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Article ; Online: Hyperglycaemia following a simultaneous pancreas and kidney transplant.

Hua, Jessica Lee Siew / Byrne, Conor / Karalliedde, Janaka / Chowdhury, Tahseen A

Diabetic medicine : a journal of the British Diabetic Association

2023 Volume 41, Issue 3, Page(s) e15208

MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Hyperglycemia/etiology ; Pancreas ; Pancreas Transplantation/adverse effects ; Abdomen ; Graft Survival
Language	English
Publishing date	2023-09-12
Publishing country	England
Document type	Journal Article
ZDB-ID	605769-x
ISSN	1464-5491 ; 0742-3071 ; 1466-5468
ISSN (online)	1464-5491
ISSN	0742-3071 ; 1466-5468
DOI	10.1111/dme.15208
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Zs.A 1954: Show issues

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Article: Presentation of new onset type 1 diabetes with diabetic ketoacidosis and hyperosmolar hyperglycaemia after a single dose of nivolumab and ipilimumab.

Stathi, Dimitra / Hussain, Sufyan / Crawley, Danielle / Karalliedde, Janaka

Endocrinology, diabetes & metabolism case reports

2023 Volume 2023, Issue 3

Abstract: Summary: A Caucasian man in his 60s with recent diagnosis of metastatic renal cell carcinoma presented to the emergency department with a 5-day history of severe polyuria, polydipsia and fatigue and 1-day history of confusion, abdominal pain, nausea and ...

Abstract	Summary: A Caucasian man in his 60s with recent diagnosis of metastatic renal cell carcinoma presented to the emergency department with a 5-day history of severe polyuria, polydipsia and fatigue and 1-day history of confusion, abdominal pain, nausea and vomiting. Investigations revealed an overlap of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS). He had received the first dose of immunotherapy with nivolumab and ipilimumab 3 weeks prior to this attendance. New-onset type 1 diabetes (T1DM) was confirmed based on the clinical features at presentation, seropositivity for glutamic acid decarboxylase antibodies and significant insulin deficiency. He is currently on a multiple daily injections of insulin and uses intermittent-scanned glucose monitoring. Given the irreversible impact on beta-cell function and clinical response with insulin resulting in improved diabetes control, immunotherapy was resumed for his metastatic cancer with good radiological response. Although rare, new-onset T1DM can present with DKA and HSS overlap after a single dose of nivolumab/ipilimumab in individuals without pre-existing history of diabetes. Learning points: Although rare, new onset of T1DM after immunotherapy can present with DKA and HSS overlap after a single dose of nivolumab/ipilimumab in individuals without pre-existing history of diabetes and normal glycaemic parameters. Due to the irreversible destruction of beta-cells, treatment with steroids is not indicated in contrast to other settings such as immunotherapy-induced hypophysitis. Presence of low c-peptide levels post-acute presentation is indicative of an irreversible impact on beta-cell function and supports resuming immunotherapy given the significant benefits on cancer prognosis. Clinicians must maintain a high index of suspicion in regards to diagnosis and management of new-onset type 1 diabetes and advice patients on reporting symptoms suggestive of diabetes and/or diabetes-related hyperglycaemic emergencies.
Language	English
Publishing date	2023-08-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2785530-2
ISSN	2052-0573
ISSN	2052-0573
DOI	10.1530/EDM-22-0389
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Article ; Online: Diabetes technology including automated insulin delivery systems to manage hyperglycemia in a failing pancreatic graft: Case series of people with type 1 diabetes and a pancreas kidney or pancreas-only transplant.

Stathi, Dimitra / Johnston, Thomas / Hyslop, Rebecca / Brackenridge, Anna / Karalliedde, Janaka

Journal of diabetes investigation

2023 Volume 14, Issue 7, Page(s) 917–920

Abstract: We share our experience of using continuous subcutaneous insulin infusion (CSII) therapy and diabetes technology in six people (5 men) with type 1 diabetes (mean duration 36 years), who developed hyperglycemia post-simultaneous kidney/pancreas (n = 5) or ...

Abstract	We share our experience of using continuous subcutaneous insulin infusion (CSII) therapy and diabetes technology in six people (5 men) with type 1 diabetes (mean duration 36 years), who developed hyperglycemia post-simultaneous kidney/pancreas (n = 5) or pancreas only (n = 1) transplant. All were on immunosuppression and multiple daily injections of insulin prior to CSII. Four people were started on automated insulin delivery, and two people on CSII and intermittently scanned continuous glucose monitoring. With diabetes technology, the median time in range glucose improved from 37% (24-49%) to 56.6% (48-62%), and similarly, glycated hemoglobin fell from 72.7 mmol/mol (72-79 mmol/mol) to 64 mmol/mol (42-67 mmol/mol; P < 0.05 for both) with no concomitant increase in hypoglycemia. Use of diabetes technology improved glycemic parameters in people with type 1 diabetes with failing pancreatic graft function. Early use of such technology should be considered to improve diabetes control in this complex cohort.
MeSH term(s)	Male ; Humans ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/surgery ; Hypoglycemic Agents/therapeutic use ; Blood Glucose Self-Monitoring ; Blood Glucose ; Insulin/therapeutic use ; Hyperglycemia/drug therapy ; Hyperglycemia/etiology ; Hyperglycemia/prevention & control ; Pancreas ; Kidney
Chemical Substances	Hypoglycemic Agents ; Blood Glucose ; Insulin
Language	English
Publishing date	2023-05-16
Publishing country	Japan
Document type	Case Reports
ZDB-ID	2625840-7
ISSN	2040-1124 ; 2040-1116
ISSN (online)	2040-1124
ISSN	2040-1116
DOI	10.1111/jdi.14019
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Zs.A 6920: Show issues

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Article ; Online: Can sodium-glucose cotransporter 2 inhibitors 'spin the thread of life'?

Maltese, Giuseppe / Koufakis, Theocharis / Kotsa, Kalliopi / Karalliedde, Janaka

Trends in endocrinology and metabolism: TEM

2022 Volume 34, Issue 1, Page(s) 1–4

Abstract: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were first used as antidiabetic agents that lower the blood glucose levels by promoting glycosuria. In recent years, randomised clinical trials have demonstrated that SGLT2i reduce cardiovascular-renal ... ...

Abstract	Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were first used as antidiabetic agents that lower the blood glucose levels by promoting glycosuria. In recent years, randomised clinical trials have demonstrated that SGLT2i reduce cardiovascular-renal events and all-cause mortality in people with and without diabetes. The cardio-renal benefits observed are independent of glucose lowering effect and multiple mechanisms have been proposed for these results. SGLT2i can exert anti-ageing effects on the vasculature and other body organs through several signalling pathways including the activation of the nuclear factor erythroid-2-related factor 2 and the induction of antioxidant enzymes. We speculate that the pro-longevity effects of the SGLT2i are mediated by soluble Klotho, an anti-ageing kidney-derived hormone and an emerging therapeutic target for cardio-renal diseases.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/metabolism ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Hypoglycemic Agents/therapeutic use ; Glucose ; Sodium/therapeutic use
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors ; Hypoglycemic Agents ; Glucose (IY9XDZ35W2) ; Sodium (9NEZ333N27)
Language	English
Publishing date	2022-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1042384-9
ISSN	1879-3061 ; 1043-2760
ISSN (online)	1879-3061
ISSN	1043-2760
DOI	10.1016/j.tem.2022.10.002
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Zs.A 2999: Show issues

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Article: Clinical Use of Insulin Glargine 300 U/mL in Adults with Type 2 Diabetes: Hypothetical Case Studies.

Harris, Stewart B / Parente, Erika B / Karalliedde, Janaka

Diabetes therapy : research, treatment and education of diabetes and related disorders

2022 Volume 13, Issue 5, Page(s) 913–930

Abstract: Type 2 diabetes (T2D) is a progressive disease, with many individuals eventually requiring basal insulin therapy to maintain glycaemic control. However, there exists considerable therapeutic inertia to the prompt initiation and optimal titration of basal ...

Abstract	Type 2 diabetes (T2D) is a progressive disease, with many individuals eventually requiring basal insulin therapy to maintain glycaemic control. However, there exists considerable therapeutic inertia to the prompt initiation and optimal titration of basal insulin therapy due to barriers that include fear of injections, hypoglycaemia, weight gain, and burdensome regimens. Hypoglycaemia is thought to be a major barrier to optimal glycaemic control and is associated with significant morbidity and mortality. Newer second-generation basal insulin analogues provide comparable glycaemic control with lower risk of hypoglycaemia compared with first-generation basal insulin analogues. The present review article discusses clinical evidence for one such second-generation basal insulin analogue, insulin glargine 300 U/mL (Gla-300), in the context of hypothetical case studies that are representative of individuals who may attend routine clinical practice. These case studies discuss individualised treatment needs for people with T2D who are insulin-naïve or pre-treated. Clinical characteristics such as older age, frequent nocturnal hypoglycaemia, and renal impairment, which are known risk factors for hypoglycaemia, are also considered.
Language	English
Publishing date	2022-03-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2566702-6
ISSN	1869-6961 ; 1869-6953
ISSN (online)	1869-6961
ISSN	1869-6953
DOI	10.1007/s13300-022-01247-7
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Article ; Online: Reduced Levels of the Antiaging Hormone Klotho are Associated With Increased Aortic Stiffness in Diabetic Kidney Disease.

Fountoulakis, Nikolaos / Psefteli, Paraskevi-Maria / Maltese, Giuseppe / Gnudi, Luigi / Siow, Richard C / Karalliedde, Janaka

Kidney international reports

2023 Volume 8, Issue 7, Page(s) 1380–1388

Abstract: Introduction: Aortic pulse wave velocity (Ao-PWV) predicts cardiovascular and kidney disease in type 2 diabetes (T2D). Klotho is a circulating antiaging hormone (sKlotho) with putative cardiorenal protective effects. The relationship between sKlotho and ...

Abstract	Introduction: Aortic pulse wave velocity (Ao-PWV) predicts cardiovascular and kidney disease in type 2 diabetes (T2D). Klotho is a circulating antiaging hormone (sKlotho) with putative cardiorenal protective effects. The relationship between sKlotho and Ao-PWV in diabetic kidney disease (DKD) is unknown. Methods: In a cross-sectional cohort study, the correlation of sKlotho measured by a validated immunoassay, and Ao-PWV measured by applanation tonometry, was investigated in 172 participants with T2D and early stage DKD (all had estimated glomerular filtration rate [eGFR] >45 ml/min) on stable renin angiotensin system (RAS) inhibition. In cultured human aortic smooth muscle cells (HASMCs) stimulated with angiotensin II (AngII), the effects of recombinant human sKlotho pretreatment were assessed on intracellular calcium ([Ca Results: Mean (range) age of the cohort was 61.3 years (40-82) and 65% were male. Mean (±SD) Ao-PWV was 11.4 (±2.3) m/s, eGFR 78.8 (±23.5) and median (interquartile range) sKlotho of 358.5 (194.2-706.3) pg/ml. In multivariable linear regression analyses, we observed a statistically significant inverse relationship between sKlotho and Ao-PWV, which was independent of clinical risk factors for cardiorenal disease. Pretreatment of cultured HASMC with sKlotho significantly attenuated AngII-stimulated [Ca Conclusions: In individuals with T2D and early DKD, lower levels of sKlotho are associated with increased Ao-PWV. Taken together with the direct effect of sKlotho on mediators of aortic wall stiffness
Language	English
Publishing date	2023-04-30
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2023.04.021
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Article ; Online: COVID-19 induced type 1 diabetes: A systematic review of case reports and series.

Stathi, Dimitra / Triantafyllidis, Konstantinos Katsikas / Zafeiri, Marina / Karalliedde, Janaka / Kechagias, Konstantinos S

The Journal of international medical research

2023 Volume 51, Issue 11, Page(s) 3000605231210403

Abstract: Aims: To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection.: Methods: PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June ... ...

Abstract	Aims: To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection. Methods: PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June 2022. Study design, geographic region or language were not restricted. Results: Twenty studies were identified and involved 37 patients (20 [54%] male, 17 [46%] female). Median age was 11.5 years (range 8 months-33 years) and 31 (84%) patients were aged ≤17 years. Most patients (33, 89%) presented with diabetic ketoacidosis (DKA). In total, 23 (62%) patients presented at the time of positive COVID-19 testing and 14 (38%) had symptoms consistent with COVID-19 infection or a previous positive test (1-56 days). Diabetes symptomatology was provided in 22 cases and (19, 86%) reported polyuria, polydipsia, polyphagia, fatigue, or weight loss or a combination of the aforementioned in the preceding weeks (3 days-12 weeks). Of the 28 patients that had data on acute and long-term treatment, all recovered well and most were managed with basal bolus insulin regimens. Quality assessment showed that most reports were either 'good' or 'moderate quality'. Conclusions: Although uncommon, new-onset T1D is a condition healthcare professionals may expect to see following a COVID-19 infection.
MeSH term(s)	Female ; Humans ; Infant ; Male ; COVID-19/complications ; COVID-19 Testing ; Diabetes Mellitus, Type 1/complications ; Diabetic Ketoacidosis/etiology ; Polyuria ; Case Reports as Topic
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	184023-x
ISSN	1473-2300 ; 0300-0605 ; 0142-2596
ISSN (online)	1473-2300
ISSN	0300-0605 ; 0142-2596
DOI	10.1177/03000605231210403
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Zs.A 925: Show issues

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Article ; Online: Microvascular disease in diabetes and severe COVID-19 outcomes.

Corcillo, Antonella / Whyte, Martin B / Vas, Prashanth / Karalliedde, Janaka

The lancet. Diabetes & endocrinology

2021 Volume 9, Issue 4, Page(s) 200–201

MeSH term(s)	COVID-19 ; Cohort Studies ; Diabetes Mellitus ; Humans ; Risk Factors ; SARS-CoV-2 ; Scotland
Language	English
Publishing date	2021-03-19
Publishing country	England
Document type	Letter ; Comment
ISSN	2213-8595
ISSN (online)	2213-8595
DOI	10.1016/S2213-8587(21)00053-X
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Article ; Online: What is the impact of microvascular complications of diabetes on severe COVID-19?

Basra, Ruman / Whyte, Martin / Karalliedde, Janaka / Vas, Prashanth

Microvascular research

2021 Volume 140, Page(s) 104310

Abstract: Evidence suggests severe coronavirus disease-19 (COVID-19) infection is characterised by pulmonary and systemic microvasculature dysfunction, specifically, acute endothelial injury, hypercoagulation and increased capillary permeability. Diabetes, which ... ...

Abstract	Evidence suggests severe coronavirus disease-19 (COVID-19) infection is characterised by pulmonary and systemic microvasculature dysfunction, specifically, acute endothelial injury, hypercoagulation and increased capillary permeability. Diabetes, which is also characterised by vascular injury in itself, confers an increased risk of adverse COVID-19 outcomes. It has been suggested that pre-existing endothelial dysfunction and microvascular disease in diabetes will exacerbate the vascular insults associated with COVID-19 and thus lead to increased severity of COVID-19 infection. In this article, we evaluate the current evidence exploring the impact of microvascular complications, in the form of diabetic retinopathy and nephropathy, in individuals with COVID-19 and diabetes. Future insights gained from exploring the microvascular injury patterns and clinical outcomes may come to influence care delivery algorithms for either of these conditions.
MeSH term(s)	Albuminuria/etiology ; COVID-19/complications ; COVID-19/physiopathology ; Capillary Permeability ; Delivery of Health Care ; Diabetic Angiopathies/complications ; Diabetic Angiopathies/physiopathology ; Diabetic Nephropathies/complications ; Diabetic Nephropathies/physiopathology ; Diabetic Neuropathies/complications ; Diabetic Neuropathies/physiopathology ; Diabetic Retinopathy/complications ; Diabetic Retinopathy/physiopathology ; Endothelium, Vascular/injuries ; Endothelium, Vascular/pathology ; Humans ; Microcirculation ; Obesity/complications ; Obesity/physiopathology ; Pandemics ; Pulmonary Circulation ; Pulmonary Edema/etiology ; Pulmonary Edema/physiopathology ; SARS-CoV-2 ; Severity of Illness Index ; Thrombophilia/etiology ; Thrombophilia/physiopathology ; Treatment Outcome
Language	English
Publishing date	2021-12-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80307-8
ISSN	1095-9319 ; 0026-2862
ISSN (online)	1095-9319
ISSN	0026-2862
DOI	10.1016/j.mvr.2021.104310
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Zs.A 746: Show issues

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Article ; Online: COVID-19 induced type 1 diabetes

Dimitra Stathi / Konstantinos Katsikas Triantafyllidis / Marina Zafeiri / Janaka Karalliedde / Konstantinos S. Kechagias

Journal of International Medical Research, Vol

A systematic review of case reports and series

2023 Volume 51

Abstract: Aims To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection. Methods PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June 2022. ... ...

Abstract	Aims To provide an overview of reported cases of new-onset type 1 diabetes mellitus (T1D) following COVID-19 infection. Methods PubMed and Scopus library databases were screened for relevant case reports published between January 2020 and June 2022. Study design, geographic region or language were not restricted. Results Twenty studies were identified and involved 37 patients (20 [54%] male, 17 [46%] female). Median age was 11.5 years (range 8 months–33 years) and 31 (84%) patients were aged ≤17 years. Most patients (33, 89%) presented with diabetic ketoacidosis (DKA). In total, 23 (62%) patients presented at the time of positive COVID-19 testing and 14 (38%) had symptoms consistent with COVID-19 infection or a previous positive test (1–56 days). Diabetes symptomatology was provided in 22 cases and (19, 86%) reported polyuria, polydipsia, polyphagia, fatigue, or weight loss or a combination of the aforementioned in the preceding weeks (3 days–12 weeks). Of the 28 patients that had data on acute and long-term treatment, all recovered well and most were managed with basal bolus insulin regimens. Quality assessment showed that most reports were either ‘good’ or ‘moderate quality’. Conclusions Although uncommon, new-onset T1D is a condition healthcare professionals may expect to see following a COVID-19 infection.
Keywords	Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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