Por favor, use este identificador para citar o enlazar este ítem: https://repositorio.bahiana.edu.br:8443/jspui/handle/bahiana/3004
Título : Double-diabetes in a real-world sample of 2711 individuals: associated with insulin treatment or part of the heterogeneity of type 1 diabetes?
Otros títulos : PubMed
Autor : Souza, Caroline Bulcão
Giuffrida, Fernando M. A.
Cobas, Roberta A.
Negrato, Carlos Antonio
Gomes, Marilia B.
Dib, Sergio Atala
Palabras clave : Double diabetes; Type 1 diabetes; Cardiovascular risk factors
Fecha de publicación : 22-mar-2016
Resumen : Background: 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.
URI : http://www7.bahiana.edu.br//jspui/handle/bahiana/3004
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