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1
Jamali, Reza. "Peripheral Hypoglycaemic Neuropathy in Type 1 Diabetic Rats : Morphologic and Metabolic Studies." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7978.
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Dekki, Wenna Nancy. "Serum proteins in type 1 diabetes /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-057-2/.
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Elfvin, Åkesson Karin. "Genetic analysis of type 1 diabetes /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-321-4/.
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Hoogma, Roeland Petrus Leonardus Maria. "Subcutaneous insulin infusion in type 1 diabetes mellitus." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2006. http://dare.uva.nl/document/29301.
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Wong, Xing-Wei. "Model-Based Therapeutics for Type 1 Diabetes Mellitus." Thesis, University of Canterbury. Mechanical Engineering, 2008. http://hdl.handle.net/10092/1573.
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The incidence of Type 1 diabetes is growing yearly. Worryingly, the aetiology of the disease is inconclusive. What is known is that the total number of affected individuals, as well as the severity and number of associated complications are growing for this chronic disease. With increasing complications due to severity, length of exposure, and poor control, the disease is beginning to consume an increasingly major portion of healthcare costs to the extent that it poses major economic risks in several nations. Research has shown that intensive insulin therapy aimed at certain minimum glycosylated haemoglobin threshold levels reduces the incidence of complications by up to 76% compared to conventional insulin therapy. Moreover, the effects of such intensive therapy regimes over a 6.5y duration persists for at least 10y after, a so called metabolic memory. Thus, early intervention can slow the momentum of complications far more easily than later intervention. Early, safe, intensive therapy protocols offer potential solutions to the growing social and economic effects of diabetes. Since the 1970s, the artificial endocrine pancreas has been heralded as just this type of solution. However, no commercial product currently exists, and ongoing limitations in sensors and pumps have resulted in, at best, modest clinical advantages over conventional methods of insulin administration or multiple daily injection. With high upfront costs, high costs of consumables, significant complexity, and the extensive infrastructure and support required, these systems and devices are only used by 2-15% of individuals with Type 1 diabetes. Clearly, there is an urgent need to address the large majority of the Type 1 diabetes population using conventional glucose measurement and insulin administration. For these individuals, current conventional or intensive therapies are failing to deliver recommended levels of glycaemic control. This research develops an understanding of clinical glycaemic control using conventional insulin administration and glucose measurement techniques in Type 1 diabetes based on a clinically validated in silico virtual patient simulation. Based on this understanding, a control protocol for Type 1 diabetes that is relatively simple and clinically practical is developed. The protocol design incorporates physiological modelling and engineering techniques to adapt to individual patient clinical requirements. By doing so, it produces accurate, patient-specific recommendations for insulin interventions. Initially, a simple, physiological compartmental model for the pharmacokinetics of subcutaneously injected insulin is developed. While the absorption process itself is subject to significant potential variability, such models enable a real-time estimation of plasma insulin concentration. This information would otherwise be lacking in the clinical environment of outpatient Type 1 diabetes treatment due to the inconvenience, cost, and laboratory turnaround for plasma insulin measurements. Hence, this validated model offers significant opportunity to optimise therapy selection. An in silico virtual patient simulation tool is also developed. A virtual patient cohort is developed on patient data from a representative cohort of the broad diabetes population. The simulation tool is used to develop a robust, adaptive protocol for prandial insulin dosing against a conventional intensive insulin therapy, as well as a controls group representative of the general diabetes population. The effect on glycaemic control of suboptimal and optimal, prandial and basal insulin therapies is also investigated, with results matching clinical expectations. To gauge the robustness of the developed adaptive protocol, a Monte Carlo analysis is performed, incorporating realistic and physiological errors and variability. Due to the relatively infrequent glucose measurement in outpatient Type 1 diabetes, a method for identifying the diurnal cycle in effective insulin sensitivity and modelling it in retrospective patient data is also presented. The method consists of identifying deterministic and stochastic components in the patient effective insulin sensitivity profile. Circadian rhythmicity and sleep-wake phases have profound effects on effective insulin sensitivity. Identification and prediction of this rhythm is of utmost clinical relevance, with the potential for safer and more effective glycaemic control, with less frequent measurement. It is thus a means of further enhancing any robust protocol and making it more clinically practical to implement. Finally, this research presents an entire framework for the realistic, and rapid development and testing of clinical glycaemic control protocols for outpatient Type 1 diabetes. The models and methods developed within this framework allow rapid and physiological identification of time-variant, patient-specific, effective insulin sensitivity profiles. These profiles form the responses of the virtual patient and can be used to develop and robustly test clinical glycaemic control protocols in a broad range of patients. These effective insulin sensitivity profiles are also rich in dynamics, specifically those circadian in nature which can be identified, and used to provide more accurate glycaemic prediction with the potential for safer and more effective control.
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Carvalho, Tiago Filipe Cruz. "Type 1 diabetes mellitus effects on mitochondrial function." Master's thesis, Universidade de Aveiro, 2011. http://hdl.handle.net/10773/7520.
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Mestrado em Bioquímica-Métodos BiomulecularesDespite type 1 diabetes mellitus being more rare, it has an autoimmune origin and appears early in life, greatly affecting its quality. With the aim of better understand the molecular mechanisms underlying the observed phenotypic alterations in the skeletal muscle from diabetic patients, it was planned an experimental protocol using 20 Wistar rats 8 weeks old, randomly divided in two groups (n=10). The animals from one group were injected with 60mg/Kg of streptozotocin (STZ), while the others were injected with vehicle buffer. Four months after STZ injection, rats were confirmed as diabetic, considering hyperglycemia and body weight loss. After animals sacrifice, gastrocnemius muscles were excised and used for mitochondria subpopulations (subsarcolemmal (SS) and intermyofibrillar (IMF)) isolation. mtDNA-to-muscle mass ratio suggest an increased biogenesis of SS mitochondria in the STZ animals, paralleled by a decreased protein content per mitochondrion, in opposite to the observed in IMF mitochondria. The BN-PAGE profile revealed a slight difference of the oxidative phosphorylation complexes organization between mitochondrial subpopulations, apparently not affected by STZ administration. Mitochondrial proteolysis analysis, evaluated through zymography, revealed two proteases with molecular weights around 15 and 25 KDa, with the smaller one presenting STZinduced significant decreased activity in IMF mitochondria. A similar behavior was observed for paraplegin, a subunit of m- AAA proteolytic system, and mitofilin, a protein involved in cristae organization. Interestingly, these protein levels were higher in SS mitochondria from diabetic animals. With this work it was verified that subsarcolemmal mitochondria are not so affected by STZ administration as IMF mitochondria. The decreased activity of the protein quality control system seems to be associated with the morphological and biochemical alterations observed in the mitochondria interspersed in fibrils.
Apesar de a diabetes tipo 1 ser uma das formas mais raras de diabetes mellitus, tem uma origem auto-imune e aparece precocemente na vida de um indivíduo afectando grandemente a qualidade da mesma. No sentido de melhor compreender os mecanismos moleculares subjacentes às alterações fenotípicas observadas no músculo esquelético dos pacientes diabéticos, delineou-se um protocolo experimental com 20 ratos Wistar com 8 semanas de idade, aleatoriamente divididos em dois grupos (n=10). Os animais de um dos grupos foram injectados com 60mg/Kg de streptozotocina (STZ), e os outros com veículo. Após 4 meses, os ratos injectados com STZ foram confirmados como diabéticos, tendo em consideração a hiperglicemia e a perda de massa corporal. Após o sacrifício dos animais foram retirados os músculos gastrocnemius, a partir dos quais foram isoladas as duas subpopulações mitocondriais (subsarcolemal (SS) e intermiofibrilar (IMF)). A análise da razão mtADN-massa muscular sugere que a administração de STZ induziu o aumento da biogénese mitocondrial SS associado a um decréscimo do teor proteico mitocondrial, ao contrário do observado nas mitocôndrias IMF. O perfil de BNPAGE revelou uma ligeira diferença entre a organização dos complexos da fosforilação oxidativa entre ambas as subpopulações mitocondriais, aparentemente não afectada pela administração de STZ. A análise da proteólise mitocondrial, efectuada por zimografia, evidenciou duas proteases com 15 e 25 KDa, tendo-se observado uma diminuição acentuada da actividade da protease com menor peso molecular nas mitocôndrias IMF dos animais diabéticos. Uma tendência semelhante foi observada para a expressão da subunidade paraplegina do sistema proteolítico m-AAA e para a mitofilina, uma proteína envolvida na organização da membrana interna mitocondrial. Curiosamente, nas mitocôndrias SS dos animais diabéticos verificaram-se níveis mais elevados destas proteínas. Com este estudo verificou-se que no gastrocnemius, as mitocôndrias IMF são mais afectadas pela diabetes mellitus tipo 1 do que as SS. A diminuição da actividade do sistema de controlo da qualidade proteica parece estar associada às alterações morfológicas e bioquímicas observadas nas mitocôndrias localizadas entre as fibrilas.
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Elrayah-Eliadarous, Hind. "Economic burden of diabetes on patients and their families in Sudan /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-450-1/.
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Walldén, Jenny. "Studies of immunological risk factors in type 1 diabetes /." Linköping : Department of Clinical and Experimental Medicine, Linköping University, 2008. http://www.bibl.liu.se/liupubl/disp/disp2008/med1075s.pdf.
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Walker, Kelly N. "Family functioning and diabetic ketoacidosis in pediatric patients with type i diabetes." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0004901.
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Thesis (M.S.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 42 pages. Includes Vita. Includes bibliographical references.
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Clark, DessyeDee M. "Computer-aided hypoglycemia detection in adolescents with insulin-dependent diabetes mellitus /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7368.
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Stavrou, Eftyhia P. "Functional losses in type 2 diabetes mellitus." Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36771/1/36771_Digitised%20Thesis.pdf.
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Aims:
Psychophysical tests such as Letter contrast sensitivity (CS) and flicker perimetry have been used to detect early functional losses in ocular disease such as age-related maculopathy (ARM) and in vascular disorders such as migraine. This study set out to determine the ability of these tests to detect early functional losses in type 2 diabetics with minimal or early diabetic retinopathy (DR).
Methods:
Subjects consisted of 20 patients with type 2 diabetes (duration, following diagnosis, ranging from 6 months to 18 years) and 24 age-matched normal controls.
Letter CS, using the Pelli-Robson cha.ii, visual acuity (VA) using the standard high contrast Bailey-Lovie chart and monocular visual fields (VF) were measured. Static and flicker VF were measured using the Medmont M600 perimeter (MFA) and SIT A-standard fields using the Humphrey Field Analyser (HFA) were tested.
Results:
Letter CS was able to discriminate those diabetic subjects with none or early DR and those with and without ME from the control group, whereas VA was not able to detect any significant differences in visual function in these diabetic sub-groups compared to the control group.
In terms of visual fields, both the pattern defect (PD) index and hill-ofvision profiles were analysed. In those with early onset of diabetes and in those with none/minimal DR, only the PD index obtained with the flicker technique was significantly worse than the control group. The hill-of-vision profiles showed that the PD loss in those with minimal DR when flicker perimetry was used, was due to a central depression close to fixation, whereas the MFA static and HFA profiles consisted of a general depression across the field. This indicated that the flicker technique is a more sensitive test than the static technique in determining central visual field defects in those with minor observable retinal changes.
The inability of the HFA to detect changes to the macula region was thought to be due to the large grid spacing of the stimuli, as when the severity of retinopathy increased to a moderate level, the MFA static technique produced central losses which were not evident with the HFA.
Conclusion:
For diabetic patients who had either, a duration of diabetes of less than five years, or displayed only minimal or no DR or no ME, VF defects were only elicited with the use of the MFA flicker technique. Further functional losses in those with no or early, clinically detectable changes, were revealed by measuring Pelli-Robson Letter CS.
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Rydgren, Tobias. "Experimental Studies Aiming to Prevent Type 1 Diabetes Mellitus." Doctoral thesis, Uppsala University, Department of Medical Cell Biology, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8292.
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Type 1 diabetes mellitus (T1DM) is an autoimmune disease in which T-cells and macrophages invade the islets of Langerhans and selectively destroy the insulin producing β-cells, either directly or through the secretion of e.g. cytokines and nitric oxide (NO). This thesis has studied possible strategies to prevent T1DM. In β-cells and macrophages, NO is produced by inducible nitric oxide synthase (iNOS).
In the first study, we found that 1400W, a highly selective inhibitor of iNOS could prevent interleukin (IL)-1β induced suppression of rat islet function in vitro, but not diabetes induced by multiple low dose streptozotocin (MLDS), a well established animal model for autoimmune diabetes, in vivo.
Next, we wanted to test a new type of high affinity blocker of IL-1 action, called IL-1 trap, in vitro. Here we found that an IL-1 trap could prevent the suppressive effects by IL-1β on rat pancreatic islet function. Also, it was sufficient to block the action of IL-1β to prevent islet cell death induced by a combination of IL-1β, tumor necrosis factor-α and interferon-γ.
In study III, a murine IL-1 trap was found to prolong islet graft survival in the recurrence of disease (ROD) model, a T1DM model that involves syngeneic transplantation of healthy pancreatic islets to diabetic nonobese diabetic mice. Mice treated with IL-1 trap displayed an increased mRNA level of the cytokine IL-4 in isolated spleen cells. This suggests a shift towards Th2-cytokine production, which in part could explain the results.
Finally, simvastatin an anti-hypercholesterolemic drug that possesses anti-inflammatory properties e.g. by interfering with transendothelial migration of leukocytes to sites of inflammation was studied. We found that the administration of simvastatin could delay, and in some mice prevent, the onset of MLDS-diabetes, and prolong islet graft survival in the ROD model.
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Holstad, Maria. "Prevention of type 1 diabetes mellitus in experimental studies." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4972-7/.
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Copeman, James Benjamin. "The genetics of type 1 (insulin dependent) diabetes mellitus." Thesis, University of Oxford, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294271.
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Lord, Christopher James. "The genetics of type 1 (insulin-dependent) diabetes mellitus." Thesis, University of Oxford, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.363956.
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Pritchard, Lynn Edward. "The genetics of type 1 (insulin-dependent) diabetes mellitus." Thesis, University of Oxford, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241656.
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Reed, Peter Wayne. "Genetic analysis of Type 1 (insulin-dependent) diabetes mellitus." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325788.
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Narendran, Partheepan. "Immune responses to proinsulin in type 1 diabetes mellitus." Thesis, University of Bristol, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325704.
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Muhammed, H., Андрій Миколайович Лобода, Андрей Николаевич Лобода, and Andrii Mykolaiovych Loboda. "Gene polymorphism in patients with type 1 diabetes mellitus." Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/60769.
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Type 1 diabetes mellitus (T1DM) is a common medical and social problem, which frequency increased during last decade. Annual incidence varies from 0.61 cases per 100,000 population in China to 41.4 cases per 100,000 population in Finland. A general amount ill child in Ukraine in 2016 is approximately 8,500. T1DM is a disease with heterogeneous etiology, influenced by environmental factors and prevalent autoimmune susceptibility. Predisposition of the autoimmune pancreatic β-cell destruction has been associated with genetic variations on different chromosomes.
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Caseiro, Armando José Cerejo. "Salivary proteomics and peptidomics of type 1 diabetes Mellitus." Doctoral thesis, Universidade de Aveiro, 2013. http://hdl.handle.net/10773/11344.
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Doutoramento em BioquímicaA Diabetes Mellitus (DM) compreende um conjunto de desordens metabólicas comuns caracterizadas por hiperglicemia, que afeta diferentes órgãos do organismo. Ao longo do tempo, ocorrem danos microvasculares no glomérulo renal, retina e nervos periféricos, bem como doença macrovascular nas artérias. A composição da saliva também é afetada pela DM, com consequências na homeostasia oral. No entanto, o proteoma e o peptidoma salivar têm sido pouco explorados na DM tipo 1 e nas suas complicações crónicas. Tendo em conta o crescente interesse na saliva como fluido diagnóstico, o objetivo principal deste trabalho foi avaliar os eventos proteolíticos subjacentes à DM tipo 1 e às suas complicações microvasculares, bem como, caracterizar as alterações induzidas pela DM tipo 1 no proteoma e peptidoma salivar. A DM tipo 1 e particularmente as complicações microvasculares associadas modulam o perfil proteolítico dos fluidos biológicos, com diferenças significativas de atividade observadas na urina e saliva, atribuídas principalmente ao complexo Metaloproteinase da Matriz (MMP)-9/lipocalina associada à gelatinase de neutrófilos, aminopeptidase N, azurocidina e calicreína 1. O aumento da atividade proteolítica observado na saliva total dos diabéticos resultou no aumento da percentagem de péptidos, principalmente de um número acrescido de fragmentos de colagénio do tipo I, refletindo possivelmente um estado inflamatório crónico dos tecidos orais e periodontais. O peptidoma também corrobora uma maior suscetibilidade das proteínas salivares, especificamente, das proteínas ricas em prolina básicas (bPRP) 1, bPRP2 e proteínas ricas em prolina ácidas (aPRP) à proteólise, evidenciando a geração de fragmentos de proteínas associadas à ligação a bactérias. A análise do proteoma salivar baseada em iTRAQ mostrou uma sobre-expressão de L-plastina, fator do adenocarcinoma do pâncreas e das proteínas S100-A8 e S100-A9, enfatizando a importância do sistema imune inato na patogénese da DM tipo 1 e das complicações microvasculares associadas. A análise integrada de todas as proteínas expressas diferencialmente entre os pacientes diabéticos com ou sem complicações microvasculares e indivíduos saudáveis foi realizada com o STRING, onde se observam três conjuntos funcionalmente ligados, um compreende a interação entre o colagénio tipo I, colagénio tipo II e MMP-9, um segundo conjunto envolve a MMP-2 e o colagénio de tipo I e um terceiro conjunto composto por proteínas salivares e inflamatórias. Estes conjuntos estão associados com as vias Kegg de interação recetor-matriz extracelular, de adesão focal e migração transendotelial dos leucócitos. Por outro lado, a análise do proteoma e peptidoma salivar destacou potenciais biomarcadores para o diagnóstico e prognóstico da DM tipo 1 e das suas complicações.
Diabetes Mellitus (DM) comprises a set of common metabolic disorders that share the phenotype of hyperglycemia, which affect many different organ systems in the body. Over time, DM-specific microvascular disease in renal glomerulus, retina and peripheral nerves occurs, as well as macrovascular pathology in arteries. The composition of saliva is also affected by DM with consequences in the oral homeostasis; however, the salivary proteome and even more the peptidome has been quite unexplored in type 1 DM and related chronic complications. Taking into account the growing interest in saliva as diagnosis fluid, the main goal of this thesis was to disclose the proteolytic events underlying type 1 DM and related microvascular complications as well as to characterize DM-induced alterations in salivary proteome and peptidome. Type 1 DM and particularly the associated microvascular complications modulates biofluids’ proteolytic profile, with significant activity differences noticed for urine and saliva mainly attributed to Matrix Metalloproteinase (MMP)-9/neutrophil gelatinase-associated lipocalin complex, aminopeptidase N, azurocidin and kallikrein 1. The higher proteolytic activity noticed in whole saliva of diabetics leads to an increase in the percentage of peptides, mainly consisting of an augmented number of collagen type I fragments, possibly reflecting a chronic inflammatory state of oral and periodontal tissues. Moreover, peptidome data also support a diabetes-related higher susceptibility of salivary proteins, namely basic proline-rich protein (bPRP) 1, bPRP2 and acidic proline-rich proteins (aPRP) to proteolysis evidencing the generation of protein fragments associated with bacterial attachment. iTRAQ-based salivary proteome profiling evidenced an overexpression of L-plastin, pancreatic adenocarcinoma factor, protein S100-A8 and S100-A9, emphasizing the importance of the innate immune system in the pathogenesis of type 1 diabetes mellitus and related microvascular complications. The integrative analysis of all different expressed proteins performed with STRING shows three clusters functionally connected, one comprehending collagen types I and II interaction and MMP-9, a second involving MMP-2 and collagen type I, and a third cluster compreending salivary proteins and inflammatory proteins. These clusters are associated with the Kegg pathways extracellular matrix-receptor interaction, focal adhesion, and leukocyte transendothelial migration. In addition, the salivary proteome and peptidome analysis highlighted potential biomarkers for the diagnosis and prognosis of type 1 diabetes mellitus and related complications.
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Nordwall, Maria. "Long term complications in juvenile diabetes mellitus." Doctoral thesis, Linköping : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6377.
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Holm, Pernilla. "Genetic studies of susceptibility to diabetes mellitus with emphasis on type 1 diabetes /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-527-1/.
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Ma, Jun. "Identification of the susceptibility genes in type 1 diabetes and diabetic nephropathy /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-398-6/.
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Fabris, Chiara. "Glucose variability assessment in diabetes mellitus monitoring and control." Doctoral thesis, Università degli studi di Padova, 2015. http://hdl.handle.net/11577/3424146.
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This dissertation is focused on the assessment of glucose variability (GV) in the treatment of the pathology of diabetes mellitus. GV is a risk factor for the development of diabetes complications, and its assessment combined with the evaluation of glycated hemoglobin levels is believed to be useful to characterize the functioning of glucose metabolism. Given the importance of GV in diabetes, a number of indicators to measure it from the retrospective analysis of sparse self-monitoring of blood glucose (SMBG) or continuous glucose monitoring (CGM) recordings have been proposed in the literature, but several issues are still open. For instance, some GV indicators have been developed specifically from SMBG data, and their use on CGM time-series has not been validated yet. Moreover, the availability of a large number of metrics to quantify GV gives rise to problems in terms of redundant conveyed information, and a compact way to extensively characterize GV would be desirable. Finally, the exploitation of CGM signals and GV to classify the metabolic condition of normal and diabetic subjects is a relatively unexplored problem that could deserve an investigation. These three topics are the object of this dissertation, which is specifically made up of six chapters whose content is briefly outlined below.
Chapter 1 will describe the etiology of the different types of diabetes, discuss the development of diabetes complications, and introduce the technologies used to monitor blood glucose levels and the strategies exploited to manage the treatment of type 1 (T1DM) and type 2 (T2DM) diabetes mellitus.
Chapter 2 will focus specifically on GV and its quantification, and, after highlighting the existing open issues, will precisely state the aims of the thesis.
Chapter 3 will consider the problem of adapting some GV indicators originally developed and validated from SMBG, to the use with CGM signals. In particular, we will specifically look at low blood glucose index (LBGI) and high blood glucose index (HBGI), popular metrics that allow to provide a rapid classification of the quality of glucose control in diabetic subjects, and will provide alternate versions of these indicators adapted to the characteristics of CGMs by modeling the relationship between LBGI/HBGI values obtained from SMBG and CGM recordings. A dataset of 28 T1DM subjects monitored with both SMBG and CGM devices will be used to tune and assess the proposed methodology.
Chapter 4 will address the issue of redundant information conveyed by the available GV indices by using the sparse principal component analysis (SPCA) technique as a tool to provide a parsimonious but still comprehensive characterization of GV in both T1DM and T2DM. Specifically, we will consider 25 GV indicators evaluated on CGM profiles acquired from 33 T1DM and 13 T2DM subjects as initial pool of variables. SPCA will be applied to this set of metrics and will be shown to be able to select a small subset of up to 10 indices that can save more than 60% of the original variance in both applications. The subset of metrics provided by SPCA can be used to parsimoniously describe GV in diabetes.
Chapter 5 will be devoted to the assessment of the possibility of using the outputs from SPCA to build GV-based classifiers of the metabolic condition of normal and diabetic subjects. In particular, by resorting to a dataset of 55 T1DM subjects, 34 normal subjects at high risk of developing T2DM, 39 impaired glucose tolerance subjects, and 29 subjects with T2DM diagnosed, we will show that support vector machines are able to successfully classify the quality of glycemic control and the metabolic condition of disordered subjects, allowing to achieve an accuracy of classification always greater than 70%. The investigation will be performed using both the whole initial pool of 25 indicators and the parsimonious set selected by SPCA as features to design the classifiers; the fact that similar results were obtained in the two scenarios strengthens the speculation that the compact description of GV provided by SPCA is effectively comprehensive for characterizing the subjects' metabolic condition.
Chapter 6 will close this dissertation, with a discussion on possible future developments of the presented investigations.L'obiettivo di questa tesi è l'indagine del ruolo della variabilità glicemica (GV) nella patologia del diabete mellito. La GV è un fattore di rischio per lo sviluppo di complicazioni dal diabete, e la sua valutazione combinata con quella dei livelli di emoglobina glicata è ritenuta essere un elemento utile nel caratterizzare il funzionamento del metabolismo del glucosio. Data l'importanza della GV nel diabete, molteplici indicatori che permettono di ottenerne una quantificazione dall'analisi retrospettiva di segnali di self-monitoring of blood glucose (SMBG) o continuous glucose monitoring (CGM) sono stati proposti in letteratura, ma in merito esistono alcune problematiche ancora aperte. Per esempio, alcuni indici sono stati sviluppati specificamente per essere applicati su serie SMBG, ed il loro utilizzo su segnali CGM non è ancora stato validato. Inoltre, il fatto che esistano numerosi indicatori per quanticare la GV dà origine a problemi di ridondanza nell'informazione trasmessa, ed un approccio che permetta di ottenere una descrizione compatta ma esaustiva della GV sarebbe desiderabile. Infine, l'uso di segnali CGM e dell'informazione sulla GV per classificare lo stato metabolico di soggetti normali e diabetici è un problema relativamente inesplorato che potrebbe meritare di essere trattato. Questi tre argomenti sono l'oggetto di questa tesi, che risulta articolata in sei capitoli il cui contenuto è brevemente delineato di seguito. Il Capitolo 1 descriverà l'eziologia dei differenti tipi di diabete, discuterà lo sviluppo delle complicazioni da diabete, ed introdurrà le tecnologie utilizzate per monitorare la glicemia ed alcune strategie che si possono seguire per trattare il diabete mellito di tipo 1 (T1DM) e 2 (T2DM). Il Capitolo 2 verterà sulla GV e la sua quantificazione, e, dopo aver evidenziato i problemi aperti esistenti, dichiarerà precisamente gli scopi della tesi. Il Capitolo 3 considererà il problema di adattare alcuni indicatori di GV originariamente sviluppati e validati su profili SMBG, all'utilizzo su segnali CGM. In particolare, ci concentreremo su low blood glucose index (LBGI) e high blood glucose index (HBGI), indici popolari che permettono di ottenere una rapida classificazione della qualità del controllo glicemico in soggetti diabetici, e forniremo versioni alternative di questi indicatori adattate alle caratteristiche dei segnali CGM, modellando la relazione tra i valori che LBGI e HBGI assumono quando calcolati da SMBG e CGM. Un dataset di 28 soggetti T1DM monitorati con dispositivi SMBG e CGM sarà utilizzato per mettere a punto la metodologia. Il Capitolo 4 affronterà il problema della ridondanza nell'informazione fornita dagli indicatori di GV esistenti, utilizzando la sparse principal component analysis (SPCA) come approccio per fornire una descrizione parsimoniosa ma allo stesso tempo esaustiva della GV in popolazioni di soggetti con T1DM e T2DM. In particolare, considereremo 25 indicatori di GV valutati su profili CGM acquisiti da 33 soggetti con T1DM e 13 con T2DM come insieme iniziale di variabili. La SPCA sarà applicata a questo pool di indici e permetterà di selezionare un piccolo sottoinsieme di 10 indicatori che consente di preservare più del 60% della varianza originariamente spiegata dall'insieme di partenza in entrambe le applicazioni. Il sottoinsieme di indicatori fornito dalla SPCA può essere utilizzato per descrivere parsimoniosamente la GV nel diabete. Il Capitolo 5 sarà dedicato alla valutazione della possibilità di utilizzare gli output della SPCA per costruire classificatori dello stato metabolico di soggetti normali e diabetici basati sulla GV. In particolare, facendo ricorso ad un dataset di 55 soggetti con T1DM, 34 normali a rischio T2DM, 39 con impaired glucose tolerance, e 29 con T2DM diagnosticato, mostreremo che classificatori progettati su support vector machine sono capaci di discriminare con successo la qualità del controllo glicemico e la condizione metabolica di soggetti con disordini, permettendo di raggiungere un'accuratezza di classicazione sempre maggiore del 70%. Lo studio sarà condotto utilizzando sia il pool iniziale di 25 indicatori che il sottoinsieme parsimonioso fornito dalla SPCA come features per costruire i classificatori; il fatto che risultati simili siano ottenuti nei due casi rafforza la speculazione che la descrizione compatta della GV fornita dalla SPCA sia effettivamente esaustiva nel caratterizzare la condizione metabolica dei soggetti. Il Capitolo 6 chiuderà la tesi, con una discussione su possibili sviluppi futuri degli studi qui presentati.
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Taslimuddin, Shaheda. "Immune response to insulin in type 1 diabetic patients." Thesis, University of Bath, 1990. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.257186.
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Persson, Theres, and Emma Värnå. "Ungdomars upplevelser av att leva med diabetes mellitus typ 1." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-25602.
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Bakgrund: Diabetes mellitus typ 1 är en kronisk sjukdom som i Sverige drabbar cirka 800 barn årligen och kräver daglig behandling med insulin. Sjukdomen innebär begränsningar i det dagliga livet. Ungdomar har ett ökat behov av att frigöra sig från föräldrar och att bli självständig är en naturlig del i ungdomars utveckling. Syfte: Beskriva ungdomars upplevelse av att leva med diabetes mellitus typ 1 samt att granska vilken undersökningsgrupp som återfinns i de inkluderade artiklarna. Metod: Beskrivande litteraturstudie. Databaserna Medline via Pubmed och Cinahl användes för att söka underlag till studien. Elva vetenskapliga artiklar återfinns i resultatet. Huvudresultat: Ungdomar med diabetes mellitus typ 1 upplevde en känsla av att vara annorlunda och att sjukdomen var en börda. Ungdomarna upplevde även att de hade fler konflikter med sina föräldrar än sina kamrater och att föräldrarna hade svårt att släppa kontrollen. För att acceptera sin sjukdom beskrev ungdomarna att de behövde integrera sjukdomen som en del i sin identitet och sitt dagliga liv. På så vis kunde ungdomarna nå självständighet och utveckla sin förmåga att ta eget ansvar gällande egenvård. Slutsats: Resultatet påvisade att majoriteten av ungdomar med diabetes mellitus typ 1 kände sig annorlunda i jämförelse med jämnåriga. Många ungdomar upplevde svårigheter i relationen till sina föräldrar relaterat till ansvar för egenvården. Ungdomarna beskrev processen att acceptera och integrera sin sjukdom som en del i deras identitet. Sjuksköterskor har en viktig uppgift att stötta och vägleda ungdomar med diabetes mellitus typ 1 mot självständighet och ge dem förutsättningar att klara av egenvård.Background: Diabetes mellitus type1 is a chronic disease which yearly afflicts around 800 children in Sweden and requires daily insulin treatment. The disease entails limitations in everyday life. Adolescents have an increased need to liberate themselves from their parents and gaining independence is a natural part of youths’ development. Aim: Describe adolescents´ experience of living with diabetes mellitus type 1 and to examine which research group is found in the included articles. Method: Descriptive literature study. The databases Medline via Pubmed and Cinahl were used in searching for study material. Eleven scientific articles are included in the results. Main findings: Adolescents with diabetes mellitus type1 had an experience of being different and that the disease was a burden. The adolescents also had the experience of having more conflicts with their parents than with their friends, and that their parents had difficulties letting go of control. In order to accept the disease, the adolescents described the need to integrate the disease as a part of their identity and daily life. In this way the adolescents could gain independence and grow in their ability to take responsibility and manage their self care. Conclusion: The findings showed that the majority of adolescents with diabetes mellitus type1 had an experience of being different compared to their peers. Many adolescents experienced difficulties in the relationship with their parents regarding the responsibility for selfcare. The adolescents described to process of acceptans and the need to integrate their disease as part of their identity. Nurses have an important task of supporting and guiding adolescents with diabetes mellitus type 1 towards independence and giving them the conditions for coping with selfcare.
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Gustafsson, Louise, and Malin Karlsson. "UTAN ÅTERVÄNDO Typ 1 diabetes mellitus i kollision med adolescensutvecklingen." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-25303.
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Adolescensutvecklingen är en känslig period, då övergången från att vara ett beroende barn till att bli en självständig vuxen skall äga rum. Under denna kritiska process sker identitetsutveckling och strävan efter att vara oberoende föräldrar ökar. År 2013 rapporterades att cirka 50000 personer i Sverige har typ 1 diabetes mellitus (T1DM) och statistik pekar på en ständig ökning av sjukdomen. T1DM är en ämnesomsättningssjukdom som kännetecknas av brist på hormonet insulin. Sjukdomen behandlas med insulin, kost och motion och kräver dessutom regelbundenhet och daglig egenvård. Syftet med studien var att identifiera hälsorelaterade utmaningar med T1DM under adolescensutvecklingen, ur ett personperspektiv. Studien är utförd som en litteraturstudie där 13 vetenskapliga artiklar har granskats och bearbetats. Resultatet visar att T1DM under adolescensutvecklingen medför speciella utmaningar och problematik kring föräldrarelationen, vikten av kunskap och stöd samt behovet av att vara som alla andra. Vidare forskning bör fokusera på föräldrars samt hälso- och sjukvårdspersonals perspektiv kring T1DM under adolescensutvecklingen, för att få ett helhetsperspektiv och kunna stödja den drabbade ungdomen på bästa sätt.The adolescence is a sensitive period with the transition from being a dependent child to becoming an independent adult. During this critical process ones identity develops and the desire to be self-sustaining without parents increases. In 2013 it was reported that approximately 50 000 people in Sweden have type 1 diabetes mellitus (T1DM) and statistics point to a steady increase of the disease. T1DM is a metabolic disease characterized by a lack of the hormone insulin. The disease is treated with insulin, diet and exercise and also requires regularity and daily self-care. The purpose of this study was to identify health related challenges with T1DM during the period of adolescence, from a person perspective. This is a literature study in which 13 scientific articles have been reviewed and processed. The result shows that T1DM during the period of adolescence poses special challenges and problems relating to the parental relationship, the importance of knowledge and support, and the need to be like everyone else. Further research should focus on the perspectives of both parents and healthcare staff on T1DM during adolescence, to get an overall perspective and be able to assist the affected youth in the best possible way.
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Aitman, Timothy John. "The molecular genetics of type 1 (insulin-dependent) diabetes mellitus." Thesis, University of Oxford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316796.
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Lucassen, Anneke M. "Molecular genetic aspects of susceptibility to Type 1 diabetes mellitus." Thesis, University of Oxford, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259885.
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Matyka, Krystyna Anna. "Nocturnal hypoglycaemia in prepubertal children with Type 1 Diabetes Mellitus." Thesis, King's College London (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.395474.
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Wong, Florence Susan. "A study of the immunogenetics of type 1 diabetes mellitus." Thesis, King's College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309474.
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Olenovych, O. A. "Nonspecific body reactivity in patients with diabetes mellitus type 1." Thesis, Materials of XI International Research and Practice Conference «Conduct of modern science – 2014». – November 30 – December 7, 2014. – UK. – Volume 19 «Medicine». – P. 47-50, 2014. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/10776.
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Grant-Thomson, Richard Grant. "Periodontal disease and type 1 diabetes mellitus in young patients /." [St. Lucia, Qld. : s.n.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16646.pdf.
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Houben, Alfonsius Josephus Hubertus Mathias. "Early (micro)circulatory haemodynamic changes in type I diabetes mellitus." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1993. http://arno.unimaas.nl/show.cgi?fid=5745.
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Bekris, Lynn Matthews. "Glutathione related enzyme gene polymorphisms and type 1 diabetes /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/8442.
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Шандиба, Ірина Олександрівна, Ирина Александровна Шандыба, Iryna Olexandrivna Shandyba, Андрій Миколайович Лобода, Андрей Николаевич Лобода, and Andrii Mykolaiovych Loboda. "Early diagnosis of diabetic nephropathy in children with type 1 diabetes mellitus using the VCAM-1 biomarker." Thesis, Lithuanian University of Health Sciences, 2020. https://essuir.sumdu.edu.ua/handle/123456789/78327.
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Васкулярна молекула клітинної адгезії-1 (VCAM-1) - це 90 кДа глікопротеїн, який експресується в ендотеліальних клітинах і бере участь в міграції і рекрутуванні запальних клітин. Недавні дослідження показали, що рівні VCAM-1 в сечі були значно підвищені у пацієнтів із захворюванням нирок. Метою цього дослідження було вивчення особливостей рівнів VCAM-1 в сечі дітей залежно від тривалості діабету. У дослідження були включені 47 дітей з діабетом 1-го типу і 8 дітей без діабету. VCAM-1 в сечі збільшився на 24 відсотки у дітей з тривалістю діабету менше одного року в порівнянні з контрольною групою. Рівні VCAM-1 були підвищені на 33 відсотки у дітей з тривалістю діабету від одного до п'яти років. Цей показник збільшився на 54 відсотки у дітей, які жили з діабетом більше п'яти років. Висновки. Збільшення рівня VCAM-1 в сечі спостерігалося вже в перший рік маніфестації діабету у дітей. Вимірювання рівня VCAM-1 в сечі може бути корисним для ранньої діагностики діабетичної нефропатії.Васкулярная молекула клеточной адгезии-1 (VCAM-1) - это 90 кДа гликопротеин, который экспрессируется в эндотелиальных клетках и участвует в миграции и рекрутировании воспалительных клеток. Недавние исследования показали, что уровни VCAM-1 в моче были значительно повышены у пациентов с заболеванием почек. Целью настоящего исследования было изучение особенностей уровней VCAM-1 в моче детей в зависимости от продолжительности диабета. В исследование были включены 47 детей с диабетом 1-го типа и 8 детей без диабета. VCAM-1 в моче увеличился на 24 процента у детей с продолжительностью диабета менее одного года по сравнению с контрольной группой. Уровни VCAM-1 были повышены на 33 процента у детей с продолжительностью диабета от одного до пяти лет. Этот показатель увеличился на 54 процента у детей, которые жили с диабетом более пяти лет. Выводы. Увеличение уровня VCAM-1 в моче наблюдалось уже в первый год манифестации диабета у детей. Измерение уровня VCAM-1 в моче может быть полезно для ранней диагностики диабетической нефропатии.
Vascular cell adhesion molecule-1 (VCAM-1) – is a 90-kDa glycoprotein that is expressed in endothelial cells and is involved in the migration and recruitment of inflammatory cells. Recent studies have shown that urinary VCAM-1 levels were significantly increased in patients with kidney disease. The aim of the current study was to investigate the features VCAM-1 levels in urine of children depending on the diabetes duration. Study included 47 children with 1 type diabetes mellitus and 8 children without diabetes. VCAM-1 in urine increased by 24 percent in children with the duration of diabetes below one year compared to the control group. VCAM-1 levels were elevated by 33 percent in children with the duration of diabetes from one to five years. The marker increased by 54 percent in children who lived with diabetes for more than five years. Conclusions. Increase in urinary VCAM-1 was observed in the first year of diabetes in children. Measuring the level of VCAM-1 in urine may be useful for the early diagnosis of diabetic nephropathy.
Thanks for the research group of Thomas Boren (Department of Medical Biochemistry and Biophysics/MIMS, Umea University) for the opportunity to conduct research in framework of collaboration in Erasmus+ (KA1) programme, 2018/2019. The authors declare absence of potential conflicts of interest.
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Österman, Lind Rebecca, and Anna Landström. "Att leva med diabetes mellitus typ 1 : Erfarenheter från vuxna." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-75009.
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Bakgrund Diabetes mellitus typ 1 är en livslång autoimmun sjukdom med stort egenvårdsbehov. I yrket som sjuksköterska är det viktigt att ha kunskaper om erfarenheter kring hur det är att leva med sjukdomen för att ge rätt stöd, råd och information. Vald teoretisk referensram är Dorothea Orems’ egenvårdsteori. Syfte Att belysa vuxna individers erfarenheter av att leva med diabetes mellitus typ 1. Metod Metoden utgjordes av en litteraturstudie. Studien byggde på databassökningar i PsycINFO, PubMed och Cinahl. Efter kvalitetsgranskning valdes tio artiklar ut för analys. Resultat Resultatet presenterades genom tre kategorier med sju underkategorier. De tre kategorierna var: att inte visa sjukdomendär erfarenheter av att dölja eller åsidosätta sjukdomen beskrevs, att låta sjukdomen vara en del av livet där prioritering och planering, begränsningar och att ha en positiv inställning dominerade och att lära känna sjukdomen tillsammans med andra där vikten av stöd och självkännedom beskrevs. Slutsats För sjuksköterskor som möter individer med diabetes mellitus typ 1 är det viktigt att känna till de olika aspekterna av att leva med sjukdomen för att kunna ta hänsyn till dessa i den individualiserade vården som borde bedrivas. Genom denna studie kan författarna dra slutsatsen att det fanns ett stort behov av stöd och acceptans från omgivningen kring individer med diabetes mellitus typ 1.
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Hedman, Christina A. "Insulin and IGF-I in type 1 diabetes /." Linköping : Univ, 2005. http://www.bibl.liu.se/liupubl/disp/disp2005/med915s.pdf.
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Wu, Douglas Ching Gee. "Cellular therapeutic strategies for the treatment of Type 1 Diabetes Mellitus." Thesis, University of Oxford, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.670111.
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Rytkönen, M. (Mika). "Geographical study on childhood type 1 diabetes mellitus (T1DM) in Finland." Doctoral thesis, University of Oulu, 2004. http://urn.fi/urn:isbn:9514272862.
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Abstract
Type 1 diabetes mellitus (T1DM) among children is of a particular importance in Finland, where its incidence is the highest in the world and still increasing. However, the aetiology of T1DM is not fully known. According to current knowledge, both genetic and environmental factors operate together, leading to an attack by the immune system on the insulin-producing beta cells.
The purpose of this study was to investigate the geographical variation in the incidence of T1DM among children aged up to 14 years in Finland. Geographical Information Systems (GIS) and Bayesian spatial statistics were applied in a search for unusual spatial patterns and risk factor associations.
The incidence of T1DM among children aged up to 14 years showed clear geographical variations in Finland. Living in a rural environment increased the risk for T1DM, and the risk was particularly high among children living in rural heartland areas. There was no association between the variation in T1DM incidence and the zinc and nitrate concentrations of drinking water. A male excess in the incidence of T1DM was seen in the low-incidence areas. The geographical variation in the risk of T1DM was marked only among children aged up to 9 years.
Because genetics is a necessary but not a sufficient cause of T1DM, it could be hypothesized that there are some thus far unknown environmental risk factors affecting particularly younger children in Finland. Some of those factors may be related to a rural environment. The geographical variation in the M/F ratio of T1DM was a challenging observation and warrants more analytical study.
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Samnegård, Björn. "Renal effects of C-peptide in experimental type-1 diabetes mellitus /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-502-X/.
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Clarke, Caroline Frances. "Autonomic neuropathy in children and adolescents with type 1 diabetes mellitus." Thesis, University of Southampton, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.359223.
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Desai, Radhika Shyam. "Inflammatory mechanisms associated with type 1 diabetes mellitus and oral diseases." Thesis, University of Newcastle upon Tyne, 2017. http://hdl.handle.net/10443/3740.
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Diabetes is a well-known risk factor for periodontal disease; however, the pathogenic links between periodontal disease and type 1diabetes (T1DM) are not completely understood. Therefore, this study evaluated, longitudinally over 6 months, the impact of periodontal disease and its treatment on clinical outcomes, glycated haemoglobin (HbA1c), high-sensitivity C-reactive protein (hsCRP), lipids and local and systemic levels of pro-inflammatory biomarkers [matrix metalloproteinase-9 (MMP-9), B-cell activating factor, resistin, epithelial neutrophil activating peptide-78/CXCL5 (ENA-78/CXCL5) and interleukin-8, (IL-8)] in patients with T1DM. 57 T1DM and 43 non-T1DM patients were recruited. Pre-treatment, T1DM patients had significantly lower diastolic BP, non-HDL and cholesterol compared to non-T1DM patients. T1DM periodontally healthy patients had significantly higher bleeding on probing (BOP) scores compared to non-T1DM periodontally healthy patients. Serum MMP-9, resistin and ENA-78/CXCL5 levels were significantly higher in T1DM patients compared to non-T1DM patients. Furthermore, T1DM periodontitis patients had significantly higher serum MMP-9 levels compared to non-T1DM periodontitis patients. Regardless of diabetes status, GCF MMP-9 levels were significant predictors of clinical periodontal condition. Moreover, T1DM periodontally healthy patients had significantly higher GCF MMP-9 and IL-8 levels compared to non-T1DM periodontally healthy patients. In T1DM and non-T1DM patients, all clinical periodontal parameters significantly improved at 3 and 6 months following non-surgical periodontal management (NSM), and both groups demonstrated significant reductions in GCF MMP-9 levels at month 6 following NSM. Furthermore, following NSM, GCF IL-8 levels significantly reduced at 3 and 6 months in T1DM patients and at month 3 in non-T1DM patients. In T1DM patients, HbA1c showed 0.45% and 0.90% reductions at 3 and 6 months following NSM, respectively, although these reductions were not statistically significant. In conclusion, NSM led to significant reductions in GCF MMP-9 and IL-8 levels, and these inflammatory mediators may play a role in the pathogenesis of periodontitis in patients with T1DM.
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Bogutska, N. K. "The association between pediatric type 1 diabetes mellitus and COVID-19." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19763.
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Al-Alvani, R. M. "Correction of zinc deficiency in children with type 1 diabetes mellitus." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27498.
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Scientific supervisor: N.V. GluschenkoThe most important in the pathogenesis of diabetes mellitus type 1 (DM-1) among trace elements has zinc (Zn). With the participation of Zn ions is an allocation of insulin from β-cells of Langerhans islands, the inclusion of insulin to transport complex, inhibition of insulinazy. Therefore, zinc deficiency can be considered as one of the factors of development and labile course of DM-1 in children. When you are citing the document, use the following link http://essuir.sumdu.edu.ua/handle/123456789/27498
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Nordfeldt, Sam. "On Severe Hypoglycaemia in Children and Adolescents with Type 1 Diabetes." Doctoral thesis, Linköping : Univ, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5018.
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Bengtsson, Felicia, and Ellinor Åkerberg. "Barns upplevelser av att leva medtyp 1-diabetes: en litteraturöversikt." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-444097.
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SAMMANFATTNING Bakgrund: Typ 1-diabetes är den vanligaste metabola sjukdomen hos barn och utgången är dödlig utan behandling. Behandlingen består av livslång insulintillförsel i kombination med blodsockerkontroll, kostberäkning och fysisk aktivitet. Trots utveckling av behandlingsregimen vid typ 1-diabetes finns det kvarstående betydande risker för långtidskomplikationer och psykisk ohälsa hos barnen som lever med sjukdomen. Familjerna och barnen utsätts för dagliga utmaningar samt den påfrestning det innebär att leva med en kronisk sjukdom. Syfte: Att undersöka hur barn med typ 1-diabetes upplever sin sjukdom samt hur de upplever att typ 1-diabetes påverkar deras liv. Metod: En systematisk litteraturstudie med induktiv design tillämpades. Sökningarna genomfördes i PubMed, CINAHL och PsycInfo och resulterade i 16 inkluderade vetenskapliga studier med kvalitativ ansats. Resultat: Barnens upplevelser av diabetes var framför allt negativa och mestadels kopplade till egenvården, som var tidskrävande, störande och smärtsam för barnen. Många barn hade blivit utsatta för stigmatisering, utanförskap och mobbning. Rädslan för att bli behandlad annorlunda av omgivningen gjorde att barnen ofta hemlighöll sin diabetes och i vissa fall struntade i behandlingen, särskilt i skolmiljön, som upplevdes dåligt anpassad efter barnens behov. Slutsats: Typ 1-diabetes påverkar barnen emotionellt och i synnerhet socialt där den mest utmanande tiden var i skolan. Barnsjuksköterskor har som ansvar att utefter barns behov stötta egenvård och självständighet och därigenom underlätta så att sjukdomen blir en del av livet för barnen.
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Tossavainen, née Riihimaa P. (Päivi). "Markers of microvascular complications in adolescents with type 1 diabetes." Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:951426892X.
Full textAbstract:
Abstract
The markers of microvascular complications of type 1 diabetes were evaluated in adolescents in a cross sectional survey of 100 out of 138 eligible patients aged 9-19 years with a duration of diabetes over two years who visited the Paediatric Outpatient Clinic at Oulu University Hospital in 1997-1999, and one hundred healthy controls.
Two patients in early or mid-puberty had non-proliferative diabetic retinopathy, but no other signs of microvascular complications.
The five patients with persistent microalbuminuria were all girls; one prepubertal, one late pubertal and three postpubertal. Their mean glycated haemoglobin A1c (HbA1c) was higher, but they had a similar duration of diabetes and age distribution to those without microalbuminuria.
The adolescent patients were predisposed to higher fasting serum total and low-density lipoprotein cholesterol and triglyceride levels and higher diastolic blood pressure than the control subjects. The proportional total body fat was highest in the girls with diabetes by the end of puberty, while serum leptin levels did not differ between the patients and healthy controls. The patients had low fasting serum insulin levels and high insulin-like growth factor-binding protein 1 levels, related to hypoinsulinaemia.
Distal motor nerve function in the lower extremities were already affected before puberty, and distal and proximal nerve function deteriorated as puberty advanced. Ten patients had neurophysiologically confirmed distal diabetic polyneuropathy, and they were older and they had longer duration of diabetes and higher HbA1c than patients without polyneuropathy.
Although cardiovascular function was in the main well preserved in the adolescents with type 1 diabetes, the power spectrum analysis of heart rate variability showed attenuated autonomic nervous system reactivity.
Taken together these data show that a relatively small proportion of adolescents with type 1 diabetes have signs of microvascular complications. The prevalences of diabetic retinopathy, persistent microalbuminuria and distal diabetic polyneuropathy were 2%, 6% and 10%, respectively. Pubertal maturation seems to promote the progression of early signs of microvascular complications in patients affected by type 1 diabetes.
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Verge, Charles Francis. "The epidemiology of childhood type 1 diabetes mellitus in New South Wales." Thesis, The University of Sydney, 1994. https://hdl.handle.net/2123/26840.
Full textAbstract:
Objectives
These 'studies aimed to determine the incidence of type I diabetes mellitus in children aged 0-14 years in New South Wales, to compare multiple autoantibody levels in a large population-based sample of newly diagnosed children, and to identify environmental factors that may be involved in the aetiology of the disorder.
Research Design and Methods
A prospective register was established, identifying 361 incident cases over a two year period (1990-91) with two independent sources of case ascertainment. The primary source was the reporting of newly diagnosed patients by physicians and diabetes educators. The secondary source was a subsidised syringe scheme.
A serum sample was available from 273 of the newly diagnosed children. Antibodies
against glutamic acid decarboxylase (anti-GAD) were measured by radioimmunoprecipitation. Insulin autoantibodies (IAA) were measured by liquid phase
radioimmunoassay on 176 sera collected within 4 days of the start of insulin therapy.
Reference ranges for anti-GAD (S 18 units) and IAA ( < 33 nU/ml) were determined
by testing a group of non-diabetic children. Islet cell antibodies (ICA) were measured by indirect immunofluorescence on cryostat sections of human pancreas (detection limit: 20 JDF U). Thyroid peroxidase antibodies (anti-TPO) and antigliadin IgA antibodies (AGA) were measured by ELISA. Anti-endomysial IgA antibodies (AEA) were measured by indirect immunofluorescence.
To study environmental factors, a case-control study was carried out with cases
ascertained during the first 18 months of the register. For each case, two age and sex matched controls were randomly selected from the population. Past environmental exposures were determined with a questionnaire completed by the parents. A completed questionnaire was returned for 92% of the cases (217/235) and 55% of the controls (258/470). The relative risk associated with each exposure was estimated with the odds ratio (OR), adjusted for confounding factors using multiple logistic regression.
Results
Using the capture-recapture method, ascertainment was estimated to be 99.4%
complete. The age-standardised incidence rate was 14.5 per 100,000 person years
(95% confidence interval: 13.0 — 16.0). There were no significant differences between
incidence rates, comparing the first and second years of the register, males and females, urban and rural areas or Aboriginal and non-Aboriginal children. The distribution of the age at onset revealed a major peak at 12 years of age. There was a seasonal variation in onset (with more cases in winter), evident in the 10-14 years age-group (P=0.01) but not in the younger age-groups. A first degree relative was already affected in 6.9% of cases. There was no significant difference in the age at onset, comparing cases with and without an affected first degree relative. The risk of type I diabetes by the age of 15 years for an individual in the general population estimated from the cumulative incidence was 0.2%.
Sixty-nine percent of the sera were positive for anti-GAD, 65% for IAA, 71% for ICA, 10% for anti-TPO, 2.6% for AGA and 3.0% for AEA. 13.7% were negative for both ICA and IAA, while only 5.8% were negative for all three of ICA, IAA and anti-GAD. There was a higher frequency of anti-GAD among girls than boys (75% versus 63%, = 0.03) and a negative correlation between the level of IAA and age at diagnosis (r = -0.41, P < 0.0001). A higher frequency of anti-TPO was found with increasing age (P = 0.05). Higher titres of ICA were associated with a higher frequency of anti-GAD (P < 0.0001) and IAA (P = 0.003), but there was no significant association between the levels of anti-GAD and IAA. Five cases (1.8%) with clear elevations of AGA and AEA were found to have asymptomatic coeliac disease by small bowel biopsy. There were no significant differences in the frequency of any antibody according to season of onset, geographical area, ethnicity or family history of type I diabetes.
The case-control study found that the introduction of cow’s milk based infant formula into the diet before 3 months of age was associated with an increased risk (OR 1.52, 95% confidence interval: 1.04 - 2.24), after allowing for confounding factors. Exclusive breast feeding for 3 months or more was associated with a protective effect (OR 0.66, 95% confidence interval: 0.45 - 0.97). A high dietary intake of cow’s milk
protein in the 12 months prior to the onset of diabetic symptoms was also associated
with an increased risk (OR 1.84, 95% confidence interval: 1.12 — 3.00). A recent infection (during the 3 months before onset of diabetic symptoms) was more common in the cases than the controls (OR 2.92, 95% confidence interval: 1.96 - 4.35), as was day care attendance prior to the age of 3 years (OR 1.73, 95% confidence interval: 1.00 - 3.00). When two age-groups defined by the median age at onset of the cases (9.2 years) were compared, the associations with early infant feeding were stronger among the younger group (< 9.2 years), whereas those with recent diet and recent infection were stronger among the older group (2 9.2 years). There was no significant association with dietary intake of nitrosamines, past infection with mumps, measles, rubella, chickenpox or herpes simplex or with mumps vaccination.
Conclusions
The incidence of childhood type I diabetes in New South Walesis similar to rates found in other predominantly Anglo—Saxon populations. Type I diabetes occurs in Aboriginal children with a frequency comparable to that in the rest of the population. There was a high frequency of anti—GAD antibodies in newly-diagnosed diabetic children. Anti- GAD were more frequent in girls than boys, IAA more frequent in younger patients, and anti-TPO in older patients. Asymptomatic coeliac disease occurred in at least 1.8% of newly diagnosed diabetic children. The addition of anti-GAD as a serological marker to the combination of ICA and IAA more than halved the number of autoantibody negative children. Only 5.8% were negative for all three serological markers, suggesting that a combination of these assays may be useful in the detection of the preclinical phase of the disease. After allowing for confounding factors, the case-control study of environmental factors found associations with dietary exposure to cow’s milk containing formula in early infancy, short duration of breast feeding, high intake of cow’s milk protein in the recent diet, infection in the three months prior to the onset of symptoms and early attendance at day care.
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Sonsona, Jocelyn B. "Factors Influencing Diabetes Self-Management of Filipino Americans with Type 2 Diabetes Mellitus: A Holistic Approach." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/1.
Full textAbstract:
There is an increasing prevalence of Type 2 diabetes mellitus among Filipino Americans. However, how well Filipino Americans with diabetes self-manage their disease and what factors influence their diabetes self-management behaviors remain unknown. Based on a holistic approach, this quantitative study was designed to investigate the diabetes self-management behaviors of this population and the factors influencing their self-management behaviors. The combined roles of diabetes knowledge, diabetes self-efficacy, spirituality, and social support were examined in predicting diabetes self-care behaviors. A convenience sample of 113 Filipino Americans with Type 2 diabetes mellitus completed the Diabetes Knowledge Test, Self-Efficacy for Diabetes Test, Daily Spiritual Experience Scale, Diabetes Social Support Questionnaire-Family Version, Summary of Diabetes Self-Care Activities (Expanded), and a researcher-designed sociodemographic survey. A single samplet -test determined that the participants engaged well in diabetes self-management practices. Multiple regression analyses revealed self-efficacy, spirituality, and social support were predictive of diabetes self-management behaviors, even after controlling for the effect of the confounding variables (e.g., acculturation, socioeconomic status, health-related data, immigration status, education). Diabetes knowledge did not have a significant relationship to self-management. The implications for positive social change include the potential impact of educating clients with diabetes and their family members about the connections between self-efficacy, spirituality, and family social support in the self-management of diabetes. Furthermore, the use of a holistic approach by health professionals would improve diabetes self-management practices of Filipino American population with Type 2 diabetes mellitus.