12 research outputs found
The potential of glucose management indicator for the estimation of glucose disposal rate in people with type 1 diabetes
No full textBackground and aims: Insulin resistance is a growing feature in type 1 diabetes (T1D). It can be quantified by calculating the estimated glucose disposal rate (eGDR) with the Epstein's formula, which includes laboratory-measured glycated hemoglobin (HbA1c). We aimed the current research to assess the agreement between the conventional eGDR formula and an alternative one (eGDR-GMI) incorporating the glucose management indicator (GMI) derived from continuous glucose monitoring (CGM). We also explored the relationship between eGDR-GMI, cardiovascular risk factors, and the prevalence of diabetes-related complications. Methods and results: We designed a cross-sectional study that included adults with T1D. eGDRGMI and eGDR (mg/kg/min) were calculated using GMI or HbA1c, waist circumference, and hypertensive state. Clinical data were collected from electronic medical records. The analyses encompassed 158 participants with a mean age of 39 f 13 years. The BlandAltman analysis showed a good agreement between eGDR-GMI and eGDR. When we divided participants in eGDR-GMI tertiles we found a higher prevalence of diabetes-related complications and a less favorable metabolic profile in the lowest eGDR-GMI tertile. The relative risk of retinopathy, nephropathy, and neuropathy significantly increased by approximately 1 unit with each decrease in eGDR-GMI, regardless of age, sex, disease duration, lipids, and smoking habit. Conclusions: eGDR-GMI represents a valid and robust alternative to the eGDR to assess insulin resistance in T1D. Low eGDR-GMI is associated with diabetes complications and a less favorable metabolic profile. Incorporating the eGDR-GMI into clinical practice can enhance the characterization of T1D people and allow for a more personalized treatment approach. (c) 2024 The Author(s). Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Empagliflozin influences blood viscosity and wall shear stress in subjects with type 2 diabetes mellitus compared with incretin-based therapy
No full textAutoimmune thyroiditis and celiac disease do not worsen endothelial function in subjects with type 1 diabetes: an observational study
No full textAbstract Background Type 1 diabetes (T1D) is frequently associated with autoimmune thyroiditis (AT) and coeliac disease (CD). Whether the coexistence of multiple autoimmune diseases increases cardiovascular risk is uncertain. We evaluated the effects of AT and CD on arterial wall thickening and endothelial function in patients with T1D. Methods This observational study analyzed data from T1D patients regularly followed by the Diabetes Care Centre. Clinical and biochemical characteristics and micro and macrovascular complications were collected from the electronic medical records. All subjects performed Echo-Doppler to evaluate Intima-Media Thickness (IMT) of the common carotid artery (CCA) and endothelial function by the flow-mediated dilation (FMD) technique. The statistical analyses were performed by SPSS for Macintosh. Comparison between means was performed using the t-test for unpaired data and the Mann–Whitney U test. The ANalysis Of VAriance and the Tukey posthoc test were applied to compare patients with and without other autoimmune diseases, and control subjects. The p-value for statistical significance was set at p < 0.05. Results A total of 110 patients were enrolled. Among these, 69 had T1D and 41 T1D and AT and or CD, of whom 33 AT, 7 CD, and 1 both AT and CD. The mean age was 35 years, mean HbA1c was 7.6%, and mean diabetes duration 18 years. The IMT of the CCA was not significantly different between T1D patients with and without concomitant autoimmune diseases (with AT and CD: right CCA 603 ± 186 µ, left 635 ± 175 µ; without AT and CD: right CCA 611 ± 176 µ, left CCA 631 ± 200 µ). FMD was also comparable between T1D groups, with AT and CD 7.9 ± 4.2%; without AT and CD 8.8 ± 4.4%. Conclusion Patients with T1D and concomitant AT and or CD show no worse morphological or functional vascular damage, evaluated by CCA IMT and brachial artery flow-mediated dilation, than patients with T1D alone
Diabetes Data Management System to Improve Glycemic Control in People With Type 1 Diabetes: Prospective Cohort Study
No full text
Empagliflozin influences blood viscosity and wall shear stress in subjects with type 2 diabetes mellitus compared with incretin-based therapy
No full textAbstract Background Cardiovascular protection following empagliflozin therapy is not entirely attributable to the glucose lowering effect. Increased hematocrit might influence the shear stress that is the main force acting on the endothelium, regulating its anti-atherogenic function. Objective We designed the study with the aim of investigating the effect of empagliflozin on blood viscosity and shear stress in the carotid arteries. A secondary endpoint was the effect of empagliflozin on carotid artery wall thickness. Methods The study was a non-randomized, open, prospective cohort study including 35 type 2 diabetic outpatients who were offered empagliflozin or incretin-based therapy (7 liraglutide, 8 sitagliptin) in combination with insulin and metformin. Blood viscosity, shear stress and carotid wall thickness were measured at baseline and at 1 and 3 months of treatment. Blood viscosity was measured with a viscometer, and shear stress was calculated using a validated formula. Intima-media thickness (IMT) of the carotid artery was detected by ultrasound and was measured with dedicated software. Results Blood viscosity (4.87 ± 0.57 vs 5.32 ± 0.66 cP, p < 0.02) and shear stress significantly increased in the Empagliflozin group while no change was detected in the Control group (4.66 ± 0.56 vs 4.98 ± 0.73 cP, p = NS). IMT significantly decreased in the Empagliflozin group after 1 and 3 months (baseline: 831 ± 156, 1-month 793 ± 150, 3-month 766 ± 127 μm; p < 0.0001), while in the liraglutide group, IMT significantly decreased only after 3 months (baseline 879 ± 120; 1-month 861 ± 163; 3-month 802 ± 114 μm; p < 0.001). In the sitagliptin group, IMT remained almost unchanged (baseline 901 ± 135; 1-month 902 ± 129; 3-month 880 ± 140 μm; p = NS). Conclusions This study is the first to describe a direct effect of empagliflozin on blood viscosity and wall shear stress. Furthermore, IMT was markedly reduced early on in the Empagliflozin group
Management of Type 2 Diabetes Mellitus through Telemedicine.
No full textBackgroundType 2 diabetes mellitus T2DM has a huge and growing burden on public health, whereas new care models are not implemented into clinical practice; in fact the purpose of this study was to test the effectiveness of a program of integrated care for T2DM, compared with ordinary diligence.Methods"Progetto Diabete Calabria" is a new organizational model for the management of patients with diabetes mellitus, based on General Practitioners (GPs) empowerment and the use of a web-based electronic health record, shared in remote consultations among GPs and Hospital Consultants. One-year change in glucose and main cardiovascular risk factors control in 104 patients (Cases) following this integrated care program has been evaluated and compared with that of 208 control patients (Controls) matched for age, gender, and cardiometabolic profile, and followed in an ordinary outpatient medical management by the Consultants only. Both patient groups had Day Hospitals before and after the study period.ResultsThe mean number of accesses to the Consultants during the study was 0.6 ± 0.9 for Cases, and 1.3 ± 1.5 for Controls (pConclusionsThe present study demonstrates that a health care program based on GPs empowerment and taking care plus remote consultation with Consultants is at least as effective as standard outpatient management, in order to improve the control of T2DM
Variations in glycemic, lipidic and body fat indexes within cases and controls during the study project.
No full text<p>Variations in glycemic, lipidic and body fat indexes within cases and controls during the study project.</p
Baseline features of the two study groups.
No full text<p>Values are mean ± standard deviation unless otherwise indicated;</p><p>*statistical significance on t-test or chi-square;</p><p>ns = not significant.</p><p>Baseline features of the two study groups.</p
"Urli trifoneschi". Per una edizione critica dei testi inediti di Trifone Benci
No full textQuesta tesi intende dare un quadro completo e dettagliato sulla vita e sulle opere di Trifone Benci, sin-golare personalità della letteratura italiana del Cinquecento, da inserire nella lirica classicistica di am-biente farnesiano: poeta latino e volgare, segretario di più papi, maestro “cifarista”, fu legato ai più in-fluenti letterati dell’epoca, tra cui Annibal Caro, Claudio Tolomei e, soprattutto, Francesco Maria Mol-za, suo intimo amico.
Nella prima parte della tesi, partendo dalla voce del Dizionario Biografico degli Italiani curata da Adriano Prosperi, si fornisce un approfondito profilo bio-bibliografico del Benci, anche attraverso il raffronto con le lettere della sua corrispondenza, le testimonianze dei contemporanei e quelle erudite d’illustri posteri come Giammaria Mazzuchelli. Si propone inoltre un’introduzione critica all’opera poetica del Benci, con particolare attenzione ai componimenti in “poesia nuova” (che Giosuè Carducci definirà “barbara”; esperimento promosso dal Tolomei presso l’Accademia della Virtù), alla corona di sonetti in morte di Faustina Mancini nonché a un interessante caso di traduzione in latino da un sonetto del Canzoniere di Petrarca.
Nella seconda parte si procura per la prima volta un’edizione critica dei testi di Trifone Benci: lettere, poesie latine e poesie volgari, per la maggior parte pubblicate in raccolte antologiche a stampa che vanno dal XVI (tra cui le Rime di diversi di Dionigi Atanagi, altro amico del Benci) al XVIII secolo, oltre ad alcuni testi tramandati invece solo da inedite fonti manoscritte, cui è stato possibile risalire at-traverso ricerche condotte presso la Biblioteca Apostolica Vaticana, la Biblioteca dell’Accademia Na-zionale dei Lincei e Corsiniana di Roma, la Biblioteca Comunale di Jesi e la Biblioteca Palatina di Parma.
Scopo della tesi è (ri)valutare agli occhi degli studiosi e dei lettori contemporanei un autore come Tri-fone Benci, originale e raffinato petrarchista, per quanto concerne la poesia volgare, intriso di cultura classica, come si evince dalla notevole produzione di versi latini; molti dei quali, peraltro, tramandati da un prezioso manoscritto individuato durante le ricerche, e ancora del tutto inediti.
This thesis aims to give a complete and detailed picture on the life and works of Trifone [Tryphon] Benci, a singular personality of the sixteenth century Italian literature, to be included in the classicist lyric poetry of the Farnese environment. He was a Latin and Vulgar poet, the secretary of several popes, a master ‘cipherer’, and he was linked to the most influential writers of the time, including An-nibal Caro, Claudio Tolomei and, above all, Francesco Maria Molza, his close friend.
The first part of the thesis, starting from the entry of the Dizionario Biografico degli Italiani [Bio-graphical Dictionary of Italian People] edited by Adriano Prosperi, provides an in-depth bio-bibliographic profile of Benci, also through comparison with the letters of his correspondence, the tes-timonies of contemporaries and the erudite ones of illustrious posterity as Giammaria Mazzuchelli. This first part also proposes a critical introduction to Benci’s poetic work, with a focus on composi-tions in poesia nuova [‘new poetry’] (that Giosuè Carducci will define barbara [‘barbarian’]; such ex-periment was sponsored by Tolomei at the Accademia della Virtù), the crown of sonnets to commemo-rate Faustina Mancini’s death as well as an interesting case of a translation into Latin of a Petrarchan sonnet of the Canzoniere.
The second part of the thesis provides for the first time a critical edition of Trifone Benci’s texts: let-ters, Latin and Italian vernacular poems, mostly published in printed anthological collections (includ-ing the Rime di diversi [Rhymes of different people] by Dionigi Atanagi, another friend of Benci) da-ting back from the sixteenth to the eighteenth century. Furthermore, some other texts were passed down only from unedited manuscript sources, traced thanks to researches conducted at the Vatican Library, the Library of the Accademia Nazionale dei Lincei e Corsiniana of Rome, the Comunale Li-brary of Jesi and the Palatina Library of Parma.
The purpose of the thesis is to re-evaluate in the eyes of scholars and contemporary readers an author like Trifone Benci, an original and refined Petrarchist, as regards the volgare poetry, steeped in classi-cal culture, as evidenced in the remarkable production of Latin verses. Moreover, many of the latter were handed down thanks a precious manuscript found during researches, and are still completely un-edited
