Pubertal lipid levels are significantly lower in youth with type 1 diabetes who experienced partial clinical remission

Importance: The physiologic changes in lipids during puberty in type 1 diabetes (T1D) is unclear as subjects in previous studies were not stratified by partial clinical remission (PCR) status. Aim: To determine the effect of PCR on lipid changes during puberty in youth with T1D. Subjects and Methods: A retrospective cross-sectional study of 194 subjects consisting of 71 controls of age 12.9±1.3y and 123 subjects with T1D stratified into remitters (n=44, age 13.0±0.8y) and non-remitters (n=79, age 11.2±0.6y). PCR was defined as insulin-dose adjusted HbA1c of ≤9. Pubertal status was determined by Tanner staging. Results: Among the pubertal cohort, low-density lipoprotein cholesterol concentration was significantly higher in the non-remitters compared to the remitters, 91.1±25.6mg/dL vs 77.2±25.8mg/dL, p=0.018; and the normal-weight controls, 91.1±25.6mg/dL vs 70.4±22.9 mg/dL, p=0.009; but was similar between the overweight/obese controls and non-remitters, 89.7±28.9mg/dL vs 91.1± 25.6mg/dL, p=0.81, and similarly between the normal-weight controls and remitters, 70.4±22.9mg/dL vs 77.2±25.8mg/dL, p=0.39. Total cholesterol was also significantly higher in the non-remitters compared to the remitters, 167.8±30.5 mg/dL vs 149.8±32.1mg/dL, p=0.012; and normal-weight controls, 167.8±30.5mg/dL vs 143.2±30.1mg/dL, p=0.011; but similar between the non-remitters and overweight/obese controls, p=0.098; and remitters and normal-weight controls, p=0.51. Non-HDL cholesterol was equally significantly higher in non-remitters compared to remitters, 111.3±30.1mg/dL vs 95.9±29.1mg/dL, p=0.028; and normal-weight controls, 111.3±30.1mg/dL vs 86.2± 32.2mg/dL, p=0.028; but similar between non-remitters and overweight/obese controls, p=0.48; and remitters versus normal-weight controls, p=0.39. Conclusions: Puberty-related reductions in LDL, TC, and non-HDL occur in remitters and normal-weight controls, but not in non-remitters and overweight/obese controls

Continuous glucose monitoring reduces pubertal hyperglycemia of type 1 diabetes

Background: Physiologic hyperglycemia of puberty is a major contributor to poor glycemic control in youth with type 1 diabetes (T1D). This study\u27s aim was to determine the effectiveness of continuous glucose monitoring (CGM) to improve glycemic control in pubertal youth with T1D compared to a non-CGM cohort after controlling for age, sex, BMI, duration, and insulin delivery methodology. The hypothesis is that consistent CGM use in puberty improves compliance with diabetes management, leading to increased percentage (%) time in range (TIR70-180 mg/dL) of glycemia, and lowering of HbA1c. Methods A longitudinal, retrospective, case-controlled study of 105 subjects consisting of 51 T1D controls (60.8% male) age 11.5 +/- 3.8 y; and 54 T1D subjects (48.1% male) age 11.1 +/- 5.0 y with confirmed CGM use for 12 months. Pubertal status was determined by Tanner staging. Results were adjusted for baseline HbA1c and diabetes duration. Results HbA1c was similar between the controls and the CGM group at baseline: 8.2 +/- 1.1% vs 8.3 +/- 1.2%, p=0.48 respectively; but was significantly lower in the CGM group 12 months later, 8.2 +/- 1.1% vs. 8.7 +/- 1.4%, p=0.035. Longitudinal change in HbA1c was similar in the prepubertal cohort between the control- and CGM groups: -0.17 +/- 0.98% vs. 0.38 +/- 1.5%, p=0.17. In contrast, HbA1c increased with advancing age and pubertal status in the pubertal controls but not in the pubertal CGM group: 0.55 +/- 1.4 vs -0.22 +/- 1.1%, p=0.020. Percent TIR was inversely related to HbA1c in the CGM group, r=-0.6, p=0.0004, for both prepubertal and pubertal subjects. Conclusions CGM use significantly improved glycemic control in pubertal youth with T1D compared to non-CGM users

Regional development gaps in Argentina: A multidimensional approach to identify the location of policy priorities

Spatial inequalities within Latin American countries have historically attracted the interest ofacademics, policy-makers, and international agencies. This article aims to provide amultidimensional diagnosis of provincial development gaps in Argentina, in order to identifythe location of policy priorities. Therefore, we built a large database, which covers sevendevelopment dimensions, and applied multivariate analysis techniques to overcome someanalytical limitations of previous studies. Results show the stability of provincial developmentgaps between 2003 and 2013 and some heterogeneity within geographic regions. Instead,cluster analysis offers a better classification of Argentine provinces according to theirdevelopment gaps, which can help the government to prioritize the places wheredevelopment policies are strategic.Fil: Niembro, Andrés Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Universidad Nacional de Río Negro; ArgentinaFil: Sarmiento, Jesica Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; Argentina. Universidad Nacional de Río Negro; Argentin

The stigma turbine:A theoretical framework for conceptualizing and contextualizing marketplace stigma

Stigmas, or discredited personal attributes, emanate from social perceptions of physical characteristics, aspects of character, and “tribal” associations (e.g., race; Goffman 1963). Extant research emphasizes the perspective of the stigma target, with some scholars exploring how social institutions shape stigma. Yet the ways stakeholders within the socio-commercial sphere create, perpetuate, or resist stigma remain overlooked. We introduce and define marketplace stigma as the labeling, stereotyping, and devaluation by and of commercial stakeholders (consumers, companies and their employees, stockholders, institutions) and their offerings (products, services, experiences). We offer the Stigma Turbine (ST) as a unifying conceptual framework that locates marketplace stigma within the broader sociocultural context, and illuminates its relationship to forces that exacerbate or blunt stigma. In unpacking the ST, we reveal the critical role market stakeholders can play in (de)stigmatization, explore implications for marketing practice and public policy, and offer a research agenda to further our understanding of marketplace stigma and stakeholder welfare