin secretion, the insulin sensitivity index, and NIDDM.

https://arctichealth.org/en/permalink/ahliterature48195
Source
Diabetes. 1997 Mar;46(3):508-12
Publication Type
Article
Date
Mar-1997
Author
L. Hansen
S M Echwald
T. Hansen
S A Urhammer
J O Clausen
O. Pedersen
Author Affiliation
Steno Diabetes Center and the Hagedorn Research Institute, Glostrup University Hospital, Copenhagen, Denmark.
Source
Diabetes. 1997 Mar;46(3):508-12
Date
Mar-1997
Language
English
Publication Type
Article
Keywords
Adenosine Triphosphate - metabolism
Adult
Blood Glucose - metabolism
C-Peptide - blood
Cohort Studies
DNA Primers
Denmark
Diabetes Mellitus, Type 2 - blood - genetics - physiopathology
European Continental Ancestry Group
Female
Glucose Tolerance Test
Humans
Hypoglycemic Agents - pharmacology
Insulin - blood - secretion
Male
Polymerase Chain Reaction
Polymorphism, Genetic
Polymorphism, Single-Stranded Conformational
Potassium Channels - genetics - metabolism
Potassium Channels, Inwardly Rectifying
Reference Values
Research Support, Non-U.S. Gov't
Tolbutamide - pharmacology
Abstract
Kir6.2 is an inwardly rectifying potassium channel that is expressed in pancreatic beta-cells and cardiac and skeletal muscle. Expressed together with the high-affinity sulphonylurea receptor, it reconstitutes a sulphonylurea- and also ATP-sensitive potassium channel resembling the native beta-cell channel. The objective of this study was to search for mutations in the Kir6.2 gene that might be associated with NIDDM or related to altered insulin secretion, insulin action, or glucose metabolism in healthy subjects. Using polymerase chain reaction-single-strand conformation polymorphism analysis (PCR-SSCP) on genomic DNA from 69 Danish NIDDM patients and 66 matched control subjects, we report the finding of three missense polymorphisms in otherwise conserved codons and three silent polymorphisms in the gene encoding Kir6.2: codon 23 (GAG/AAG), Glu-->Lys; codon 190 (GCT/GCC), Ala-->Ala; codon 267 (CTC/CTG), Leu-->Leu; codon 270 (CTG/GTG), Leu-->Val; codon 337 (ATC/GTC), Ile-->Val; codon 381 (AAG/AAA), Lys-->Lys. The codon 23 and codon 337 amino acid polymorphisms were always coupled. The allelic frequencies of the polymorphisms were similar in NIDDM patients and control subjects. The amino acid polymorphisms were not associated with altered insulin secretion after intravenous glucose or tolbutamide injections or with altered glucose effectiveness in a phenotype study of 346 young healthy subjects. However, carriers of the maximal load of amino acid variants, the compound homozygous codon 23/337 and heterozygous codon 270, had on average a 62% higher insulin sensitivity index (P = 0.006), compared with noncarriers. We conclude that a combination of common Kir6.2 amino acid variants may contribute to the genetic background behind the large variation of the insulin sensitivity index in the general population.
PubMed ID
9032110 View in PubMed
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Arctic berry extracts target the gut-liver axis to alleviate metabolic endotoxaemia, insulin resistance and hepatic steatosis in diet-induced obese mice.

https://arctichealth.org/en/permalink/ahliterature297424
Source
Diabetologia. 2018 04; 61(4):919-931
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2018
Author
Fernando F Anhê
Thibault V Varin
Mélanie Le Barz
Geneviève Pilon
Stéphanie Dudonné
Jocelyn Trottier
Philippe St-Pierre
Cory S Harris
Michel Lucas
Mélanie Lemire
Éric Dewailly
Olivier Barbier
Yves Desjardins
Denis Roy
André Marette
Author Affiliation
Department of Medicine, Faculty of Medicine, Cardiology Axis of the Québec Heart and Lung Institute, Laval University, Bureau Y4340, Québec City, QC, G1V 4G5, Canada.
Source
Diabetologia. 2018 04; 61(4):919-931
Date
04-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Animals
C-Peptide - blood
Diet, High-Fat
Endotoxemia - metabolism
Fatty Liver - drug therapy - metabolism
Fruit - chemistry
Glucose - metabolism
Homeostasis
Insulin - blood - metabolism
Insulin Resistance
Intestines - drug effects
Liver - drug effects - metabolism
Male
Mice
Mice, Inbred C57BL
Mice, Obese
Obesity - metabolism
Plant Extracts - pharmacology
RNA, Ribosomal, 16S - genetics
Time Factors
Abstract
There is growing evidence that fruit polyphenols exert beneficial effects on the metabolic syndrome, but the underlying mechanisms remain poorly understood. In the present study, we aimed to analyse the effects of polyphenolic extracts from five types of Arctic berries in a model of diet-induced obesity.
Male C57BL/6 J mice were fed a high-fat/high-sucrose (HFHS) diet and orally treated with extracts of bog blueberry (BBE), cloudberry (CLE), crowberry (CRE), alpine bearberry (ABE), lingonberry (LGE) or vehicle (HFHS) for 8 weeks. An additional group of standard-chow-fed, vehicle-treated mice was included as a reference control for diet-induced obesity. OGTTs and insulin tolerance tests were conducted, and both plasma insulin and C-peptide were assessed throughout the OGTT. Quantitative PCR, western blot analysis and ELISAs were used to assess enterohepatic immunometabolic features. Faecal DNA was extracted and 16S rRNA gene-based analysis was used to profile the gut microbiota.
Treatment with CLE, ABE and LGE, but not with BBE or CRE, prevented both fasting hyperinsulinaemia (mean ± SEM [pmol/l]: chow 67.2?±?12.3, HFHS 153.9?±?19.3, BBE 114.4?±?14.3, CLE 82.5?±?13.0, CRE 152.3?±?24.4, ABE 90.6?±?18.0, LGE 95.4?±?10.5) and postprandial hyperinsulinaemia (mean ± SEM AUC [pmol/l?×?min]: chow 14.3?±?1.4, HFHS 31.4?±?3.1, BBE 27.2?±?4.0, CLE 17.7?±?2.2, CRE 32.6?±?6.3, ABE 22.7?±?18.0, LGE 23.9?±?2.5). None of the berry extracts affected C-peptide levels or body weight gain. Levels of hepatic serine phosphorylated Akt were 1.6-, 1.5- and 1.2-fold higher with CLE, ABE and LGE treatment, respectively, and hepatic carcinoembryonic antigen-related cell adhesion molecule (CEACAM)-1 tyrosine phosphorylation was 0.6-, 0.7- and 0.9-fold increased in these mice vs vehicle-treated, HFHS-fed mice. These changes were associated with reduced liver triacylglycerol deposition, lower circulating endotoxins, alleviated hepatic and intestinal inflammation, and major gut microbial alterations (e.g. bloom of Akkermansia muciniphila, Turicibacter and Oscillibacter) in CLE-, ABE- and LGE-treated mice.
Our findings reveal novel mechanisms by which polyphenolic extracts from ABE, LGE and especially CLE target the gut-liver axis to protect diet-induced obese mice against metabolic endotoxaemia, insulin resistance and hepatic steatosis, which importantly improves hepatic insulin clearance. These results support the potential benefits of these Arctic berries and their integration into health programmes to help attenuate obesity-related chronic inflammation and metabolic disorders.
All raw sequences have been deposited in the public European Nucleotide Archive server under accession number PRJEB19783 ( https://www.ebi.ac.uk/ena/data/view/PRJEB19783 ).
PubMed ID
29270816 View in PubMed
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Association between autoantibodies to the Arginine variant of the Zinc transporter 8 (ZnT8) and stimulated C-peptide levels in Danish children and adolescents with newly diagnosed type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature123577
Source
Pediatr Diabetes. 2012 Sep;13(6):454-62
Publication Type
Article
Date
Sep-2012
Author
Marie Louise M Andersen
Fariba Vaziri-Sani
Ahmed Delli
Sven Pörksen
Emma Jacobssen
Jane Thomsen
Jannet Svensson
Jacob Steen Petersen
Lars Hansen
Ake Lernmark
Henrik B Mortensen
Lotte B Nielsen
Author Affiliation
Department of Paediatrics, Herlev University Hospital, Herlev, Denmark. ml.max.andersen@dadlnet.dk
Source
Pediatr Diabetes. 2012 Sep;13(6):454-62
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Amino Acid Substitution - immunology - physiology
Arginine - genetics - immunology
Autoantibodies - blood - genetics
C-Peptide - blood
Cation Transport Proteins - genetics - immunology
Child
Child, Preschool
Denmark
Diabetes Mellitus, Type 1 - blood - diagnosis - genetics - immunology
Female
Genetic Association Studies
Genetic Predisposition to Disease
Genotype
Humans
Infant
Male
Mutant Proteins - immunology
Up-Regulation
Abstract
The zinc transporter 8 (ZnT8) was recently identified as a common autoantigen in type 1 diabetes (T1D) and inclusion of ZnT8 autoantibodies (ZnT8Ab) was found to increase the diagnostic specificity of T1D.
The main aims were to determine whether ZnT8Ab vary during follow-up 1 year after diagnosis, and to relate the reactivity of three types of ZnT8Ab to the residual stimulated C-peptide levels during the first year after diagnosis.
A total of 129 newly diagnosed T1D patients
PubMed ID
22686132 View in PubMed
Less detail

Association between stimulated plasma C-peptide and age: the Wadena City Health Study.

https://arctichealth.org/en/permalink/ahliterature73500
Source
J Am Geriatr Soc. 1992 Apr;40(4):309-15
Publication Type
Article
Date
Apr-1992
Author
L R French
F C Goetz
A M Martinez
J R Boen
S A Bushhouse
J M Sprafka
Author Affiliation
Chronic Disease and Environmental Epidemiology Section, Minnesota Department of Health.
Source
J Am Geriatr Soc. 1992 Apr;40(4):309-15
Date
Apr-1992
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aging - blood - metabolism - urine
Blood Glucose - analysis
Body mass index
C-Peptide - blood - urine
Cholesterol - blood
Creatinine - blood - urine
Cross-Sectional Studies
Eating - physiology
Fasting
Fatty Acids, Nonesterified - blood
Female
Hemoglobin A, Glycosylated - analysis
Hemoglobins - analysis
Humans
Least-Squares Analysis
Linear Models
Lipoproteins - blood
Male
Middle Aged
Minnesota
Predictive value of tests
Research Support, U.S. Gov't, P.H.S.
Sex Factors
Triglycerides - blood
Abstract
OBJECTIVE: To assess age-related changes in stimulated plasma C-peptide in a population-based sample of adults. DESIGN: Cross-sectional study. SETTING: Wadena, Minnesota, a city of 4,699 residents (1980 census) in west central Minnesota, approximately 150 miles from Minneapolis/St. Paul. STUDY SUBJECTS: 344 non-diabetic subjects (NDDG standards) from a stratified random sample of the total adult population of Wadena, MN. The six-study strata were men and women from three age groups: young, 20-39 years of age; middle-aged, 40-59; and older, greater than 60 years of age. MEASUREMENTS: During a liquid meal of Ensure-Plus (Ensure-Plus challenge test; EPCT; Ross Laboratories), blood samples were taken for glucose, free fatty acids, creatinine, and C-peptide. Plasma C-peptide taken 90 minutes after the EPCT was used as a surrogate measure for insulin. Clinical tests included one-time samples for hemoglobin, glycosylated hemoglobin, plasma cholesterol, triglycerides, and lipoproteins. Physical measurements included height, weight, and blood pressure. Urine was assayed for C-peptide and creatinine. Assays of urine and plasma C-peptide used antibody M1221 (from Novo; Copenhagen, Denmark). MAIN RESULTS: No differences were observed for the relationship between age and C-peptide within each of the three age groups for men and the three age groups for women. However, the levels of plasma C-peptide for older men or women were statistically significantly higher than levels for the young age groups of the same sex; fasting plasma glucose also was higher for older groups of both sexes, and postmeal glucose was significantly higher for older women. There were decreases with age in urine C-peptide clearance for women and men; the decline for women was statistically significant. In multiple regression models for men alone and women alone, that controlled for age, post-meal plasma glucose best explained plasma C-peptide levels. For young men, plasma glucose alone provided the best prediction of plasma C-peptide levels; body mass index (BMI) and plasma glucose provided the best prediction for young women. For older men and both middle-aged and older women, a combination of urine C-peptide clearance and plasma glucose best predicted plasma C-peptide levels; for middle-aged men, BMI also contributed to the prediction. CONCLUSIONS: Secretion of insulin in response to an orally administered mixed meal is undiminished with age in non-diabetic adults.
PubMed ID
1556356 View in PubMed
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Atherosclerotic vascular disease in middle-aged, insulin-treated, diabetic patients. Association with endogenous insulin secretion capacity.

https://arctichealth.org/en/permalink/ahliterature233138
Source
Arteriosclerosis. 1988 May-Jun;8(3):237-44
Publication Type
Article
Author
T. Rönnemaa
M. Laakso
P. Puukka
V. Kallio
K. Pyörälä
Author Affiliation
Rehabilitation Research Centre, Social Insurance Institution, Turku, Finland.
Source
Arteriosclerosis. 1988 May-Jun;8(3):237-44
Language
English
Publication Type
Article
Keywords
Arteriosclerosis - blood - epidemiology - etiology
C-Peptide - blood
Coronary Disease - blood - epidemiology - etiology
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - complications - drug therapy
Diabetes Mellitus, Type 2 - blood - complications - drug therapy
Diabetic Angiopathies - blood - epidemiology - etiology
Female
Finland
Glucagon - diagnostic use
Humans
Insulin - secretion - therapeutic use
Male
Middle Aged
Myocardial Infarction - blood - epidemiology - etiology
Risk factors
Abstract
The prevalence of atherosclerotic vascular disease (ASVD) and its risk factors were investigated in 263 insulin-treated diabetic patients, ages 45 to 64 years, who were older than 30 years when their diabetes was diagnosed. The patients were divided into two groups based on the degree of endogenous insulin secretion capacity: Group A: glucagon-stimulated plasma C-peptide less than 0.20 nmol/l and Group B: C-peptide greater than or equal to 0.20 nmol/l. The age-adjusted prevalence of definite myocardial infarction was significantly higher in Group B than in Group A (16.8% vs. 5.2%, p less than 0.01). A similar difference between Groups A and B was found for definite or possible coronary heart disease (54.6% vs. 32.9%, p less than 0.001) and stroke (9.3% vs. 2.0%, p less than 0.05). In multivariate analysis, high glucagon-stimulated plasma C-peptide level (greater than or equal to 0.20 nmol/l) was positively associated with definite or possible coronary heart disease independently of other cardiovascular risk factors. Our results indicate that among insulin-treated patients with a late onset of diabetes, the prevalence of ASVD is markedly higher in those with persistent endogenous insulin secretion (noninsulin-dependent diabetes) than in those with low or no insulin secretion (insulin-dependent diabetes).
PubMed ID
3285822 View in PubMed
Less detail
Source
Lakartidningen. 2018 03 06; 115:
Publication Type
Journal Article
Review
Date
03-06-2018
Author
Claude Marcus
Author Affiliation
Karolinska Institutet - CLINTEC enheten för pediatrik Stockholm, Sweden Karolinska Institutet - CLINTEC enheten för pediatrik Stockholm, Sweden.
Source
Lakartidningen. 2018 03 06; 115:
Date
03-06-2018
Language
Swedish
Publication Type
Journal Article
Review
Keywords
Adolescent
Autoantibodies - blood
C-Peptide - blood
Child
Child, Preschool
Diabetes Mellitus - diagnosis
Diabetes Mellitus, Type 1 - diagnosis - epidemiology - genetics - immunology
Diabetes Mellitus, Type 2 - diagnosis
Diagnostic Tests, Routine
Histocompatibility testing
Humans
Infant
Sweden - epidemiology
Abstract
The Swedish study Better Diabetes Diagnosis (BDD) has now been ongoing for ten years and detailed information and blood samples have been collected from more than 8000 children and adolescents with newly diagnosed diabetes. We have been able to demonstrate that by means of HLA diabetes antibodies and C-peptide the discrimination between type one and type 2 diabetes is improved. These analyses are therefore included in the clinical check-up for all children and adolescents in Sweden who are diagnosed with diabetes. Type 1 diabetes is by far the most prevalent type of diabetes among Swedish children and adolescents. Type 2 diabetes is still relatively rare in Sweden but it is urgent to obtain a correct diagnosis as the long-term prognosis depends on a prompt pharmacological treatment. Monogenic diabetes (MODY) is also important to identify early. We therefore recommend that sequencing of MODY genes should be performed if an individual with newly-diagnosed diabetes is auto-antibody negative and has an HLA pattern associated with low risk for type 1 diabetes. However, despite these analytical tools it can be difficult to make the correct diabetes diagnosis initially. It is therefore prudent to re-evaluate the diabetes diagnosis after one year.
PubMed ID
29509210 View in PubMed
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ß-cell function and metabolic control in latent autoimmune diabetes in adults with early insulin versus conventional treatment: a 3-year follow-up.

https://arctichealth.org/en/permalink/ahliterature139204
Source
Eur J Endocrinol. 2011 Feb;164(2):239-45
Publication Type
Article
Date
Feb-2011
Author
Maria Thunander
Hlin Thorgeirsson
Carina Törn
Christer Petersson
Mona Landin-Olsson
Author Affiliation
Department of Endocrinology and Diabetology, Lund University Hospital, Lund, Sweden. maria.thunander@ltkronoberg.se
Source
Eur J Endocrinol. 2011 Feb;164(2):239-45
Date
Feb-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
C-Peptide - blood
Diabetes Mellitus, Type 1 - metabolism - therapy
Female
Follow-Up Studies
Glucagon - pharmacology
Hemoglobin A, Glycosylated
Humans
Insulin - metabolism - therapeutic use
Insulin-Secreting Cells - drug effects - metabolism
Male
Middle Aged
Regression Analysis
Sweden
Treatment Outcome
Abstract
The optimal treatment of latent autoimmune diabetes in adults (LADA) is not established. We explored whether early insulin treatment, which has shown beneficial effects in rodents and in human pilot studies, would result in better preservation of ß-cell function or metabolic control, compared with conventional treatment.
Glucagon-stimulated C-peptide and HbAlc were evaluated at baseline and after 12, 24 and 36 months in 37 patients recently diagnosed with diabetes, aged = 30 years, non-insulin-requiring and GADAb and/or ICA positive. Twenty patients received early insulin and 17 received conventional treatment (diet ± oral hypoglycaemic agents (OHA), metformin, some and/or sulfonylurea) and insulin when necessary.
Level of metabolic control, HbAlc, was preserved in the early insulin treated, while it significantly deteriorated in the conventionally treated. There was no significant difference between the groups in C-peptide after 12, 24 or 36 months, or in the decline of C-peptide. Only baseline C-peptide predicted a C-peptide of = 0.5 nmol/l at 36 months. Gender, body mass index, antibody titres or HbAlc did not influence the levels of C-peptide or HbAlc at baseline or end-of-study, or the decline in C-peptide. Among the diet ± OHA-treated, 5/17 (30%) developed insulin dependency during the follow-up. No major hypoglycaemic events occurred.
Early insulin treatment in LADA leads to better preservation of metabolic control and was safe. Superior preservation of C-peptide could not be significantly demonstrated. Only baseline level of C-peptide significantly influenced C-peptide level after 3 years. Further studies exploring the best treatment in LADA are warranted.
Notes
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PubMed ID
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