Cardiac Autonomic Function Correlates with Arterial Stiffness in the Early Stage of Type 1 Diabetes

Arterial stiffness is increased in type 1 diabetes (T1D), before any clinical complications of the disease are evident. The aim of the present paper was to investigate the association between cardiac autonomic function and arterial stiffness in a cohort of young T1D patients, without history of hypertension and any evidence of macrovascular and/or renal disease. Large artery stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV). Cardiac autonomic function was assessed by the cardiovascular tests proposed by Ewing and Clarke. Patients with a high cardiac autonomic neuropathy score (≥4) had significantly higher PWV than those with a low score (0-1). A negative, heart rate-independent, correlation between PWV and heart rate variation during respiration was observed (r = −0.533,  P < 0.001). In multivariable analysis, E/I index was the strongest correlate of PWV (β-coefficient = −0.326, P = 0.002). Cardiac parasympathetic function is a strong predictor of large arterial stiffness, in young T1D patients free of macrovascular and renal complications

Development and validation of two self-reported tools for insulin resistance and hypertension risk assessment in a European cohort : the Feel4Diabetes-study

Early identification of type 2 diabetes mellitus (T2DM) and hypertension (HTN) risk may improve prevention and promote public health. Implementation of self-reported scores for risk assessment provides an alternative cost-effective tool. The study aimed to develop and validate two easy-to-apply screening tools identifying high-risk individuals for insulin resistance (IR) and HTN in a European cohort. Sociodemographic, lifestyle, anthropometric and clinical data obtained from 1581 and 1350 adults (baseline data from the Feel4Diabetes-study) were used for the European IR and the European HTN risk assessment index respectively. Body mass index, waist circumference, sex, age, breakfast consumption, alcohol, legumes and sugary drinks intake, physical activity and sedentary behavior were significantly correlated with Homeostatic Model Assessment of IR (HOMA-IR) and/or HTN and incorporated in the two models. For the IR index, the Area Under the Curve (AUC), sensitivity and specificity for identifying individuals above the 75th and 95th of HOMA-IR percentiles were 0.768 (95%CI: 0.721–0.815), 0.720 and 0.691 and 0.828 (95%CI: 0.766–0.890), 0.696 and 0.778 respectively. For the HTN index, the AUC, sensitivity and specificity were 0.778 (95%CI: 0.680–0.876), 0.667 and 0.797. The developed risk assessment tools are easy-to-apply, valid, and low-cost, identifying European adults at high risk for developing T2DM or having HTN

Neuro-ophthalmological abnormalities in neurological diseases of dogs and cats: a retrospective study of 114 cases (2010-2015)

The current retrospective study includes 99 canine and 15 feline cases with neurologic disease accompanied by neuro-ophthalmological abnormalities (blindness, strabismus, nystagmus, anisocoria, miosis, mydriasis, Horner’s syndrome). All cases were presented in the Companion Animal Clinic of the School of Veterinary Medicine – Faculty of Health Sciences (Aristotle University of Thessaloniki) over a six-year period (2010-2015). The most frequent presenting complaints were head tilt (n=22/99) and paresis/paralysis (n=22/99) in dogs and head tilt (n=3/15) and ataxia (n=3/15) in cats. The most common neuro-ophthalmological abnormalities were strabismus (n=55/99) in dogs and anisocoria (n=7/15) in cats. The localization of lesions was found to be multifocal (n=38/99), and focal, in the vestibular system (n=37/99) in dogs, whilst in cats it was solely multifocal (n=6/15). An etiological diagnosis was reached only in 48 dogs and 10 cats; the former were mainly diagnosed with distemper encephalitis (10/48) and congenital hydrocephalus (6/48) and the latter mostly with encephalitis (n=5/10). Neuro-ophthalmological cases reached a 18.24% of the total neurologic case load (n=625) admitted during a six-year period. Neuro-ophthalmological examination as well as the correlation of the observed abnormalities with the overall neurological symptomatology is important for the neuroanatomic diagnosis, the assessment of severity and prognosis of the respected mainly diseases

Neuro-ophthalmological abnormalities in neurological diseases of dogs and cats: a retrospective study of 114 cases (2010-2015)

The current retrospective study includes 99 canine and 15 feline cases with neurologic disease accompanied by neuro-ophthalmological abnormalities (blindness, strabismus, nystagmus, anisocoria, miosis, mydriasis, Horner’s syndrome). All cases were presented in the Companion Animal Clinic of the School of Veterinary Medicine – Faculty of Health Sciences (Aristotle University of Thessaloniki) over a six-year period (2010-2015). The most frequent presenting complaints were head tilt (n=22/99) and paresis/paralysis (n=22/99) in dogs and head tilt (n=3/15) and ataxia (n=3/15) in cats. The most common neuro-ophthalmological abnormalities were strabismus (n=55/99) in dogs and anisocoria (n=7/15) in cats. The localization of lesions was found to be multifocal (n=38/99), and focal, in the vestibular system (n=37/99) in dogs, whilst in cats it was solely multifocal (n=6/15). An etiological diagnosis was reached only in 48 dogs and 10 cats; the former were mainly diagnosed with distemper encephalitis (10/48) and congenital hydrocephalus (6/48) and the latter mostly with encephalitis (n=5/10). Neuro-ophthalmological cases reached a 18.24% of the total neurologic case load (n=625) admitted during a six-year period. Neuro-ophthalmological examination as well as the correlation of the observed abnormalities with the overall neurological symptomatology is important for the neuroanatomic diagnosis, the assessment of severity and prognosis of the respected mainly diseases

Evaluation of the Finnish Diabetes Risk Score as a screening tool for undiagnosed type 2 diabetes and dysglycaemia among early middle-aged adults in a large-scale European cohort. The Feel4Diabetes-study

Aim: To assess the diagnostic accuracy of the FINDRISC for undiagnosed type 2 diabetes mellitus (T2DM) and dysglycaemia (i.e. the presence of prediabetes or T2DM) among early middle-aged adults from vulnerable groups in a large-scale European cohort. Methods: Participants were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland) and in HICs under austerity measures (Greece-Spain) and from the overall population in low/middle-income countries (LMICs) (Bulgaria-Hungary). Study population comprised of 2116 parents of primary-school children from families identified at increased risk of T2DM, based on parental self-reported FINDRISC. Sensitivity (Se), specificity (Sp), area under the receiver operating characteristic curves (AUC-ROC) and the optimal cut-offs of FINDRISC that indicate an increased probability for undiagnosed T2DM or dysglycaemia were calculated. Results: The AUC-ROC for undiagnosed T2DM was 0.824 with optimal cut-off =14 (Se = 68%, Sp = 81.7%) for the total sample, 0.839 with optimal cut-off =15 (Se = 83.3%, Sp = 86.9%) for HICs, 0.794 with optimal cut-off =12 (Se = 83.3%, Sp = 61.1%) for HICs under austerity measures and 0.882 with optimal cut-off =14 (Se = 71.4%, Sp = 87.8%) for LMICs. The AUC-ROC for dysglycaemia was 0.663 with optimal cut-off =12 (Se = 58.3%, Sp = 65.7%) for the total sample, 0.656 with optimal cut-off =12 (Se = 54.5%, Sp = 64.8%) for HICs, 0.631 with optimal cut-off =12 (Se = 59.7%, Sp = 62.0%) for HICs under austerity measures and 0.735 with optimal cut-off =11 (Se = 72.7%, Sp = 70.2%) for LMICs. Conclusion: FINDRISC can be applied for screening primarily undiagnosed T2DM but also dysglycaemia among vulnerable groups across Europe, considering the use of different cut-offs for each subpopulation

Arterial stiffness is inversely related to plasma adiponectin levels in young normotensive patients with type 1 diabetes

OBJECTIVE This study investigated the association between arterial stiffness and plasma adiponectin in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS Participants were normotensive patients with type 1 diabetes who were up to age 40 years. Subjects on statins with macrovascular disease or overt nephropathy were excluded. Large artery stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV), whereas plasma adiponectin was measured by radioimmunoassay. RESULTS Data from 80 patients (age 27.1 ± 6.1 years, BMI 24.2 ± 3.1 kg/m2, HbA1c 7.5 ± 1.6%, 39 men, adiponectin 13.9 ± 6.7 μg/mL, and PWV 5.6 ± 0.9 m/s) were analyzed. Log adiponectin inversely correlated with age-adjusted PWV (r = −0.291, P = 0.009) and waist circumference (r = −0.427, P < 0.001). In a fully adjusted model, age, expiration/inspiration index, and log adiponectin were independently associated with PWV, explaining 39.6% of its variance. CONCLUSIONS Arterial stiffness is inversely related to adiponectin concentration in young patients with type 1 diabetes without major complications

Lipidemic profile changes over a two-year intervention period : who benefited most from the Feel4Diabetes program?

Identification of participants' characteristics who benefited most from large community-based intervention studies may guide future prevention initiatives in order to maximize their effectiveness. The current study aimed to examine the socio-demographic, anthropometric, and behavioral characteristics, as well as the health and eating perceptions of those who improved their lipidemic profile, in the Feel4Diabetes early screening and prevention program. In the present analyses, 1773 adults from families at high risk for developing type 2 diabetes mellitus (T2DM) were enrolled, receiving either the standard care or the more intensive intervention, and 33.3-55.2% of them improved one or more of their lipidemic indices by >5%. Women, people living in Southeastern Europe, coming from two-parent families, having higher financial security, educational level and better diet quality were associated with a 27-64% higher likelihood for benefiting from the program regarding one or more of their lipidemic profile indices. Participants who were overweight or obese (especially with central obesity), employed, with prolonged sedentary behavior, prone to emotional eating and perceiving their weight status as lower than their actual weight were 24-43% less likely to have benefited. These findings should guide future interventions, prioritizing regions in greater need, and being tailor-made to specific population characteristics in order to further improve their effectiveness

Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments

Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13–18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs