Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy
Objective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients.Research Design and Methods: This was a cross-sectional study based on a previo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2019.00747/full |
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| author | Jaquellyne Gurgel Penaforte-Saboia Jaquellyne Gurgel Penaforte-Saboia Carlos Eduardo Barra Couri Carlos Eduardo Barra Couri Virginia Oliveira Fernandes Virginia Oliveira Fernandes Virginia Oliveira Fernandes Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Lívia Aline De Araújo Batista Lívia Aline De Araújo Batista Lenita Zajdenverg Carlos Antonio Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana Bernardes Elias Dias Juliana Bernardes Elias Dias Maria Carolina Oliveira Maria Carolina Oliveira Akhtar Hussain Akhtar Hussain Akhtar Hussain Marilia Brito Gomes Renan Magalhães Montenegro Renan Magalhães Montenegro Renan Magalhães Montenegro |
| author_facet | Jaquellyne Gurgel Penaforte-Saboia Jaquellyne Gurgel Penaforte-Saboia Carlos Eduardo Barra Couri Carlos Eduardo Barra Couri Virginia Oliveira Fernandes Virginia Oliveira Fernandes Virginia Oliveira Fernandes Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Lívia Aline De Araújo Batista Lívia Aline De Araújo Batista Lenita Zajdenverg Carlos Antonio Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana Bernardes Elias Dias Juliana Bernardes Elias Dias Maria Carolina Oliveira Maria Carolina Oliveira Akhtar Hussain Akhtar Hussain Akhtar Hussain Marilia Brito Gomes Renan Magalhães Montenegro Renan Magalhães Montenegro Renan Magalhães Montenegro |
| author_sort | Jaquellyne Gurgel Penaforte-Saboia |
| collection | DOAJ |
| description | Objective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients.Research Design and Methods: This was a cross-sectional study based on a previous study, “Microvascular Complications in Type 1 Diabetes: a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) and conventional medical therapy (CT)”. The 168 patients in that study (144 from CT plus 24 from AHST) were re-subdivided into two groups, according to their IDAA1c values (30 patients had IDAA1c ≤ 9; 138 had IDAA1c > 9). Then, the prevalence of MC (diabetic renal disease, neuropathy, and retinopathy), hypoglycemia (blood glucose <60 mg/dL), and severe hypoglycemic (episode of hypoglycemia that required the assistance of another person to treat) events were compared between the groups. The groups were well-matched on these factors: duration of disease, sex, and age at the time of diagnosis of T1DM.Results: After an average of 8 years after diagnosis, only 6.6% (2/30) of the patients from IDAA1c ≤ 9 group developed any MC, whereas 21.0% (29/138) from the IDAA1c > 9 group had at least one complication (p = 0.044). Regarding hypoglycemic events, the proportion of individuals who reported at least 1 episode of hypoglycemia in the last month was 43.3 and 64.7% from the IDAA1c ≤ 9 and IDAA1c > 9 groups, respectively (p = 0.030). Regarding severe hypoglycemia, the proportion of patients presenting at least one episode in the last month and the rate of episode/patient/month were similar between groups (6.7 vs. 13.2%; p = 0.535; and 0.1/patient/month vs. 0.25/patient/month; p = 0.321).Conclusion: In a representative Brazilian population of T1DM patients, those with IDAA1c ≤ 9 presented a lower frequency of MC, as well as fewer episodes of hypoglycemia, in the month prior to the analysis. |
| first_indexed | 2024-12-21T16:29:38Z |
| format | Article |
| id | doaj.art-511d1f75aa2f4ebd9196c872ec6acc8d |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-21T16:29:38Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-511d1f75aa2f4ebd9196c872ec6acc8d2022-12-21T18:57:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922019-11-011010.3389/fendo.2019.00747477359Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional TherapyJaquellyne Gurgel Penaforte-Saboia0Jaquellyne Gurgel Penaforte-Saboia1Carlos Eduardo Barra Couri2Carlos Eduardo Barra Couri3Virginia Oliveira Fernandes4Virginia Oliveira Fernandes5Virginia Oliveira Fernandes6Ana Paula Dias Rangel Montenegro7Ana Paula Dias Rangel Montenegro8Ana Paula Dias Rangel Montenegro9Lívia Aline De Araújo Batista10Lívia Aline De Araújo Batista11Lenita Zajdenverg12Carlos Antonio Negrato13Kelen Cristina Ribeiro Malmegrim14Daniela Aparecida Moraes15Daniela Aparecida Moraes16Juliana Bernardes Elias Dias17Juliana Bernardes Elias Dias18Maria Carolina Oliveira19Maria Carolina Oliveira20Akhtar Hussain21Akhtar Hussain22Akhtar Hussain23Marilia Brito Gomes24Renan Magalhães Montenegro25Renan Magalhães Montenegro26Renan Magalhães Montenegro27Postgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilClinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilPostgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilClinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, BrazilPostgraduate Program in Public Health, Department of Community Health, Federal University of Ceará, Fortaleza, BrazilPostgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilClinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, BrazilPostgraduate Program in Public Health, Department of Community Health, Federal University of Ceará, Fortaleza, BrazilPostgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilPostgraduate Program in Public Health, Department of Community Health, Federal University of Ceará, Fortaleza, BrazilUniversity Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilBrazilian Society of Diabetes, São Paulo, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilCenter for Cell-Based Therapy, Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilDepartment of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, BrazilPostgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilFaculty of Health Sciences, Nord University, Bodø, NorwayCentre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, Bangladesh0Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio de Janeiro, BrazilPostgraduate Program in Medical Sciences, Department of Clinical Medicine, Federal University of Ceará, Fortaleza, BrazilClinical Research Unit, Walter Cantidio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, BrazilPostgraduate Program in Public Health, Department of Community Health, Federal University of Ceará, Fortaleza, BrazilObjective: To evaluate the association between insulin-dose adjusted A1C (IDAA1c) and microvascular complications (MC) and hypoglycemia in a representative Brazilian population of Type 1 diabetes mellitus (T1DM) patients.Research Design and Methods: This was a cross-sectional study based on a previous study, “Microvascular Complications in Type 1 Diabetes: a comparative analysis of patients treated with autologous nonmyeloablative hematopoietic stem-cell transplantation (AHST) and conventional medical therapy (CT)”. The 168 patients in that study (144 from CT plus 24 from AHST) were re-subdivided into two groups, according to their IDAA1c values (30 patients had IDAA1c ≤ 9; 138 had IDAA1c > 9). Then, the prevalence of MC (diabetic renal disease, neuropathy, and retinopathy), hypoglycemia (blood glucose <60 mg/dL), and severe hypoglycemic (episode of hypoglycemia that required the assistance of another person to treat) events were compared between the groups. The groups were well-matched on these factors: duration of disease, sex, and age at the time of diagnosis of T1DM.Results: After an average of 8 years after diagnosis, only 6.6% (2/30) of the patients from IDAA1c ≤ 9 group developed any MC, whereas 21.0% (29/138) from the IDAA1c > 9 group had at least one complication (p = 0.044). Regarding hypoglycemic events, the proportion of individuals who reported at least 1 episode of hypoglycemia in the last month was 43.3 and 64.7% from the IDAA1c ≤ 9 and IDAA1c > 9 groups, respectively (p = 0.030). Regarding severe hypoglycemia, the proportion of patients presenting at least one episode in the last month and the rate of episode/patient/month were similar between groups (6.7 vs. 13.2%; p = 0.535; and 0.1/patient/month vs. 0.25/patient/month; p = 0.321).Conclusion: In a representative Brazilian population of T1DM patients, those with IDAA1c ≤ 9 presented a lower frequency of MC, as well as fewer episodes of hypoglycemia, in the month prior to the analysis.https://www.frontiersin.org/article/10.3389/fendo.2019.00747/fulltype 1 diabetes (T1D)IDAA1cresidual B-cell functionglycemic controlmicrovascular complications |
| spellingShingle | Jaquellyne Gurgel Penaforte-Saboia Jaquellyne Gurgel Penaforte-Saboia Carlos Eduardo Barra Couri Carlos Eduardo Barra Couri Virginia Oliveira Fernandes Virginia Oliveira Fernandes Virginia Oliveira Fernandes Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Ana Paula Dias Rangel Montenegro Lívia Aline De Araújo Batista Lívia Aline De Araújo Batista Lenita Zajdenverg Carlos Antonio Negrato Kelen Cristina Ribeiro Malmegrim Daniela Aparecida Moraes Daniela Aparecida Moraes Juliana Bernardes Elias Dias Juliana Bernardes Elias Dias Maria Carolina Oliveira Maria Carolina Oliveira Akhtar Hussain Akhtar Hussain Akhtar Hussain Marilia Brito Gomes Renan Magalhães Montenegro Renan Magalhães Montenegro Renan Magalhães Montenegro Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy Frontiers in Endocrinology type 1 diabetes (T1D) IDAA1c residual B-cell function glycemic control microvascular complications |
| title | Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy |
| title_full | Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy |
| title_fullStr | Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy |
| title_full_unstemmed | Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy |
| title_short | Lower Insulin-Dose Adjusted A1c (IDAA1c) Is Associated With Less Complications in Individuals With Type 1 Diabetes Treated With Hematopoetic Stem-Cell Transplantation and Conventional Therapy |
| title_sort | lower insulin dose adjusted a1c idaa1c is associated with less complications in individuals with type 1 diabetes treated with hematopoetic stem cell transplantation and conventional therapy |
| topic | type 1 diabetes (T1D) IDAA1c residual B-cell function glycemic control microvascular complications |
| url | https://www.frontiersin.org/article/10.3389/fendo.2019.00747/full |
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