Kietsiriroje, N, Pearson, S, Campbell, M orcid.org/0000-0001-5883-5041 et al. (2 more authors) (2019) Double diabetes: A distinct high‐risk group? Diabetes, Obesity and Metabolism, 21 (12). pp. 2609-2618. ISSN 1462-8902
Abstract
The term double diabetes (DD) has been used to refer to individuals with type 1 diabetes (T1D) who are overweight, have a family history of type 2 diabetes and/or clinical features of insulin resistance. Several pieces of evidence indicate that individuals who display features of DD are at higher risk of developing future diabetes complications, independently of average glucose control, measured as glycated haemoglobin (HbA1c) concentration. Given the increased prevalence of individuals with features of DD, pragmatic criteria are urgently required to identify and stratify this group, which will help with subsequent implementation of more effective personalized interventions. In this review, we discuss the potential criteria for the clinical identification of individuals with DD, highlighting the strengths and weaknesses of each definition. We also cover potential mechanisms of DD and how these contribute to increased risk of diabetes complications. Special emphasis is placed on the role of estimated glucose disposal rate (eGDR) in the diagnosis of DD, which can be easily incorporated into clinical practice and is predictive of adverse clinical outcome. In addition to the identification of individuals with DD, eGDR has potential utility in monitoring response to different interventions. T1D is a more heterogeneous condition than initially envisaged, and those with features of DD represent a subgroup at higher risk of complications. Pragmatic criteria for the diagnosis of individuals with DD will help with risk stratification, allowing a more personalized and targeted management strategy to improve outcome and quality of life in this population.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Kietsiriroje, N, Pearson, S, Campbell, M, Ariëns, RAS, Ajjan, RA. Double diabetes: A distinct high‐risk group? Diabetes Obes Metab. 2019; 21: 2609– 2618. https://doi.org/10.1111/dom.13848, which has been published in final form at https://doi.org/rg/10.1111/dom.13848. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | double diabetes; estimated glucose disposal rate; metabolic syndrome; obesity; type 1 diabetes |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Environment (Leeds) > School of Food Science and Nutrition (Leeds) > FSN Nutrition and Public Health (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 11 Sep 2019 12:18 |
Last Modified: | 02 Aug 2020 00:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/dom.13848 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:150705 |