C-peptide, the molecule produced in an equimolar concentration to insulin, has become an established insulin secretion biomarker in diabetic patients. Measurement of C-peptide level can be helpful in clinical practice for assessing insulin-producing b-cells residual function, especially in the...

Children with type 1 diabetes (T1DM) are the high-risk group of accelerated atherosclerosis. Real-time continuous glucose monitoring (RT-CGM) provides possibilities for the detection of glycaemic variability, newly recognized cardiovascular risk factor. The aim of the study was to assess the usefulness of RT-CGM as an educational tool to find and reduce glycaemic variability in order to improve endothelial function in T1DM adolescents. Forty patients aged 14.6 years were recruited. The study was based on one-month CGM sensors use. Parameters of glycaemic variability were analyzed during first and last sensor use, together with brachial artery flow-mediated dilatation (FMD) to assess endothelial function. In the whole group, FMD improvement was found (10.9% to 16.6%,p<0.005), together with decrease in all studied glycaemic variability parameters. In patients with HbA₁c improvement compared to the group without HbA₁c improvement, we found greater increase of FMD (12% to 19%,p<0.005versus 8.2% to 11.3%,p=0.080) and greater improvement of glucose variability. RT-CGM can be considered as an additional tool that offers T1DM adolescents the quick reaction to decrease glycaemic variability in short time observation. Whether such approach might influence improvement in endothelial function and reduction of the risk of future cardiovascular disease remains to be elucidated.

In the modern era, organ transplantation has become an important means of treating certain diseases. Although it is widespread and medically accepted, certain controversies still exist. The aim of this study was to evaluate attitudes toward organ transplantation among medical students. The anonymous survey was conducted among 273 medical students (from the departments of medicine, dentistry, nursing, and physiotherapy). The questionnaire was self-designed and contained 15 dichotomous questions. Among students, 99.6% accepted transplantation as a therapeutic method. Live-donor transplantation was accepted by 98.9% of students and transplantation from unrelated donors by 92.6% and 87.6% (depending on the existence of an emotional bond between the donor and the recipient). Interestingly, 12.8% of students approved of the selling of organs as a means of expanding the donor pool, and there were significant differences between divisions. On average, 90.1% of students declared knowledge of the definition of brain death with statistically significant differences between groups. Unfortunately, only 81.3% of students accepted the definition of brain death. Moreover, 98.5% of students would accept an organ if needed but only 93.8% declared willingness to donate organs after death. Interestingly, 26.4% of subjects stated that family should decide whether organs can be retrieved. Only 69.2% of respondents had talked to loved ones about their attitudes concerning organ transplantation. Although organ transplantation as a therapeutic method is widely accepted, there are still certain areas where considerable controversies exist. A structured, well-planned educational program should be implemented to improve awareness and attitude, especially among medical students.

Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17. The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. The population living in these areas accounts for 35% of the Polish population. DKA was defined as a capillary pH < 7.3, blood glucose > 11 mmol/L. The analyzed data included age, sex, diabetes recognition, pH, glycated hemoglobin (HbA1c), fasting C-peptide, and body mass index standard deviation score (BMI-SDS). We observed DKA in 28.6% of children. There were 2 peaks in DKA occurrence: in children <5 years of age (33.9%) and aged 10-12 (34%). The highest incidence of DKA was noted in children aged 0-2 (48.4%). In the group with DKA, moderate and severe DKA occurred in 46.7% of children. Girls and children <2 years of age were more prone to severe DKA. The multiple logistic regression analysis showed the following factors associated with DKA: age (P = .002), fasting C-peptide (P = .0001), HbA1c (P = .0001), no family history of T1D (P = .0001), and BMI-SDS (P = .0001). The incidence of DKA is high and remained unchanged over the last 5 years. Increasing the awareness of symptoms of DKA is recommended among children <5 years of age (especially <2 years of age) and aged 10–12. Children <2 years of age and girls were at the highest risk of severe DKA.

Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of age compared with subjects 5–17 years old with a week correlation of trend comparison between both groups, r=0.69, p=0.001. Similar seasonal variation in the incidence of T1D was noted in children from urban and rural setting. For girls, seasonal pattern peaks were observed one month earlier as compared to boys. Conclusions Seasonal variation in incidence of T1D diagnosis of Polish children supports the role of different environmental factors in diabetes onset. The majority of children were diagnosed with diabetes in autumn and winter.