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Autoimmune Disease
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Nanette Morales, Jessica Landry, Christy McDonald Lenahan, Janine Santora
Along with immunological improvements, metabolic changes resulting from intentional exercise or physical activity can modify possible development of comorbid conditions. Patients with an autoimmune rheumatic disease (ARD) are at a greater risk for development of cardiovascular diseases. This may be caused by changes in vascular homeostasis, and physical activity is integral to preventing these effects (Pecanha, 2021). ARD patients have accelerated atherosclerotic processes that can be improved with regular physical activity. In patients with ARDs, home-based physical activity improved quality of life (Sieczkowska et al., 2021). Furthermore, patients who participated in greater than 30 minutes of moderate physical activity, three times per week, showed a reduced risk for development of latent autoimmune diabetes (Hjort et al., 2020). Physical activity improved glucose uptake in patients and had beneficial effects on body weight.
Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diabetes mellitus, diabetic ketoacidosis, and nonketotic hyperosmolar syndrome are the most common conditions linked to carbohydrate metabolism. Type 1 and type 2 diabetes are distinguished by various features. Impaired glucose regulation is related to impaired glucose tolerance or impaired fasting glucose. These strong risk factors for diabetes mellitus may be present for many years before the disease actually manifests. Diabetes is linked to higher risks for cardiovascular disease, but in most cases, common microvascular complications do not develop. In type 1 diabetes mellitus, there is insufficient insulin produced, due to autoimmune pancreatic beta cell destruction. This situation may be initiated by environmental factors, if an individual is genetically susceptible. The beta cells are continually destroyed over months or years, until their mass has decreased to a point at which insulin concentration can no longer control plasma levels of glucose. Type 1 diabetes most often develops in childhood or adolescence. In the past decades, it was the most common form of diabetes diagnosed in people younger than age 30. However, type 1 diabetes can also develop in adults, often seeming to be type 2 diabetes at first, and described as latent autoimmune diabetes of adulthood. In non-Caucasians, some cases of type 1 diabetes are idiopathic and do not apparently related to autoimmunity. It is not fully understood how beta cells are destroyed, but there are interactions between environmental factors, autoantigens, and susceptibility genes.
Lifestyle Therapies for the Management of Diabetes
Published in James M. Rippe, Lifestyle Medicine, 2019
Type 1 diabetes accounts for approximately 5% of diagnosed diabetes and is due to cellular-mediated autoimmune destruction of the pancreatic beta-cells, usually leading to absolute insulin deficiency.1 The rate of beta-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults). Immune-mediated diabetes commonly occurs in childhood and adolescence, but it can occur at any age, even in the eighth and ninth decades of life.8 Children and adolescents may present with ketoacidosis as the first symptom of the disease. Adults may retain sufficient beta-cell function to prevent ketoacidosis for many years; however, such individuals eventually become dependent on insulin for survival and are at risk for ketoacidosis. This later-onset type 1 diabetes picture is referred to as Latent Autoimmune Diabetes of Adults (LADA).
Auto-reactivity against gut bacterial peptides in patients with late-onset diabetes
Published in Autoimmunity, 2020
Mohammad Sajid, Krishna Biswas, Harpreet Singh, Sapna Negi
Diabetes mellitus is a non-communicable disease causing a burden for global human health. In 2017, worldwide there were approximately 451 million individuals who had diabetes mellitus (DM) and with the current trend, it is expected to reach 693 million by 2045 [1]. Approximately 90–95% of DM belongs to type 2 diabetes (T2D). It is essential to predict DM and prevent it in time, for which we need to understand the disease completely. The main triggers of this disease are an unhealthy lifestyle, obesity, and advanced age. The mounting inflammatory response in T2D is assigned through autoimmunity [2]. Further, another adult-onset autoimmune diabetic condition is known as Latent autoimmune diabetes in adults (LADA) and this phenotype mainly does not need insulin therapy [3]. Most of the T2D is mainly due to insulin resistance [4]. T2D is known to be a metabolic disorder. In this study, we hypothesize that sera binding of some metabolic peptides might cause a spectrum of diseases including T2D.
Long-term safety and effectiveness of biosimilar insulin glargine in Japanese patients with diabetes mellitus in routine clinical practice: results of a post-marketing safety study
Published in Current Medical Research and Opinion, 2020
Tomotaka Shingaki, Kentaro Taki, Momoha Koyanagi, Soshi Nagaoka, Kenichi Yoshizawa, Norika Oki, Aki Yoshikawa, Takeshi Imaoka
No control groups were included in this observational study. Data analyses did not control for effects of pre-treatment or confounding baseline characteristics. No formal statistical inference was made and multiplicity for statistical tests was not corrected. Data collection and clinical laboratory testing was conducted at each study site and was not centralized. The number of patients planned to be enrolled and analyzed in the study was based on the incidence and features of adverse events of interest; however, the number of patients in subgroup analyses was dependent on data availability and in some cases included a limited number of patients. The statistical power of subgroup results is therefore limited. The observation period for this observational study was 12 months, and it remains possible that additional adverse events would be identified over longer-term treatment and observation. Individual patients with lower compliance for GLY administration could have impacted interpretation of aggregate safety and effectiveness results, including off-label and oral anti-hyperglycemic medications taken among the insulin-naive T1DM patient population. This may have been due to the T1DM group including patients with slowly progressive insulin-dependent diabetes mellitus or latent autoimmune diabetes in adults, however these diagnoses were not collected for the T1DM patients in this observational study.
The association between rs1893217, rs478582 in PTPN2 and T1D risk with different diagnosed age, and related clinical characteristics in Chinese Han population
Published in Autoimmunity, 2019
Shu Chen, Hongqi Fan, Yingjie Feng, Yuyue Zhang, Yang Chen, Yong Gu, Yun Shi, Hao Dai, Mei Zhang, Xinyu Xu, Heng Chen, Tao Yang, Kuanfeng Xu
A total of 1023 unrelated T1D patients and 1247 healthy controls were recruited from the First Affiliated Hospital of Nanjing Medical University between January 2008 and December 2016. T1D was diagnosed according to the World Health Organization (WHO) criteria and with at least one autoantibody positive (ZnT8A, GADA, IA-2A or IAA). In addition, we further excluded patients that had clinical features of latent autoimmune diabetes in adults (LADA). Clinical characteristics of all subjects are listed in Table S1. Healthy controls were enrolled from the same geographical region without diabetes or overt autoimmune diseases. Informed consent was obtained from all the subjects included or their guardians in a written way, and study population was determined as Chinese Han by questionnaire. The study was approved by the Ethics Committee from the First Affiliated Hospital of Nanjing Medical University.