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Type 1 Diabetes Mellitus

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181. RETINAL HYPERREFLECTIVE FOCI IN TYPE 1 DIABETES MELLITUS. (Abstract)

RETINAL HYPERREFLECTIVE FOCI IN TYPE 1 DIABETES MELLITUS. To investigate hyperreflective foci (HF) on spectral-domain optical coherence tomography in patients with Type 1 diabetes mellitus across different stages of diabetic retinopathy (DR) and diabetic macular edema (DME) and to study clinical and morphological characteristics associated with HF.Spectral-domain optical coherence tomography scans and color fundus photographs were obtained of 260 patients. Spectral-domain optical coherence (...) was only reached for moderate nonproliferative DR (P = 0.001) and proliferative DR (P = 0.019). Higher numbers of HF were associated with longer diabetes duration (P = 0.029), lower high-density lipoprotein cholesterol (P = 0.005), and the presence of microalbuminuria (P = 0.005). In addition, HF were associated with morphological characteristics on spectral-domain optical coherence tomography, including central retinal thickness (P = 0.004), cysts (P < 0.001), subretinal fluid (P = 0.001

2019 Retina

182. Greater Suppression of Glucagon, Lipolysis, and Ketogenesis with Insulin Glargine U300 as Compared with Glargine U100 in Type 1 Diabetes Mellitus. Full Text available with Trip Pro

Greater Suppression of Glucagon, Lipolysis, and Ketogenesis with Insulin Glargine U300 as Compared with Glargine U100 in Type 1 Diabetes Mellitus. The aim of this study was to establish the effects of clinical doses of Gla-300 versus Gla-100 on suppression of glucagon, lipolysis, and ketogenesis in type 1 diabetes mellitus (T1DM). Eighteen persons with T1DM (age 40 ± 12 years, diabetes duration 26 ± 12 years, body mass index 23.4 ± 2 kg/m2, A1C 7.19% ± 0.52% [55 ± 6 mmol/mol]) were studied (...) after 3 months of titration with Gla-300 and Gla-100 (randomized, crossover design) with a 24-h euglycemic clamp (s.c. injection of individual insulin daily doses used by subjects for previous 2 weeks, Gla-300 0.35 ± 0.08 and Gla-100 0.28 ± 0.07 U/kg). Gla-300 resulted in (1) less increase in insulin concentration for 0-12 h, but greater insulin concentration in 12-24 h (no differences for 24 h); (2) greater glucagon suppression; (3) greater prehepatic insulin-to-glucagon molar ratio, primarily

2019 Diabetes technology & therapeutics Controlled trial quality: uncertain

183. Evaluating a dietary pattern in adolescents with type 1 diabetes mellitus: The dash-d approach. (Abstract)

Evaluating a dietary pattern in adolescents with type 1 diabetes mellitus: The dash-d approach. Adolescents with type 1 diabetes (T1DM) must consider multiple factors in diet planning, including glycemic control and cardiovascular disease prevention, while ensuring adequate nutrition for growth. We examined diet composition, quality, and compliance for two dietary patterns - the traditional Dietary Approaches to Stop Hypertension (DASH) and a modified version of DASH in this population.Two (...) feeding studies were conducted. First, adolescents with T1DM consumed their usual diet for 3 days followed by traditional DASH for 6 days. Next, DASH menus were adjusted to align with T1DM nutrition guidelines, and this modified DASH for Diabetes (DASH-D) was tested on a new group of adolescents with T1DM for 6 days, following 3 days of usual diet. Usual diet was measured via 24-hr dietary recalls. Dietary composition of DASH-D was compared to DASH and usual diet. Eighteen adolescents (9/group

2019 Diabetes management (London, England) Controlled trial quality: uncertain

184. Effects of type 1 diabetes mellitus on efferent auditory system in children and adolescents. (Abstract)

Effects of type 1 diabetes mellitus on efferent auditory system in children and adolescents. To investigate whether type 1 diabetes mellitus (T1DM) could affect the efferent auditory system by analyzing the relationship between the activation of the medial olivocochlear reflex with disease duration, metabolic control and age at time of diagnosis.A total of 101 children and adolescents were evaluated. They were divided into two groups: 50 with T1DM and 51 without the disease. The participants

2019 International Journal of Pediatric Otorhinolaryngology

185. Stiff Person Syndrome and Type 1 Diabetes Mellitus: a Case of the Chicken or the Egg? Full Text available with Trip Pro

Stiff Person Syndrome and Type 1 Diabetes Mellitus: a Case of the Chicken or the Egg? Anti-glutamic acid decarboxylase (anti-GAD) antibodies are linked with both autoimmune diabetes and the rare neurological disorder stiff person syndrome (SPS). SPS is an uncommon autoimmune-mediated condition characterized by painful episodic spasms and progressive muscle rigidity. We present the case of a 23-year-old non-diabetic, insulin-naïve woman with known SPS who was hospitalized for SPS-related (...) symptomatology. The patient quickly developed type 1 diabetes mellitus (T1DM) with unexpectedly large insulin requirements. To our knowledge, there are no other reports describing rapid T1DM development during an acute hospitalization for SPS and fewer than 5 case reports describing the association of SPS with extreme insulin resistance. Our case highlights the key clinical features, pathology, and pathogenesis of both SPS and T1DM and explores the relationship between the two disease processes.

2019 Journal of General Internal Medicine

186. Fulminant type 1 diabetes mellitus: Two case reports. Full Text available with Trip Pro

Fulminant type 1 diabetes mellitus: Two case reports. Fulminant type 1 diabetes mellitus (FT1DM) is a new subtype of type 1 diabetes mellitus that was first proposed by the Japanese scholar Imagawa in 2000. In the 2 patient cases described in this study, gastrointestinal symptoms were the first symptoms reported, and the initial blood glucose levels were very high. However, the glycosylated hemoglobin (HbA1c) levels were not very high, the islet β-cell function was almost completely lost (...) , the long-term insulin replacement therapy of "insulin aspart plus insulin glargine" was selected.FT1DM is a new subtype of type 1 diabetes mellitus. The onset of this disease is rapid, and the function of islet β cells is almost completely lost in a short time period. This metabolic disorder is severe, and the clinical manifestations are nonspecific. Unless a timely and accurate diagnosis is made, and patients receive prompt treatment, it is difficult to control the disease and the risk of death

2019 Medicine

187. Accumulation of advanced glycation end products in the skin is accelerated in relation to insulin resistance in people with Type 1 diabetes mellitus. (Abstract)

Accumulation of advanced glycation end products in the skin is accelerated in relation to insulin resistance in people with Type 1 diabetes mellitus. To evaluate the association between skin advanced glycation end products and insulin resistance in Type 1 diabetes.The study group consisted of 476 people with Type 1 diabetes (247 men) with a median (interquartile range) age of 42 (33-53) years, disease duration of 24 (19-32) years and HbA1c concentration of 63 (55-74) mmol/mol [7.9 (7.2-8.9 (...) autofluorescence.The results of this study offer strong evidence for a two-way relationship between insulin resistance and advanced glycation product accumulation in the skin in people with Type 1 diabetes.© 2019 Diabetes UK.

2019 Diabetic Medicine

188. Safety and Efficacy of Empagliflozin as Add-On Therapy to GLP-1 Receptor Agonist (Liraglutide) in Japanese Patients with Type 2 Diabetes Mellitus: A Randomised, Double-Blind, Parallel-Group Phase 4 Study. Full Text available with Trip Pro

Safety and Efficacy of Empagliflozin as Add-On Therapy to GLP-1 Receptor Agonist (Liraglutide) in Japanese Patients with Type 2 Diabetes Mellitus: A Randomised, Double-Blind, Parallel-Group Phase 4 Study. Empagliflozin, a highly selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, improves glycaemic control in patients with type 2 diabetes mellitus (T2DM) by inducing urinary glucose excretion. Combination therapy with empagliflozin and glucagon-like peptide-1 (GLP-1) receptor agonists (...) had not previously been assessed, so we investigated the safety, tolerability and efficacy of empagliflozin as an add-on therapy to liraglutide, a GLP-1 receptor agonist.This was a randomised, double-blind, parallel-group phase 4 trial of empagliflozin (10 mg or 25 mg) for 52 weeks as an add-on therapy to liraglutide (0.9 mg/day) in Japanese patients with T2DM insufficiently controlled by liraglutide alone.59.4% (19/32) and 66.7% (22/33) of patients in the empagliflozin 10 mg and 25 mg groups

2019 Diabetes therapy : research, treatment and education of diabetes and related disorders Controlled trial quality: uncertain

189. Health-related quality of life in type 1 diabetes mellitus pediatric patients and their caregivers in Spain: an observational cross-sectional study. Full Text available with Trip Pro

Health-related quality of life in type 1 diabetes mellitus pediatric patients and their caregivers in Spain: an observational cross-sectional study. This study assessed the health-related quality of life (HRQOL) of pediatric patients with type 1 diabetes mellitus (T1DM) and their caregivers.CHRYSTAL was an observational cross-sectional study conducted in Spain in 2014 on 275 patients under 18 years old diagnosed with T1DM. Patient/caregiver pairs were stratified by patients' HbA1c level (≥7.5

2019 Current medical research and opinion

190. Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database. Full Text available with Trip Pro

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database. To examine the effect of pump vs injection therapy on the lipid profile of children with Type 1 diabetes mellitus.A cross-sectional analysis of the lipid profile of children aged ≤ 18 years with Type 1 diabetes mellitus from SWEET, an international diabetes registry, was conducted with a focus on the effect of treatment (...) regimen. Dyslipidaemia was defined as LDL cholesterol ≥2.6 mmol/l or non-HDL cholesterol ≥3.1 mmol/l. LDL and non-HDL cholesterol values among 14 290 children (52% boys, 51% receiving pump therapy) from 60 SWEET centres were analysed by linear and logistic regression analysis adjusted for sex, age, diabetes duration, HbA1c and BMI-standard deviation score group, region, and common interactions between age, sex, HbA1c and BMI.This study confirmed the established associations of increased lipids

2019 Diabetic Medicine

191. Clinical pharmacology study of ipragliflozin in Japanese patients with type 1 diabetes mellitus: A phase 2, randomized, placebo-controlled trial. Full Text available with Trip Pro

Clinical pharmacology study of ipragliflozin in Japanese patients with type 1 diabetes mellitus: A phase 2, randomized, placebo-controlled trial. To evaluate the pharmacodynamics, pharmacokinetics, and safety of the novel oral sodium-glucose co-transporter 2 inhibitor, ipragliflozin, in Japanese patients with type 1 diabetes mellitus.We conducted a multicenter, double-blind, placebo-controlled, parallel-group study. Patients were randomized to receive 25, 50, or 100 mg/day ipragliflozin (...) in severity; no patients discontinued the study because of treatment-emergent AEs.The pharmacokinetic and pharmacodynamic properties of ipragliflozin in Japanese patients with type 1 diabetes mellitus were confirmed. Increases in urinary glucose excretion lead to dose-dependent decreases in plasma glucose. Concomitant insulin dose decreased with ipragliflozin treatment. No clinically relevant safety concerns were identified. This article is protected by copyright. All rights reserved.This article

2019 obesity & metabolism Controlled trial quality: uncertain

192. Understanding adolescent and parent acceptability and feasibility experience in a large Type 1 diabetes mellitus behavioural trial. (Abstract)

Understanding adolescent and parent acceptability and feasibility experience in a large Type 1 diabetes mellitus behavioural trial. Using an 18-month, multisite randomized control trial as an exemplar, the aim of this study was to identify themes related to adolescent and parental feasibility and acceptability for participation in large behavioural trials designed to improve adolescents' Type 1 diabetes self-management.Thematic analysis methodology was used to develop themes describing factors (...) related to acceptability and feasibility.Based on a sample of interviews (N = 72), factors contributing to intervention acceptability and feasibility were identified. Aspects of acceptability included: a framework for goal-setting, the coach as a non-judgemental listener, perception of an ongoing benefit to participation and the delivery mode. Aspects of feasibility included: participants' altruism to help adolescents with Type 1 diabetes; pre-enrolment preparation for intervention content

2019 Diabetic Medicine Controlled trial quality: uncertain

193. 11β Hydroxysteroid dehydrogenase - 1 activity in type 2 diabetes mellitus: a comparative study. Full Text available with Trip Pro

11β Hydroxysteroid dehydrogenase - 1 activity in type 2 diabetes mellitus: a comparative study. A comparative study of 11 β HSD 1 activity in type 2 diabetes mellitus subjects with respect to fasting blood glucose and other metabolic parameters was conducted.A case control experimental study was performed enrolling thirty type 2 diabetes mellitus patients and thirty age, gender and BMI matched controls using cortisone acetate test.The rise of serum cortisol after oral 25 mg cortisone acetate (...) from baseline (dexamethasone suppressed level) is higher in subjects with type 2 diabetes and is associated with exercise, BMI, SGOT but not daily calorie intake, lipid parameters and thyroid status. Fasting blood glucose after overnight 1 mg oral dexamethasone is a strong predictor of 11HSD1 activity, irrespective of presence of type 2 diabetes.11β HSD 1 activity is higher in type 2 diabetes mellitus subjects, especially those who are lean. Future 11 β HSD 1 inhibitors targeting metabolic syndrome

2019 BMC Endocrine Disorders

194. Glucose Metabolism is Required for Platelet Hyperactivation in a Murine Model of Type 1 Diabetes Mellitus. (Abstract)

Glucose Metabolism is Required for Platelet Hyperactivation in a Murine Model of Type 1 Diabetes Mellitus. Patients with type 1 diabetes mellitus (T1DM) have increased thrombosis and platelet activation. The mechanisms for platelet hyperactivation in diabetes are incompletely understood. T1DM is accompanied by hyperglycemia, dyslipidemia, and increased inflammation, in addition to an altered hormonal milieu. In vitro analysis of platelets revealed that normal glucose reduces platelet activation (...) and convulxin. In contrast, platelets isolated from (glucose transporter 1 (GLUT1 and GLUT3) double knockout (DKO) mice, which lack the ability to utilize glucose, failed to increase activation in hyperglycemic mice. Diabetic mice displayed decreased survival in a collagen/epinephrine induced pulmonary embolism model of in vivo platelet activation, relative to non-diabetic controls. Survival following pulmonary embolism was increased in diabetic DKO mice, relative to non-diabetic controls. These data reveal

2019 Diabetes

195. Model-based characterization of the relationship between dapagliflozin systemic exposure and HbA1c response in patients with type 1 diabetes mellitus. Full Text available with Trip Pro

Model-based characterization of the relationship between dapagliflozin systemic exposure and HbA1c response in patients with type 1 diabetes mellitus. To quantitatively describe the relationship between dapagliflozin systemic exposure and HbA1c response among patients with type 1 diabetes mellitus (T1DM) and assess the potential impact of covariate effects.Individual longitudinal HbA1c data from two phase 3 studies in patients with T1DM (24-week treatment with once-daily dapagliflozin 5 or 10 (...) dapagliflozin systemic exposure and HbA1c response was successfully described in patients with T1DM. None of the tested covariates affected the efficacy of dapagliflozin to a clinically relevant extent. Therefore, no dose adjustment of dapagliflozin is required in patients with T1DM based on the tested covariates. ClinicalTrials.gov, NCT02268214; NCT02460978.© 2019 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

2019 obesity & metabolism

196. Impaired awareness of hypoglycemia in children and adolescents with type 1 diabetes mellitus in north of Jordan. Full Text available with Trip Pro

Impaired awareness of hypoglycemia in children and adolescents with type 1 diabetes mellitus in north of Jordan. Hypoglycemia is a common complication of insulin therapy in patients with Type 1 Diabetes Mellitus (DM). Awareness of hypoglycemic symptoms helps patients to recognize hypoglycemia and initiate self-treatment. Impaired Awareness of Hypoglycemia (IAH) exposes patients to severe hypoglycemia, which could be associated with seizures and unconsciousness. This study aimed to assess IAH (...) , frequency of hypoglycemia, severe hypoglycemia and intensity of hypoglycemic symptoms among children and adolescents with Type 1 DM in North of Jordan.Data were collected from 94 children and adolescents with Type 1 DM. Clarke's and Edinburgh surveys were used to assess IAH and individual symptoms of hypoglycemia, respectively. Frequency of hypoglycemia and other related information were obtained by self-reporting or from medical records.16.0% of participants were having IAH, 66.0% of participants

2019 BMC Endocrine Disorders

197. Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports. Full Text available with Trip Pro

Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports. The use of immune checkpoint inhibitor (ICI) therapy is becoming a standard of care for several cancers. Monoclonal antibodies targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed cell death protein 1 (PD-1) or its ligand (PD-L1) cause a broad spectrum of autoimmune adverse events. ICI-induced type 1 diabetes (...) mellitus (T1DM) is extremely rare (< 1%) but potentially life-threatening. It appears to be more common with PD-1 blockade (or combination immunotherapy) than with anti-CTLA-4 therapy, often during the first three to six months of therapy.We report an acute onset T1DM with severe inaugural diabetic ketoacidosis (DKA) and remarkably elevated Glutamic Acid Decarboxylase antibody (GADA) titres following a single administration of combined ICI therapy with nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4

2019 BMC Endocrine Disorders

198. Measurement Properties of the Online EuroQol-5D-Youth Instrument in Children and Adolescents With Type 1 Diabetes Mellitus: Questionnaire Study. Full Text available with Trip Pro

Measurement Properties of the Online EuroQol-5D-Youth Instrument in Children and Adolescents With Type 1 Diabetes Mellitus: Questionnaire Study. The lack of continuity between health-related quality of life (HRQoL) instruments designed for children and adults hinders change analysis with a life course approach. To resolve this gap, EuroQol (EQ) developed the EQ-5D-Youth (EQ-5D-Y), derived from the EQ-5D for adults. Few studies have assessed the metric properties of EQ-5D-Y in children (...) with specific chronic conditions, and none have done so for children with type I diabetes mellitus (T1DM).This study aimed to evaluate the acceptability, validity, reliability, and responsiveness of the EQ-5D-Y in children and adolescents with T1DM, when administered online.Participants with T1DM were consecutively recruited from July to December 2014, from a list of potential candidates aged 8-19 years, who attended outpatient pediatric endocrinology units. Before every quarterly routine visit

2019 Journal of medical Internet research

199. Worse Metabolic Control and Dynamics of Weight Status in Adolescent Girls Point to Eating Disorders in the First Years after Manifestation of Type 1 Diabetes Mellitus: Findings from the Diabetes Patienten Verlaufsdokumentation Registry. (Abstract)

Worse Metabolic Control and Dynamics of Weight Status in Adolescent Girls Point to Eating Disorders in the First Years after Manifestation of Type 1 Diabetes Mellitus: Findings from the Diabetes Patienten Verlaufsdokumentation Registry. To assess indications of eating disorders in girls with type 1 diabetes mellitus (T1DM).In total 31 556 girls aged >6 months and <23 years of age with T1DM from the Diabetes Patienten Verlaufsdokumentation (DPV) cohort were analyzed including 155 (0.49%) girls (...) with anorexia nervosa, 85 (0.27%) girls with bulimia nervosa, 45 (0.14%) girls with binge eating disorder, and 229 (0.73%) girls with eating disorders not otherwise specified. Patient characteristics, weight changes, numbers of patients with severe hypoglycemia and diabetic ketoacidosis (DKA), changes of glycosylated hemoglobin A1c (HbA1c) levels, use of pumps, and prevalence of celiac disease and autoimmune thyroiditis were compared between girls with and without eating disorders. Multiple logistic

2018 Journal of Pediatrics

200. DETERMINING THE EFFECT OF DIABETES DURATION ON RETINAL AND CHOROIDAL THICKNESSES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS. (Abstract)

DETERMINING THE EFFECT OF DIABETES DURATION ON RETINAL AND CHOROIDAL THICKNESSES IN CHILDREN WITH TYPE 1 DIABETES MELLITUS. Determining the effect of diabetes mellitus duration on retinal and choroidal thicknesses in children with Type 1 diabetes mellitus (T1DM).Children (aged 6-18 years) with Type 1 diabetes and no diabetic retinopathy and age-matched controls were examined using Topcon spectral domain optical coherence tomography. Choroidal thickness and retinal thickness in macula area were (...) measured. The study group was divided into 3 subgroups depending on diabetes mellitus duration-Group 1: <5 years (n = 52), Group 2: 5 to 10 years (n = 39), and Group 3: >10 years (n = 30).One hundred and twenty-one diabetic children and 32 controls were included. The central choroidal thickness increased from 305.5 μm (SD: 61.7 μm) in the control group to 309.2 μm (SD: 70.1 μm) in Group 1, 315.2 μm (SD: 64.3 μm) in Group 2, and 367.4 μm (SD: 66.0 μm) in Group 3. Group 3 differed significantly from

2018 Retina

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