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Browsing by Author "Cengiz, Eda"
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Item Gender differences in diabetes self-care in adults with type 1 diabetes: Findings from the T1D Exchange clinic registry(Elsevier, 2018-10) Shah, Viral N.; Wu, Mengdi; Polsky, Sarit; Snell-Bergeon, Janet K.; Sherr, Jennifer L.; Cengiz, Eda; DiMeglio, Linda A.; Pop-Busui, Rodica; Mizokami-Stout, Kara; Foster, Nicole C.; Beck, Roy W.; Pediatrics, School of MedicineAims To evaluate gender differences in diabetes self-care components including glycemic, blood pressure and lipid control, utilization of diabetes technologies and acute diabetes complications in adults with type 1 diabetes. Methods A total of 9,481 participants >18 years were included in the analysis, 53% were female. Variables of interest included glycemic control measured by HbA1c, systolic/diastolic blood pressures, presence of dyslipidemia, insulin delivery modality, and rates of acute complications. Results Glycemic control was similar in women and men (mean HbA1c in both groups: 8.1% ± 1.6% (64 ± 16 mmol/mol), (p = 0.54). More women used insulin pump therapy (66% vs. 59%, p < 0.001) but use of sensor technology was similar (p < = 0.42). Women had higher rates of diabetic ketoacidosis (DKA) (5% vs. 3%, p < 0.001) and eating disorders (1.7% vs. 0.1%, p < 0.001). Severe hypoglycemia rates were not different between men and women (p = 0.42). Smoking (6% vs 4%, p < 0.001), systolic (125 ± 14.2 vs. 121 ± 14.4, p < 0.001) and diastolic blood pressure (73.3 ± 9.5 vs. 72.2 ± 9.3, p < 0.001) and rate of dyslipidemia (28% vs. 23%, p < 0.001) were higher in men. Conclusion While glycemic control in type 1 diabetes was similar regardless of gender, rates of DKA and eating disorders were higher in women while rates of smoking, hypertension and dyslipidemia were higher in men.Item Metformin Improves Peripheral Insulin Sensitivity in Youth With Type 1 Diabetes(Endocrine Society, 2019-08) Cree-Green, Melanie; Bergman, Bryan C.; Cengiz, Eda; Fox, Larry A.; Hannon, Tamara S.; Miller, Kellee; Nathan, Brandon; Pyle, Laura; Kahn, Darcy; Tansey, Michael; Tichy, Eileen; Tsalikian, Eva; Libman, Ingrid; Nadeau, Kristen J.; Pediatrics, School of MedicineContext: Type 1 diabetes in adolescence is characterized by insulin deficiency and insulin resistance (IR), both thought to increase cardiovascular disease risk. We previously demonstrated that adolescents with type 1 diabetes have adipose, hepatic, and muscle IR, and that metformin lowers daily insulin dose, suggesting improved IR. However, whether metformin improves IR in muscle, hepatic, or adipose tissues in type 1 diabetes was unknown. Objective: Measure peripheral, hepatic, and adipose insulin sensitivity before and after metformin or placebo therapy in youth with obesity with type 1 diabetes. Design: Double-blind, placebo-controlled clinical trial. Setting: Multi-center at eight sites of the T1D Exchange Clinic Network. Participants: A subset of 12- to 19-year-olds with type 1 diabetes (inclusion criteria: body mass index ≥85th percentile, HbA1c 7.5% to 9.9%, insulin dosing ≥0.8 U/kg/d) from a larger trial (NCT02045290) were enrolled. Intervention: Participants were randomized to 3 months of metformin (N = 19) or placebo (N = 18) and underwent a three-phase hyperinsulinemic euglycemic clamp with glucose and glycerol isotope tracers to assess tissue-specific IR before and after treatment. Main outcome measures: Peripheral insulin sensitivity, endogenous glucose release, rate of lipolysis. Results: Between-group differences in change in insulin sensitivity favored metformin regarding whole-body IR [change in glucose infusion rate 1.3 (0.1, 2.4) mg/kg/min, P = 0.03] and peripheral IR [change in metabolic clearance rate 0.923 (-0.002, 1.867) dL/kg/min, P = 0.05]. Metformin did not impact insulin suppression of endogenous glucose release (P = 0.12). Adipose IR was not assessable with traditional methods in this highly IR population. Conclusions: Metformin appears to improve whole-body and peripheral IR in youth who are overweight/obese with type 1 diabetes.Item Women in diabetes research: Stepping towards equity(The Lancet, 2022-04) DiMeglio, Linda A.; Wood, Jamie R.; Cengiz, Eda; Pediatrics, School of MedicineInternational Women's Day is on March 8, 2022. This day's history is rooted in early 20th century American suffragist efforts to ensure that women would receive equity in pay, working hours, and the right to vote. Over 100 years later, this day is now celebrated internationally. The anniversary provides an opportunity for reflection on continued observed gender disparities in diabetes research.