Type 1 diabetes: Complications and comorbidities

People with type 1 diabetes treated with multiple daily insulin injections struggle to achieve guideline-recommended targets for time in hypoglycemia while simultaneously reaching their glycated hemoglobin goals, researchers report.

Continuous glucose monitoring is well accepted and reduces time in hypoglycemia among older individuals with type 1 diabetes, report researchers in JAMA.

A proof-of-concept study indicates that taking some basal insulin as a single injection of degludec improves glucose control during and after exercise in people with type 1 diabetes who prefer to remove their insulin pump while exercising.

A major study of children from three continents suggests that diabetic ketoacidosis remains unacceptably high among those newly identified with type 1 diabetes and shows few signs of improving.

A large observational study reveals a strong link between reduced kidney function and increased incidence of hypoglycemia in adults with diabetes in routine clinical practice.

Three-quarters of people who undergo islet transplantation for type 1 diabetes have sustained graft survival with associated improvements in glucose control, insulin requirements, and hypoglycemia incidence 10 years later, research shows.

Simon Heller explains why time-in-range targets are so helpful for people with diabetes… yet handing out continuous glucose monitoring devices willy-nilly could do more harm than good.

Implementing a nursing protocol that includes point-of-care testing at triage reduces the time to diabetic ketoacidosis diagnosis and the number of unnecessary intravenous placements in the pediatric emergency department, say researchers.

Glycated hemoglobin levels correlate strongly with continuous glucose monitoring-measured average blood glucose and hyperglycemia, but poorly with hypoglycemia, say researchers.

Children with type 1 diabetes are more likely than their non-diabetic peers to seek primary care for a number of specific conditions in the year before their diagnosis, which could aid detection before the onset of diabetic ketoacidosis, say researchers.

Experts have developed consensus recommendations for minimizing diabetic ketoacidosis risk in patients with type 1 diabetes treated with SGLT inhibitors.

The effect of sleep duration on glucose regulation and cardiometabolic risk is becoming an increasingly high-profile issue. medwireNews takes a look at the latest evidence, which shows the gravity of the problem but also offers some solutions.

Insulin manipulation, the practice of deliberately under- or overdosing insulin, is strongly associated with psychiatric comorbidity in children and young adults with type 1 diabetes, Austrian research shows.

The addition of empagliflozin to insulin therapy reduces glycated hemoglobin levels in patients with type 1 diabetes, indicate findings from the phase III EASE-2 and 3 trials.

Weekly application of an autologous immune cell, fibrin, and platelet patch significantly increases the rate of healing of hard-to-heal foot ulcers compared with standard care in people with diabetes, randomized trial data show.

Lucidi P et al. Curr Diab Rep 2018; 18: 83. doi: 10.1007/s11892-018-1065-6

Uazman Alam and colleagues interrogate current evidence and real-world clinical scenarios to address whether enough is being done with the tools available to screen and diagnose diabetic neuropathy.

Neither the rate of administration nor the sodium chloride content of replacement fluids given to children with diabetic ketoacidosis influences their neurologic outcomes, show the results of the PECARN DKA FLUID Study.

Oriot P et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1170-7

People with type 1 diabetes are approximately twice as likely to experience gastrointestinal symptoms as those without, and these symptoms are associated with poor glycemic control and quality of life, study results suggest.