Immunological relation of atopy with typel diabetes in children

Objective: Assess immunological relation between atopic disease and Type 1 diabetes mellitus

Subject and Method: Across sectional study was done by written questionnaire adopted from American Academy of Dermatology Journal, [March 2008], from 200 children with Type 1 diabetes mellitus attending pediatric clinic, National Institute of Diabetes, and 200 non diabetic children attending pediatric clinic, New Cairo hospital

Results: Cases had lower frequency of asthma compared to controls with statistically significant difference between both groups, no allergic conjunctivitis among cases was found but was 2% among controls, cases had lower frequency of allergic rhinitis compared to controls with statistically significant difference both groups, and cases had lower frequency of atopic dermatitis compared to controls with no of statistically significant difference between both groups

This study shows no statistically significant difference between both groups as regard type of lactation, effect of food in presence of atopical symptoms, exposure to tobacco smoke. This study shows that cases had lower frequency of interference with daily activities; lower frequency of family history of atopy. This study indicates that positive atopical cases had higher frequency of positive family of atopy compared to negative group with statistically significant difference In between. This study shows that insulin dose among positive atopy cases was lower compared to negative atopy cases group with no significant difference

Conclusion: Patients with Type 1 diabetes have a lower prevalence of atopic symptoms, mainly asthma and allergic rhinitis which is consistent with the Th1/Th2 polarization concept

Additional studies are needed to evaluate the effect of atopy and allergic diseases on glycemic control and long term complications I patients with Type1 diabetes ad to understand why allergic symptoms among children with Type 1 diabetes have decreased

Adiponectin serum levels in adolescent boys with type 1 diabetes in relationships to pubertal grouth, development and glycemic control

Introduction: Adiponectin is a protein hormone secreted exclusive by adipocytes that regulate the metabolism of lipids and glucose. It has antidiabetic, antiatherogenic and anti-inflammatory properties

Objective: To asses adiponectin serum levels in adolescent boys with type development, body mass index [BMI], glycemic control and insulin dosage

Research design and methods: A case-control study was carried out on 45 adolescent boys with T1DM aged [12-18] years and 37 healthy control boys of similar age. Each of the cases and control groups were divided into four subgroups according to their Tanner stage .They were subjected to full history, reviewing medical records, auxology and pubertal stage assessment. Serum total adiponectin level was determined by ELISA technique in addition to giycatedhaemoglobin [HbAlc] and fasting blood glucose

Results: Mean adiponectin serum level [ +/- SD] was significantly higher in T1DM boys compared to healthy control group [12.93 +/- 5.24micro g/mlversus 8.91 +/- 3.21 micro g/ ml] [P<0.001] . Such higher serum levels of adiponectin were detected mainly at Tanner stage 2 [16.571 4.60 micro g/ mlvs 11.88 +/- 3.39 micro g/ ml] [P= 0.025] and Tanner stage 3 [12.77 +/- 3.71 micro g/ ml vs.6.59i 1.54 micro g ml] [P= 0.002]. Adiponectin level decreased significantly during pubertal development in control group and T1DM group. Adiponectin level was significantly higher in diabetic-poor controlled group than diabetic good-controlled group. Adiponectin was negatively correlated with pubertal stage, age, intermediate/ long acting insulin dose and positively correlated to HbAlc in diabetic group. In control group adiponectin levels were negatively correlated with pubertal stage and BMI

Conclusion: Adiponectin serum levels in adolescent boys with type 1 diabetes were significantly higher than control mainly at early puberty. It decreased significantly during pubertal development and was' strongly positively related to glycemic control

Evaluation of bone turnover in adolescent male patients with type 1 diabetes mellitus

A major consequence of metabolic derangement in diabetic patient is the defective bone mineralization. To evaluate the bone turnover in type 1 diabetic male adolescents, 20 male adolescents with type 1 diabetes and 10 age and sex matched healthy adolescents were subjected to a detailed history taking, thorough physical examination and serum investigations including fasting glucose, creatinine, albumin, total protein, fructosamine, total calcium, corrected calcium, ionized calcium, phosphorus, alkaline phosphatase, total testosterone, free testosterone, albumin-bound testosterone, parathyroid hormone [PTH], calcitonin, osteocalcin [OS], carboxy-terminals propeptide of type 1 procollagen [PICP], type 1 collagen cross-linked carboxy terminal telopeptide [ICTP] and beta 2 microglobulin [beta 2 M]. All values were expressed as mean +/- SD and significance was calculated according to unpaired students test. It was concluded that male adolescents with type-1 diabetes had a low bone turnover state due to decreased bone formation and increased bone resorption. The reduced bio-available testosterone in these patients plays as important role in this process and is negatively correlated with the duration of the disease. However, parathyroid hormone plays a nonsignificant role in this process

Detection of antigliadin antibodies [AGA] as a serological marker of silent celiac disease among young type 1 diabetic Egyptian patients

This work aimed to study the prevalence of serum AGA-IgA [immunoglobulin] as a marker of celiac disease [CD] in 150 asymptomatic young type 1 diabetic patients. The control group consisted of 100 healthy comparable subjects. Both groups had no gastrointestinal symptoms. They were subjected to full history taking, thorough clinical examinations, full laboratory investigations including the estimation of AGA-IgA using ELISA method. The results showed that seven type 1 diabetic patients were positive for AGA, while there were no positive AGA cases among the control group. Six out of seven positive AGA patients showed villous atrophy after doing intestinal biopsy. The level of serum AGA was not correlated to age, fasting as well as postprandial blood glucose levels, glycated HbA1c, microalbuminuria and duration of diabetes. It was concluded that in young type 1 diabetic patients, the prevalence of CD is higher than that in general population

Significance of acarbose in the treatment of type 1 diabetics

Significance of acarbose in the treatment of type 1 diabetics ABST: The aim of this controlled clinical study was to investigate the significance of the use of Acarbose to type 1 diabetic patients. Forty-five type 1 diabetic patients aged 12-20 years were subjected to this trial as a study group. They received Acarbose orally in an increasing dose starting from 50 mg per day till reaching to 300 mg per day for 3 months. Another 20 diabetic patients of the same age, sex and duration of diabetes were studied as a control group. Placebo tablets were given for them for 12 weeks. An evaluation of these patients, before and after Acarbose and placebo use, was done by the estimation of fasting and postprandial plasma glucose levels, serum creatinine, liver function tests [ALT and AST], glycated HbA1c, serum cholesterol and triglycerides and the detection of hypoglycemic attacks during the last two weeks. The results of the control group showed that there were no statistical differences between before and after placebo use, while there were no significant differences between before and after Acarbose use for the study group as regarding fasting plasma glucose levels [before = 117.25 +/- 50.63 and after = 104.74 +/- 41.06], postprandial plasma glucose levels [before = 141.82 +/- 68.86 and after = 115.88 +/- 35.65], glycated HbA1c levels [before = 7.98 +/- 66.03 and after = 7.15 +/- 63.20] and insulin daily dose. There was a highly significant difference between before and after Acarbose use as regarding the average number of hypoglycemic attacks during the last two weeks. But, there was no significant difference between the results before and after the use of Acarbose as regarding serum cholesterol and triglycerides levels, liver function tests [ALT and AST], serum creatinine and body weight in kg

Evaluation of serrum insulin-like growth factor-I [IGF-I] in type 1 diabetic adolescents

This research aimed to study the IGF-I levels in type 1 diabetic patients aged from 9 to 17 years and the relation of these levels to the control of diabetes and to other factors related to the disease. The study group consisted of 60 type 1 diabetic patients and the control group consisted of 25 healthy subjects matched for age, sex and socioeconomic classes. Both groups were subjected to full history taking, thorough clinical examinations and full laboratory investigations including the estimation of serum IGF-I level, microalbuminuria level as well as the estimation of HbA1c concentration