Tyypin 1 diabetes ja muut autoimmuunisairaudet

Vertaisarvioitu.Joka viidennellä tyypin 1 diabetesta sairastavalla on vähintään toinen muu autoimmuunisairaus, ja sairastuvuus autoimmuunitauteihin on moninkertainen muuhun väestöön verrattuna. Lapsuusiän jälkeen tyypin 1 diabetekseen sairastuneiden, naispuolisten ja iäkkäiden kilpirauhasen vajaatoiminnan riski on suurin, kun taas keliakia puhkeaa diabetekseen sairastuneille useammin alle kymmenvuotiaana. Syitä autoimmuunisairauksien kasautumisesta samoille yksilöille ei tunneta riittävästi. Kyseessä on monisyinen tapahtumaketju, johon liittyvät perimä, puolustusjärjestelmän toiminta ja ulkoiset tekijät. Uudet solubiologian tutkimusmenetelmät yhdessä kliinisten ja epidemiologisten tutkimusten kanssa lisäävät tietoa, jota tarvitaan autoimmuunisairauksien ennustamiseen, taudinkuvan lievittymiseen tai parhaimmillaan sairastumisen ehkäisemiseen. Sitä odotellessa on tarpeen seuloa autoimmuunisairauksia Diabeteksen Käypä hoito -suosituksen mukaisesti ja kliinisten oireiden perusteella.Peer reviewe

The Self-reported Use of Probiotics is Associated with Better Glycaemic Control and Lower Odds of Metabolic Syndrome and its Components in Type 1 Diabetes

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Association between adherence to dietary recommendations and high-sensitivity C-reactive protein level in type 1 diabetes

Aims: Inflammation plays an important role in the pathogenesis of cardiovascular diseases. Diet, as a modifiable risk factor, may in turn impact systemic inflammation. We therefore assessed whether adherence to the dietary recommendations is associated with high-sensitivity C-reactive protein (hs-CRP) concentrations in type 1 diabetes. Methods: Cross-sectional data from 677 FinnDiane study participants (48% men, mean +/- standard deviation age 46 +/- 13 years) were included. Dietary intake was assessed with a self-administered questionnaire. A diet score, with higher values denoting better adherence to the recommendations, was calculated. Serum hs-CRP concentration was measured, and individuals with hs-CRP 3.0 but <10.0 mg/l were compared. Results: Men and women with high hs-CRP had higher BMI, waist circumference, and triglyceride concentration, but lower HDL-cholesterol concentration. Adjusted for BMI, mean diet score was higher in the low hs-CRP group, both in men (10.8 +/- 3.6 vs. 9.9 +/- 3.8, p = 0.023) and women (12.7 +/- 3.4 vs. 11.6 +/- 3.5, p = 0.021). After further adjustments with potential confounding factors, the difference remained significant only in men. Conclusions: A diet that more closely adheres to the dietary recommendations is associated with lower hs-CRP in men. A prudent diet may help reduce systemic inflammation in type 1 diabetes. (C) 2017 Elsevier B.V. All rights reserved.Peer reviewe

The association between macronutrient intake and the metabolic syndrome and its components in type 1 diabetes

Diet is a major modifiable lifestyle factor that may affect the components of the metabolic syndrome. We aimed to investigate the association between relative proportions of macronutrients and the components of the metabolic syndrome in a population of individuals with type 1 diabetes. In all, 791 individuals without nephropathy, with plausible energy intake and known metabolic syndrome status, taking part in the Finnish Diabetic Nephropathy Study were included in the analyses. Dietary data were collected with a diet record. The association between the relative macronutrient intake and the outcome variables were analysed using multivariable nutrient density substitution models. The relative proportions of dietary macronutrients or fatty acids were not associated with the presence of the metabolic syndrome. In men, however, favouring carbohydrates over fats was associated with lower odds of the waist component, whereas favouring either carbohydrates or fats over proteins was associated with lower odds of the blood pressure component of the metabolic syndrome. In women, substituting carbohydrates for fats was associated with lower HDL-cholesterol concentration. Substituting carbohydrates or fats for alcohol or protein was, in men, associated with lower systolic blood pressure. To conclude, the relative distribution of macronutrients may have some relevance for the metabolic syndrome.Peer reviewe

Fear of hypoglycaemia and self-management in type 1 diabetes

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Dietary patterns are associated with various vascular health markers and complications in type 1 diabetes

Aims: Diet plays an important role in the management of type 1 diabetes. However, the association between dietary intake and health has not been extensively studied in this population. We studied the cross-sectional association between dietary factors, and selected vascular health markers and complications in type 1 diabetes. Methods: Data from 874 individuals with type 1 diabetes participating in the FinnDiane Study were included. Dietary intake was assessed using a self-reported questionnaire and a diet score, expressing the extent to which individuals adhered to the dietary recommendations, was calculated. Diet questionnaire was also used to reveal dietary patterns using factor analysis. Results: Seven factors with high degree of inter-correlation were formed; healthy, traditional, vegetable, sweets, modern, low-fat cheese, and fish and eggs. In multivariate models, higher diet score and healthy factor score were associated with better glycaemic control. Higher diet score was associated with higher, while sweets, and fish and eggs patterns were associated with lower systolic blood pressure. Healthy, sweets, and fish and eggs factors were additionally associated with lower diastolic blood pressure. Conclusions: Closer adherence to the dietary recommendations, and a diet high in fresh vegetables, fruits and berries, cooked vegetables, fish dishes, and yoghurt may be beneficial for the glycaemic control in type 1 diabetes. Moreover, a diet pattern with fish and eggs may have beneficial effects for blood pressure. (C) 2016 Published by Elsevier Inc.Peer reviewe

Risk of Thyroid Cancer in People With Type 1 Diabetes by Autoimmune Thyroid Diseases and Tumor Histology

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