Double-diabetes in a real-world sample of 2711 individuals: associated with insulin treatment or part of the heterogeneity of type 1 diabetes?

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dc.citation.volume8
dc.contributor.authorGiuffrida, Fernando M. A.
dc.contributor.authorBulcao, Caroline
dc.contributor.authorCobas, Roberta A.
dc.contributor.authorNegrato, Carlos Antonio
dc.contributor.authorGomes, Marilia B.
dc.contributor.authorDib, Sergio Atala [UNIFESP]
dc.coverageLondon
dc.date.accessioned2020-08-21T16:59:48Z
dc.date.available2020-08-21T16:59:48Z
dc.date.issued2016
dc.description.abstractBackground: Double diabetes (DD) describes both individuals with obesity upon diagnosis of type 1 diabetes and those who have gained weight during follow-up, although cardiovascular risk factors (CVRF) are not well understood in this group. We aim to evaluate the frequency of DD in a real-world type 1 diabetes sample and the interaction of insulin treatment with CVRF. Methods: Multicentre cross-sectional study of 2711 individuals with clinical diagnosis of type 1 diabetes from secondary diabetes centres in 20 Brazilian cities. Results: Patients with diabetes duration <5 and >= 5 years had similar frequency of overweight (20.4 vs. 25 %) and obesity, (9.8 vs. 6.1 %), p 0.28 for trend. Insulin dose (U/kg/day) was lower in obese individuals compared to normal BMI, with mean (95 % CI) 0.72 (0.62-0.83) vs. 0.88 (0.84-0.92) U/kg/day for diabetes duration < 5 years and 0.84 (0.77-0.92) vs. 0.99 (0.97-1.01) U/kg/day for duration >= 5 years. Obese individuals had lower HDL (47.5 vs. 54.4 mg/dL) and higher non-HDL-cholesterol (134.5 vs. 115.2 mg/dL) than lean ones only among those with more than 5 years of diabetes. Conclusions: Lower insulin doses in obese individuals point to a role of clinical heterogeneity in insulin deficiency rather than normal progression of type 1 diabetes. Early obesity in type 1 diabetes is associated to lower HDL-cholesterol and higher number of CVRF. These data suggest a broad landscape of pathophysiological phenomena in double diabetes, rather than simple progression of a homogeneous clinical entity.en
dc.description.affiliationUniv Estado Bahia UNEB, Dept Ciencias Vida, Rua Silveira Martins 2555, BR-41150000 Salvador, BA, Brazil
dc.description.affiliationCtr Diabet & Endocrinol Estado Bahia CEDEBA, Salvador, BA, Brazil
dc.description.affiliationUniv Estado Rio De Janeiro, Rio De Janeiro, Brazil
dc.description.affiliationAssociacao Diabet Bauru, Bauru, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Ctr Diabet, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Ctr Diabet, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipBrazilian Diabetes Society (SBD)
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s13098-016-0143-7
dc.identifier.citationDiabetology & Metabolic Syndrome. London, v. 8, p. -, 2016.
dc.identifier.doi10.1186/s13098-016-0143-7
dc.identifier.fileWOS000372569300003.pdf
dc.identifier.issn1758-5996
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57774
dc.identifier.wosWOS:000372569300003
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofDiabetology & Metabolic Syndrome
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDouble diabetesen
dc.subjectType 1 diabetesen
dc.subjectCardiovascular risk factorsen
dc.titleDouble-diabetes in a real-world sample of 2711 individuals: associated with insulin treatment or part of the heterogeneity of type 1 diabetes?en
dc.typeinfo:eu-repo/semantics/article
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