Palacze z cukrzycą typu 1 są bardziej oporni na insulinę. Wyniki z Poznań Prospective Study (PoProStu).

  Aim. The aim of the study was to evaluate the rela­tionship between smoking and insulin resistance in patients with type 1 diabetes (DM1). Material and methods. The study group consisted of 81 patients with DM1 (51 men, 30 women) from the Poznan Prospective Study (PoProStu), aged 34 ± 6 years, and with diabetes duration 10 ± 1.5 years. Patients were divided into two groups depending on the smoking status: smokers and non-smokers. Insulin resistance was assessed on the basis of indirect param­eters such as: estimated glucose disposal rate (eGDR), anthropometric data and liver function. Results. Smokers (n = 36) in comparison with non-smokers (n = 45) had: higher weight (80.4 ± 14.4 vs. 72.9 ± 15 kg, p = 0.02), larger waist circumference (89.6 ± 10.5 vs. 83.1 ± 10.9 cm, p = 0.003), higher waist-to-hip ratio (0.9 ± 0.08 vs. 0.86 ± 0.09, p = 0.006), higher level of gamma-glutamyl transferase [23 (15–36) vs. 15 (11–21) U/l, p = 0.003] and lower eGDR (7.11 ± 2.47 vs. 8.82 ± 1.79 mg/kg/min, p = 0.001). A significant relationship, adjusted for age, duration of diabetes, triglycerids (TG) and high density lipoproteins (HDL) cholesterol level between smoking and eGDR < 7.5 mg/kg/min was revealed [odds ratio OR 4.39 (95% confidence interval CI 1.52–12.66); p = 0.005]. Conclusions. The results of this study confirm the healthy dimension of not smoking among people with type 1 diabetes. Smoking in patients with type 1 dia­betes, treated from the initial diagnosis with intensive insulin therapy, is associated with insulin resistance. (Clin Diabetol 2018; 7, 2: 122–127)  Cel Celem pracy była ocena związku między paleniem tytoniu a insulinoopornością u pacjentów z cukrzycą typu 1 (DM1). Materiał i metody Grupa badana składała się z 81 pacjentów z DM1 (51 mężczyzn, 30 kobiet) z Poznan Prospective Study (PoProStu), w wieku 34±6.4 roku, z cukrzycą trwającą 10.5 roku. Pacjenci zostali podzieleni na dwie grupy w zależności od statusu palenia: palacze i osoby niepalące. Insulinooporność oceniano na podstawie parametrów pośrednich, takich jak: szacowany wskaźnik dystrybucji glukozy (eGDR), dane antropometryczne i czynność wątroby. Wyniki Palacze (n=36) w porównaniu z niepalącymi (n=45) mieli: wyższą masę ciała (80.4±14.4 vs 72.9±15 kg, p=0.02), większy obwód talii (89.6±10.5 vs 83.1±10.9 cm, p=0.003), wyższy WHR (0.9±0.08 vs. 0.86±0.09, p=0.006), wyższy poziom transferazy gamma-glutamylowej (23 [15-36] vs 15 [11-21] U/l, p=0.003) i niższy eGDR (7.11±2.47 vs 8.82±1.79 mg/kg/min, p=0.001). Wykazano istotny związek, skorygowany pod względem wieku, czasu trwania cukrzycy, triglicerydów (TG) i poziomu cholesterolu HDL (high density lipoproteins) między paleniem tytoniu a eGD

Arterial stiffness and the non-dipping pattern in type 1 diabetes males with and without erectile dysfunction

Abstract Arterial stiffness (AS) and non-dipping pattern are early predictors of cardiovascular diseases but are not used in clinical practice. We aimed to assess if AS and the non-dipping pattern are more prevalent in the erectile dysfunction (ED) group than in the non-ED group among subjects with type 1 diabetes (T1DM). The study group consisted of adults with T1DM. Aortic pulse wave velocity (PWV Ao)—a marker of increased AS, central systolic blood pressure, and heart rate (HR) were measured with a brachial oscillometric device (Arteriograph 24). Erectile dysfunction (ED) was assessed by the International Index of Erectile Function-5. A comparison between the groups with and without ED was performed. Of 34 investigated men with T1DM, 12 (35.3%) suffered from ED. The group with ED had higher mean 24 h HR (77.7 [73.7–86.5] vs 69.9 [64.0–76.8]/min; p = 0.04, nighttime PWV Ao (8.1 [6.8–8.5] vs 6.8 [6.1–7.5] m/s; p = 0.015) and prevalence of non-dipping SBP Ao pattern (11 [91.7] vs 12 [54.5]%; p = 0.027) than individuals without ED. The presence of ED detected a central non-dipping pattern with a sensitivity of 47.8% and a specificity of 90.9%. The central non-dipping pattern was more prevalent and the nighttime PWV was higher in T1DM subjects with ED than in those without ED