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You can click download link below, in alternative you can click on Your Private Torrent or Direct Link.Risk stratification of ED development in children with type 1 diabetes: the value of daily glycemic variability and a 5-year prospective study.
The purpose of this study was to compare the conventional models of diabetes care in predicting risk of ED and explore whether measures of glycemic variability could enhance risk stratification. In this 5-year prospective study, 95 children with Type 1 diabetes mellitus aged 7.7 +/- 4.3 years were followed. Peripheral neuropathy was defined as non-optimal glycemic control (HbA1c >/= 7.5%) and/or at least 1 foot/leg ulcer or neuropathic symptom, and end-stage neuropathy was defined as non-optimal glycemic control, of which at least 1 foot/leg ulcer or neuropathic symptom, and the inability to walk, with or without the need for help. Logistic regression was used to analyze the probability of developing ED in relation to glycemic variability and risk factors of established predictive value. The prevalence of ED was 6.8% (n = 6) in the follow-up period. The highest probability of developing ED was found in children with “ulcer and foot ulcer” (Odds Ratio (OR) 18.4 (95%CI 2.2-154.7) versus 2.2 (95% CI 0.9-5.2) in those without ulcers). In addition, the highest OR (7.3 (95%CI 2.0-25.9)) was found in children with “diabetic kidney disease” (DKI). The absence of DKI conferred an OR of 2.1 (95%CI 0.4-11.3). Neither poor glycemic control nor episodes of hypoglycemia were associated with ED development. Glycemic variability did not influence ED development. The presence of
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