Bożenna Klonowska - Profile on Academia.edu (original) (raw)
Papers by Bożenna Klonowska
Experimental and Clinical Endocrinology & Diabetes, Mar 5, 2018
High incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes among Polish children aged 10-12 and under 5 years of age: A multicenter study
Pediatric Diabetes, Oct 11, 2016
Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the de... more Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17. The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. The population living in these areas accounts for 35% of the Polish population. DKA was defined as a capillary pH < 7.3, blood glucose > 11 mmol/L. The analyzed data included age, sex, diabetes recognition, pH, glycated hemoglobin (HbA1c), fasting C-peptide, and body mass index standard deviation score (BMI-SDS). We observed DKA in 28.6% of children. There were 2 peaks in DKA occurrence: in children <5 years of age (33.9%) and aged 10-12 (34%). The highest incidence of DKA was noted in children aged 0-2 (48.4%). In the group with DKA, moderate and severe DKA occurred in 46.7% of children. Girls and children <2 years of age were more prone to severe DKA. The multiple logistic regression analysis showed the following factors associated with DKA: age (P = .002), fasting C-peptide (P = .0001), HbA1c (P = .0001), no family history of T1D (P = .0001), and BMI-SDS (P = .0001). The incidence of DKA is high and remained unchanged over the last 5 years. Increasing the awareness of symptoms of DKA is recommended among children <5 years of age (especially <2 years of age) and aged 10-12. Children <2 years of age and girls were at the highest risk of severe DKA.
Diabetes-metabolism Research and Reviews, Dec 28, 2017
The incidence of childhood Type-1 diabetes (T1D) varies greatly between populations and the estim... more The incidence of childhood Type-1 diabetes (T1D) varies greatly between populations and the estimates and/or predictions of the rates would aid in adequate planning of health care resources. The study's aim was to assess the incidence of T1D in the paediatric population of eastern and central Poland. In this cohort study covering the period from January 2010 to December 2014 data were collected for children and adolescents below 18 years of age with newly diagnosed T1D, living in eastern and central Poland. A total of 2174 children were included in the analysis. The population estimates were from the Central Statistical Office of Poland. Results Overall, the annual incidence of T1D increased from 12.84/100 000 in 2010 to 18.46/100 000 in 2014 with the incidence rate ratio (IRR) of 1.5 (an increase in the incidence This article is protected by copyright. All rights reserved. rate (IR) by 12.7% per year over 5 years). The lowest increase in the IR by 7.1% per year was seen in 15-17-year-olds. In the urban population (age 0-17 years), the overall IR was significantly higher than in subjects from rural communities (p<0.02). A statistically significant difference was demonstrated between the incidence of T1D in rural areas in densely populated voivodships vs less populated regions (p=0.004), but no such dependence in urban areas. The incidence of T1D in children living in eastern and central Poland increased 1.5-fold over the 5-year observation period with the highest rise in 10-14-year-olds and significantly higher rates in urban children compared to their peers living in rural areas.
Next- generation sequencing is an effective method for diagnosing patients with different forms of monogenic diabetes
Diabetes Research and Clinical Practice
AIM Monogenic diabetes (MD) represents 5-7% of antibody-negative diabetes cases and is a heteroge... more AIM Monogenic diabetes (MD) represents 5-7% of antibody-negative diabetes cases and is a heterogeneous group of disorders. METHODS We used targeted next-generation sequencing (NGS) on Illumina NextSeq 550 platform involving the SureSelect assay to perform genetic and clinical characteristics of a study group of 684 individuals, including 542 patients referred from 12 Polish Diabetes Centers with suspected MD diagnosed between December 2016 and December 2019 and their 142 family members (FM). RESULTS In 198 probands (36.5%) and 66 FM (46.5%) heterozygous causative variants were confirmed in 11 different MD-related genes, including 31 novel mutations, with the highest number in the GCK gene (206/264), 22/264 in the HNF1A gene and 8/264 in the KCNJ11 gene. Of the 183 probands with MODY1-5 diabetes, 48.6% of them were diagnosed at the pre-diabetes stage and most of them (68.7%) were on diet only at the time of genetic diagnosis, while 31.3% were additionally treated with oral hypoglycaemic drugs and/or insulin. CONCLUSIONS In summary, the results obtained confirm the efficacy of targeted NGS method in the molecular diagnosis of patients with suspected MD and broaden the spectrum of new causal variants, while updating our knowledge of the clinical features of patients defined as having MD.
Above 40% of Polish children and young adults with type 1 diabetes achieve international HbA1c target ‐ results of a nationwide cross‐sectional evaluation of glycemic control: The PolPeDiab HbA1c study
Pediatric Diabetes, 2021
Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and... more Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and need structured interventions. Those should be based on unbiased, national‐scale outcomes, which have not yet been successfully assessed in Poland.
Pediatric endocrinology, diabetes, and metabolism, 2019
Hyponatremia is the one of the most common electrolyte abnormality in the clinical practice and i... more Hyponatremia is the one of the most common electrolyte abnormality in the clinical practice and is associated with increased morbidity and mortality. Decreased serum sodium levels are occasionally observed in patients with diabetes mellitus, especially in those, who present with the diabetic ketoacidosis. It can develop at the each stage of a treatment, as a complication of hyperglycemia and intensity of the therapy, but also the other underlying causes should be consider. In this report we present a patient with symptomatic hyponatremia in the new diagnosed patient with type 1 diabetes mellitus.
Frontiers in Endocrinology, Jul 24, 2020
Background: Immunological and hormonal disorders have undoubted influence on the development of a... more Background: Immunological and hormonal disorders have undoubted influence on the development of atherosclerotic process. Autoimmune diseases accompanying type 1 diabetes (T1D) may additionally accelerate atherosclerosis progression and increase the risk of cardiovascular events in the future. The influence of subclinical hypothyroidism on the cardiovascular system, in particular, has recently aroused great interest. The aim of our study was to assess intima-media thickness (cIMT) of common carotid arteries and the occurrence of classical atherosclerosis risk factors together with selected new biomarkers of cardiovascular diseases in young patients with type 1 diabetes mellitus coexisting with Hashimoto's disease (HD). The study included 50 adolescents and young adults with T1D with mean age 17.1 ± 3 years, with mean diabetes duration of 10.5 ± 3.3 years, including 20 patients with diagnosed HD: T1D and HD(+), and 30 patients with no additional diseases: T1D and HD(-). Twenty-two healthy, age-matched volunteers formed control group (C). We analyzed mean HbA 1 c value from all years of disease, BMI, blood pressure, lipids, new biomarkers of atherosclerosis (hsCRP, adiponectin, myeloperoxidase, NT-proBNP peptide, vitamin D), and cIMT of common carotid arteries. Results: In the group of patients with T1D and HD(+), significantly higher BMI was found: 23.3 ± 4.4 vs. 21.28 ± 2.9 in group HD(-) and 19.65 ± 2.4 kg/m 2 in group C (p = 0.003), and higher waist circumference: 79 ± 10.9 vs. 75.10 ± 7.6 in group HD(-) vs. 69.0 ± 7.4 cm in group C (p < 0.001). The mean value of HbA 1 c was higher in group T1D and HD(+): 8.8% than in group HD(-): 8.1% (p = 0.04). Significantly higher concentration of hsCRP and lower vitamin D were observed in T1D and HD(+) in comparison to T1D and HD(-) and the control group. The IMT index in the HD(+) group was 0.46 ± 0.05 mm and was comparable to the HD(-) group but significantly higher than in healthy controls: 0.41 ± 0.03 mm (P < 0.05). Głowinska-Olszewska et al. Diabetes, Hashimoto's Thyroiditis, and Cardiovascular Risk Conclusions: Young patients with type 1 diabetes mellitus and with coexisting Hashimoto's thyroiditis have a higher BMI, a higher waist circumference, and a higher HbA 1 c value, which altogether may cause faster development of macroangiopathy in the near future. Additional risk for cardiovascular disease may result from low vitamin D and increased hsCRP concentration in this group of patients. Coexistence of Hashimoto's thyroiditis did not significantly affect the cIMT value in the studied population.
Journal of Clinical Medicine, Aug 13, 2022
Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in ... more Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intimamedia thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10-26 age range), including 20 patients with VC (+) and 30 VC (-). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11-26 age range). In the VC (+) patients, we found a significantly higher concentration of HbA1c, lipid levels, hsCRP and NT-proBNP. BMI and blood pressure values were highest in the VC (+) group. Higher levels of MPO and lower levels of vitamin D were found in both diabetic groups vs. Control. IMT in VC (+) patients was significantly higher and correlated positively with HbA1c, hsCRP, NT-pro-BNP and negatively with vitamin D levels. In conclusion, youth with T1D and VC (+) present many abnormalities in the classical and new CVD biomarkers. hsCRP and MPO seem to be the most important markers for estimating the risk of macroangiopathy. NT-proBNP may present a possible marker of early myocardial injury in this population.
Journal of Clinical Medicine
Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in ... more Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intima-media thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10–26 age range), including 20 patients with VC (+) and 30 VC (−). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11–26 age range). In the VC (+...
Diabetes/Metabolism Research and Reviews, 2017
BackgroundThe incidence of childhood type 1 diabetes (T1D) varies greatly between populations, an... more BackgroundThe incidence of childhood type 1 diabetes (T1D) varies greatly between populations, and the estimates and/or predictions of the rates would aid in adequate planning of health care resources. The study's aim was to assess the incidence of T1D in the paediatric population of eastern and central Poland.MethodsIn this cohort study covering the period from January 2010 to December 2014, data were collected for children and adolescents below 18 years of age with newly diagnosed T1D living in eastern and central Poland. A total of 2174 children were included in the analysis. The population estimates were from the Central Statistical Office of Poland.ResultsOverall, the annual incidence of T1D increased from 12.84/100,000 in 2010 to 18.46/100,000 in 2014 with the incidence rate (IR) ratio of 1.5 (an increase in the IR by 12.7% per year over 5 years). The lowest increase in the IR by 7.1% per year was seen in 15 to 17‐year‐olds. In the urban population (age 0‐17 years), the ov...
[Estimation of the severity of metabolic disorders in children with newly diagnosed insulin dependent diabetes mellitus (IDDM)]
Medycyna wieku rozwojowego
The objective of this study was to estimate the severity of metabolic disorders at onset in child... more The objective of this study was to estimate the severity of metabolic disorders at onset in children with insulin dependent diabetes mellitus (IDDM). Biochemical results taken at onset of IDDM were analysed in 158 children on their admission. Metabolic acidosis was found in 37.97% of those and ketoacidosis was confirmed in 18.99% children. Mean values of biochemical parameters are similar to those reported in the others European countries. The most severe changes of the acid-base balance parameters were observed in youngest children (1-4 y.o) living in the rural areas (pH, 7.22, HCO3- 10.2 mmol/l, BE - 16.06 mmol/l, p=0.05); this should suggest that those children are watchfully observed and IDDM should be always be considered as a possible cause of any alarming symptoms which occur.
Carotid artery intima-media thickness (cIMT) in young type 1 diabetic patients in relation to comorbid additional autoimmune diseases and microvascular complications
Pediatric endocrinology, diabetes, and metabolism, 2016
INTRODUCTION Atherosclerosis, which is the cause of diseases of the cardiovascular system, and fr... more INTRODUCTION Atherosclerosis, which is the cause of diseases of the cardiovascular system, and frequent and serious complications of type 1 diabetes (T1DM), has an autoimmune origin. Some diseases of this type, as rheumatoid arthritis, but also Hashimoto thyroiditis or celiac disease are associated with a higher incidence of heart disease. So far no studies evaluated the preclinical phase of development of atherosclerosis (cIMT) in young patients with T1DM and the comorbid additional autoimmune diseases. AIM OF THE STUDY was evaluation of cIMT (carotid intima media thickness) carotid arteries and the risk factors of atherosclerosis in young patients with type 1 diabetes according to the comorbid autoimmune diseases and a comparison group of patients with known vascular complications and a group of healthy people. PATIENTS AND METHODS The study involved a group of 90 adolescents and young adults with T1DM in middle age 17,1±3years, with an average disease duration of 10,5±3,3 years. Diabetes patients were divided into 4 groups - diabetes without complications - C, diabetes with celiac disease - CC, diabetes with Hashimoto's thyroiditis - CH, diabetes with vascular complications - CN. The control group (K) consisted of 22 healthy age-matched volunteers. In statistical analysis rated: average A1C of all the years of illness, BMI, blood pressure, lipid values, duration of illness, presence of diabetes complications, daily insulin dose and cIMT thickness of the common carotid artery. RESULTS cIMT of T1DM patients was significantly higher: 0,470 mm than in healthy: 0,409 mm. In the group with vascular complications of diabetes was found the highest rate of cIMT: 0,501 mm in comparison to the group of diabetes without complications: 0,462 mm, diabetes with celiac disease: 0,462 mm, and diabetes with Hashimoto's thyroiditis: 0,453 mm. HbA1c was highest in the group CN: 9,84±1,5%, compared to CH: 9,04± 1,2%, CC: 8,84±1,8% and C without complications: 8,55±1,2%. BMI was highest in the group CN: 23,3± 4,4kg/m2and CH: 22,6 ± 2,4 kg/m2. It was the same with waist circumference: CN: 79,33± 9,39and CH: 79,2 ± 9,56 cm. Patients with vascular complications were characterized by the higher value of blood pressure and lipids compared to patients with additional autoimmune disease. Coexistence of celiac disease was not associated with a greater value of cIMT and cardiovascular risk factors in young patients with type 1 diabetes. CONCLUSIONS 1. Increased value of cIMT, and thus increased risk of early disease of the cardiovascular system depends primarily on metabolic compensation and classic risk factors for atherosclerosis. 2. The coexistence of additional autoimmune disease does not significantly affect the value of cIMT in the study population. 3. Young patients with diabetes type 1 and coexisting Hashimoto disease have greater BMI and waist circumference, what can lead to earlier macroangiopathy in the future.
in 15–29 age group in Warmia and Mazury Region between 1994–2003 Background. The incidence rate o... more in 15–29 age group in Warmia and Mazury Region between 1994–2003 Background. The incidence rate of type 1 diabetes (T1DM) has increased worldwide. Most studies have been performed in the 0–14 year age-group and only a few registries include the group over 15 years of age. The aim of the study was to assess the incidence of T1DM in the age group 15–29. Materials and methods. Between 1994–2003 all newly diagnosed cases of T1DM in the age group 15–29 years in Olsztyn Region were recorded prospectively. General data on the population were taken from the Demographic Year-book of Poland. Incidence in the group aged 15–29 years by age, sex, were calculated per 100,000 population. Results. A total number of new cases registered 1994– –2003 was 148. The incidence rate per year was 7.7 in age group 15–29 years. There was no sex differences. The high-est incidence was recorded in women aged 25–29 — 7.8 and men aged 15–19 — 9.3. Comparing 5-years periods there were no significant changes in the...
Seasonal Variation in Month of Diagnosis of Polish Children with Type 1 Diabetes - A Multicenter Study
Experimental and Clinical Endocrinology & Diabetes
Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis t... more Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of ...
Seasonal Variation in Month of Diagnosis of Polish Children with Type 1 Diabetes - A Multicenter Study
Experimental and Clinical Endocrinology & Diabetes
Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis t... more Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of ...
Does Hashimoto's Thyroiditis Increase the Risk of Cardiovascular Disease in Young Type 1 Diabetic Patients?
Frontiers in Endocrinology
Factors associated with preservation of C-peptide levels at the diagnosis of type 1 diabetes
Journal of Diabetes and its Complications
Symptomatic hyponatremia during the diabetic ketoacidosis in 5 years old child with new onset diabetes – own experience
Pediatric Endocrinology Diabetes and Metabolism
Carotid artery intima-media thickness (cIMT) in young type 1 diabetic patients in relation to comorbid additional autoimmune diseases and microvascular complications
Pediatric Endocrinology Diabetes and Metabolism
High incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes among Polish children aged 10-12 and under 5 years of age: A multicenter study
Pediatric Diabetes, 2016
Experimental and Clinical Endocrinology & Diabetes, Mar 5, 2018
High incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes among Polish children aged 10-12 and under 5 years of age: A multicenter study
Pediatric Diabetes, Oct 11, 2016
Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the de... more Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17. The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. The population living in these areas accounts for 35% of the Polish population. DKA was defined as a capillary pH &amp;amp;amp;amp;amp;lt; 7.3, blood glucose &amp;amp;amp;amp;amp;gt; 11 mmol/L. The analyzed data included age, sex, diabetes recognition, pH, glycated hemoglobin (HbA1c), fasting C-peptide, and body mass index standard deviation score (BMI-SDS). We observed DKA in 28.6% of children. There were 2 peaks in DKA occurrence: in children &amp;amp;amp;amp;amp;lt;5 years of age (33.9%) and aged 10-12 (34%). The highest incidence of DKA was noted in children aged 0-2 (48.4%). In the group with DKA, moderate and severe DKA occurred in 46.7% of children. Girls and children &amp;amp;amp;amp;amp;lt;2 years of age were more prone to severe DKA. The multiple logistic regression analysis showed the following factors associated with DKA: age (P = .002), fasting C-peptide (P = .0001), HbA1c (P = .0001), no family history of T1D (P = .0001), and BMI-SDS (P = .0001). The incidence of DKA is high and remained unchanged over the last 5 years. Increasing the awareness of symptoms of DKA is recommended among children &amp;amp;amp;amp;amp;lt;5 years of age (especially &amp;amp;amp;amp;amp;lt;2 years of age) and aged 10-12. Children &amp;amp;amp;amp;amp;lt;2 years of age and girls were at the highest risk of severe DKA.
Diabetes-metabolism Research and Reviews, Dec 28, 2017
The incidence of childhood Type-1 diabetes (T1D) varies greatly between populations and the estim... more The incidence of childhood Type-1 diabetes (T1D) varies greatly between populations and the estimates and/or predictions of the rates would aid in adequate planning of health care resources. The study's aim was to assess the incidence of T1D in the paediatric population of eastern and central Poland. In this cohort study covering the period from January 2010 to December 2014 data were collected for children and adolescents below 18 years of age with newly diagnosed T1D, living in eastern and central Poland. A total of 2174 children were included in the analysis. The population estimates were from the Central Statistical Office of Poland. Results Overall, the annual incidence of T1D increased from 12.84/100 000 in 2010 to 18.46/100 000 in 2014 with the incidence rate ratio (IRR) of 1.5 (an increase in the incidence This article is protected by copyright. All rights reserved. rate (IR) by 12.7% per year over 5 years). The lowest increase in the IR by 7.1% per year was seen in 15-17-year-olds. In the urban population (age 0-17 years), the overall IR was significantly higher than in subjects from rural communities (p<0.02). A statistically significant difference was demonstrated between the incidence of T1D in rural areas in densely populated voivodships vs less populated regions (p=0.004), but no such dependence in urban areas. The incidence of T1D in children living in eastern and central Poland increased 1.5-fold over the 5-year observation period with the highest rise in 10-14-year-olds and significantly higher rates in urban children compared to their peers living in rural areas.
Next- generation sequencing is an effective method for diagnosing patients with different forms of monogenic diabetes
Diabetes Research and Clinical Practice
AIM Monogenic diabetes (MD) represents 5-7% of antibody-negative diabetes cases and is a heteroge... more AIM Monogenic diabetes (MD) represents 5-7% of antibody-negative diabetes cases and is a heterogeneous group of disorders. METHODS We used targeted next-generation sequencing (NGS) on Illumina NextSeq 550 platform involving the SureSelect assay to perform genetic and clinical characteristics of a study group of 684 individuals, including 542 patients referred from 12 Polish Diabetes Centers with suspected MD diagnosed between December 2016 and December 2019 and their 142 family members (FM). RESULTS In 198 probands (36.5%) and 66 FM (46.5%) heterozygous causative variants were confirmed in 11 different MD-related genes, including 31 novel mutations, with the highest number in the GCK gene (206/264), 22/264 in the HNF1A gene and 8/264 in the KCNJ11 gene. Of the 183 probands with MODY1-5 diabetes, 48.6% of them were diagnosed at the pre-diabetes stage and most of them (68.7%) were on diet only at the time of genetic diagnosis, while 31.3% were additionally treated with oral hypoglycaemic drugs and/or insulin. CONCLUSIONS In summary, the results obtained confirm the efficacy of targeted NGS method in the molecular diagnosis of patients with suspected MD and broaden the spectrum of new causal variants, while updating our knowledge of the clinical features of patients defined as having MD.
Above 40% of Polish children and young adults with type 1 diabetes achieve international HbA1c target ‐ results of a nationwide cross‐sectional evaluation of glycemic control: The PolPeDiab HbA1c study
Pediatric Diabetes, 2021
Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and... more Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and need structured interventions. Those should be based on unbiased, national‐scale outcomes, which have not yet been successfully assessed in Poland.
Pediatric endocrinology, diabetes, and metabolism, 2019
Hyponatremia is the one of the most common electrolyte abnormality in the clinical practice and i... more Hyponatremia is the one of the most common electrolyte abnormality in the clinical practice and is associated with increased morbidity and mortality. Decreased serum sodium levels are occasionally observed in patients with diabetes mellitus, especially in those, who present with the diabetic ketoacidosis. It can develop at the each stage of a treatment, as a complication of hyperglycemia and intensity of the therapy, but also the other underlying causes should be consider. In this report we present a patient with symptomatic hyponatremia in the new diagnosed patient with type 1 diabetes mellitus.
Frontiers in Endocrinology, Jul 24, 2020
Background: Immunological and hormonal disorders have undoubted influence on the development of a... more Background: Immunological and hormonal disorders have undoubted influence on the development of atherosclerotic process. Autoimmune diseases accompanying type 1 diabetes (T1D) may additionally accelerate atherosclerosis progression and increase the risk of cardiovascular events in the future. The influence of subclinical hypothyroidism on the cardiovascular system, in particular, has recently aroused great interest. The aim of our study was to assess intima-media thickness (cIMT) of common carotid arteries and the occurrence of classical atherosclerosis risk factors together with selected new biomarkers of cardiovascular diseases in young patients with type 1 diabetes mellitus coexisting with Hashimoto's disease (HD). The study included 50 adolescents and young adults with T1D with mean age 17.1 ± 3 years, with mean diabetes duration of 10.5 ± 3.3 years, including 20 patients with diagnosed HD: T1D and HD(+), and 30 patients with no additional diseases: T1D and HD(-). Twenty-two healthy, age-matched volunteers formed control group (C). We analyzed mean HbA 1 c value from all years of disease, BMI, blood pressure, lipids, new biomarkers of atherosclerosis (hsCRP, adiponectin, myeloperoxidase, NT-proBNP peptide, vitamin D), and cIMT of common carotid arteries. Results: In the group of patients with T1D and HD(+), significantly higher BMI was found: 23.3 ± 4.4 vs. 21.28 ± 2.9 in group HD(-) and 19.65 ± 2.4 kg/m 2 in group C (p = 0.003), and higher waist circumference: 79 ± 10.9 vs. 75.10 ± 7.6 in group HD(-) vs. 69.0 ± 7.4 cm in group C (p < 0.001). The mean value of HbA 1 c was higher in group T1D and HD(+): 8.8% than in group HD(-): 8.1% (p = 0.04). Significantly higher concentration of hsCRP and lower vitamin D were observed in T1D and HD(+) in comparison to T1D and HD(-) and the control group. The IMT index in the HD(+) group was 0.46 ± 0.05 mm and was comparable to the HD(-) group but significantly higher than in healthy controls: 0.41 ± 0.03 mm (P < 0.05). Głowinska-Olszewska et al. Diabetes, Hashimoto's Thyroiditis, and Cardiovascular Risk Conclusions: Young patients with type 1 diabetes mellitus and with coexisting Hashimoto's thyroiditis have a higher BMI, a higher waist circumference, and a higher HbA 1 c value, which altogether may cause faster development of macroangiopathy in the near future. Additional risk for cardiovascular disease may result from low vitamin D and increased hsCRP concentration in this group of patients. Coexistence of Hashimoto's thyroiditis did not significantly affect the cIMT value in the studied population.
Journal of Clinical Medicine, Aug 13, 2022
Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in ... more Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intimamedia thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10-26 age range), including 20 patients with VC (+) and 30 VC (-). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11-26 age range). In the VC (+) patients, we found a significantly higher concentration of HbA1c, lipid levels, hsCRP and NT-proBNP. BMI and blood pressure values were highest in the VC (+) group. Higher levels of MPO and lower levels of vitamin D were found in both diabetic groups vs. Control. IMT in VC (+) patients was significantly higher and correlated positively with HbA1c, hsCRP, NT-pro-BNP and negatively with vitamin D levels. In conclusion, youth with T1D and VC (+) present many abnormalities in the classical and new CVD biomarkers. hsCRP and MPO seem to be the most important markers for estimating the risk of macroangiopathy. NT-proBNP may present a possible marker of early myocardial injury in this population.
Journal of Clinical Medicine
Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in ... more Recent years have confirmed the importance of oxidative stress and biomarkers of inflammation in estimating the risk of cardiovascular disease (CVD) and explaining not fully understood pathogenesis of diabetic macroangiopathy. We aimed to analyze the relation between the intima-media thickness (IMT) of common carotid arteries and the occurrence of classical cardiovascular risk factors, together with the newly proposed biomarkers of CVD risk (high-sensitivity C-reactive protein (hsCRP), myeloperoxidase (MPO), adiponectin, N-terminal-pro B-type natriuretic peptide (NT-proBNP) and vitamin D) in youth with type 1 diabetes (T1D) recognized in screening tests to present early stages of microvascular complications (VC). The study group consisted of 50 adolescents and young adults with T1D, mean age 17.1 years (10–26 age range), including 20 patients with VC (+) and 30 VC (−). The control group (Control) consisted of 22 healthy volunteers, mean age 16.5 years (11–26 age range). In the VC (+...
Diabetes/Metabolism Research and Reviews, 2017
BackgroundThe incidence of childhood type 1 diabetes (T1D) varies greatly between populations, an... more BackgroundThe incidence of childhood type 1 diabetes (T1D) varies greatly between populations, and the estimates and/or predictions of the rates would aid in adequate planning of health care resources. The study's aim was to assess the incidence of T1D in the paediatric population of eastern and central Poland.MethodsIn this cohort study covering the period from January 2010 to December 2014, data were collected for children and adolescents below 18 years of age with newly diagnosed T1D living in eastern and central Poland. A total of 2174 children were included in the analysis. The population estimates were from the Central Statistical Office of Poland.ResultsOverall, the annual incidence of T1D increased from 12.84/100,000 in 2010 to 18.46/100,000 in 2014 with the incidence rate (IR) ratio of 1.5 (an increase in the IR by 12.7% per year over 5 years). The lowest increase in the IR by 7.1% per year was seen in 15 to 17‐year‐olds. In the urban population (age 0‐17 years), the ov...
[Estimation of the severity of metabolic disorders in children with newly diagnosed insulin dependent diabetes mellitus (IDDM)]
Medycyna wieku rozwojowego
The objective of this study was to estimate the severity of metabolic disorders at onset in child... more The objective of this study was to estimate the severity of metabolic disorders at onset in children with insulin dependent diabetes mellitus (IDDM). Biochemical results taken at onset of IDDM were analysed in 158 children on their admission. Metabolic acidosis was found in 37.97% of those and ketoacidosis was confirmed in 18.99% children. Mean values of biochemical parameters are similar to those reported in the others European countries. The most severe changes of the acid-base balance parameters were observed in youngest children (1-4 y.o) living in the rural areas (pH, 7.22, HCO3- 10.2 mmol/l, BE - 16.06 mmol/l, p=0.05); this should suggest that those children are watchfully observed and IDDM should be always be considered as a possible cause of any alarming symptoms which occur.
Carotid artery intima-media thickness (cIMT) in young type 1 diabetic patients in relation to comorbid additional autoimmune diseases and microvascular complications
Pediatric endocrinology, diabetes, and metabolism, 2016
INTRODUCTION Atherosclerosis, which is the cause of diseases of the cardiovascular system, and fr... more INTRODUCTION Atherosclerosis, which is the cause of diseases of the cardiovascular system, and frequent and serious complications of type 1 diabetes (T1DM), has an autoimmune origin. Some diseases of this type, as rheumatoid arthritis, but also Hashimoto thyroiditis or celiac disease are associated with a higher incidence of heart disease. So far no studies evaluated the preclinical phase of development of atherosclerosis (cIMT) in young patients with T1DM and the comorbid additional autoimmune diseases. AIM OF THE STUDY was evaluation of cIMT (carotid intima media thickness) carotid arteries and the risk factors of atherosclerosis in young patients with type 1 diabetes according to the comorbid autoimmune diseases and a comparison group of patients with known vascular complications and a group of healthy people. PATIENTS AND METHODS The study involved a group of 90 adolescents and young adults with T1DM in middle age 17,1±3years, with an average disease duration of 10,5±3,3 years. Diabetes patients were divided into 4 groups - diabetes without complications - C, diabetes with celiac disease - CC, diabetes with Hashimoto's thyroiditis - CH, diabetes with vascular complications - CN. The control group (K) consisted of 22 healthy age-matched volunteers. In statistical analysis rated: average A1C of all the years of illness, BMI, blood pressure, lipid values, duration of illness, presence of diabetes complications, daily insulin dose and cIMT thickness of the common carotid artery. RESULTS cIMT of T1DM patients was significantly higher: 0,470 mm than in healthy: 0,409 mm. In the group with vascular complications of diabetes was found the highest rate of cIMT: 0,501 mm in comparison to the group of diabetes without complications: 0,462 mm, diabetes with celiac disease: 0,462 mm, and diabetes with Hashimoto's thyroiditis: 0,453 mm. HbA1c was highest in the group CN: 9,84±1,5%, compared to CH: 9,04± 1,2%, CC: 8,84±1,8% and C without complications: 8,55±1,2%. BMI was highest in the group CN: 23,3± 4,4kg/m2and CH: 22,6 ± 2,4 kg/m2. It was the same with waist circumference: CN: 79,33± 9,39and CH: 79,2 ± 9,56 cm. Patients with vascular complications were characterized by the higher value of blood pressure and lipids compared to patients with additional autoimmune disease. Coexistence of celiac disease was not associated with a greater value of cIMT and cardiovascular risk factors in young patients with type 1 diabetes. CONCLUSIONS 1. Increased value of cIMT, and thus increased risk of early disease of the cardiovascular system depends primarily on metabolic compensation and classic risk factors for atherosclerosis. 2. The coexistence of additional autoimmune disease does not significantly affect the value of cIMT in the study population. 3. Young patients with diabetes type 1 and coexisting Hashimoto disease have greater BMI and waist circumference, what can lead to earlier macroangiopathy in the future.
in 15–29 age group in Warmia and Mazury Region between 1994–2003 Background. The incidence rate o... more in 15–29 age group in Warmia and Mazury Region between 1994–2003 Background. The incidence rate of type 1 diabetes (T1DM) has increased worldwide. Most studies have been performed in the 0–14 year age-group and only a few registries include the group over 15 years of age. The aim of the study was to assess the incidence of T1DM in the age group 15–29. Materials and methods. Between 1994–2003 all newly diagnosed cases of T1DM in the age group 15–29 years in Olsztyn Region were recorded prospectively. General data on the population were taken from the Demographic Year-book of Poland. Incidence in the group aged 15–29 years by age, sex, were calculated per 100,000 population. Results. A total number of new cases registered 1994– –2003 was 148. The incidence rate per year was 7.7 in age group 15–29 years. There was no sex differences. The high-est incidence was recorded in women aged 25–29 — 7.8 and men aged 15–19 — 9.3. Comparing 5-years periods there were no significant changes in the...
Seasonal Variation in Month of Diagnosis of Polish Children with Type 1 Diabetes - A Multicenter Study
Experimental and Clinical Endocrinology & Diabetes
Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis t... more Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of ...
Seasonal Variation in Month of Diagnosis of Polish Children with Type 1 Diabetes - A Multicenter Study
Experimental and Clinical Endocrinology & Diabetes
Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis t... more Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of ...
Does Hashimoto's Thyroiditis Increase the Risk of Cardiovascular Disease in Young Type 1 Diabetic Patients?
Frontiers in Endocrinology
Factors associated with preservation of C-peptide levels at the diagnosis of type 1 diabetes
Journal of Diabetes and its Complications
Symptomatic hyponatremia during the diabetic ketoacidosis in 5 years old child with new onset diabetes – own experience
Pediatric Endocrinology Diabetes and Metabolism
Carotid artery intima-media thickness (cIMT) in young type 1 diabetic patients in relation to comorbid additional autoimmune diseases and microvascular complications
Pediatric Endocrinology Diabetes and Metabolism
High incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes among Polish children aged 10-12 and under 5 years of age: A multicenter study
Pediatric Diabetes, 2016