type 1 diabetes continue glucose monitoring autoimmune polyendocrine syndromes
Elucidating the contribution of NAFLD (non-alcoholic fatty liver disease) and insulin resistance in the development of cardiovascular complications in people with type 1 diabetes.
AbstractCardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes (T1D). The risk of CVD is 7 times higher compared to the general population, especially in overweight and insulin resistant (IR) subjects. Nowadays, half of the T1D patients show overweight,. IR may contribute to the development of non-alcoholic fatty liver disease (NAFLD), which is characterized by liver steatosis. Importantly, CVD is the main cause of death in NAFLD. The diagnosis of NAFLD is highly dependent on liver biopsy, which is not suitable for routine screening. Non-invasive techniques are used for the diagnosis of NAFLD, but have not been validated in T1D. The exact prevalence of NAFLD and the contribution of IR have not yet been investigated in T1D. Assessing IR is difficult due to the invasive nature of the gold standard (clamp test). Since IR might play an important role in CVD and NAFLD, there is a compelling need for non-invasive diagnostics. In this multidisciplinary project, we will assess the accuracy of non-invasive tests for NAFLD, develop a screening algorithm, validate an innovative breath test to assess IR, assess the exact prevalence of NAFLD and IR in T1D, investigate the link between IR and NAFLD, and finally, assess the independent contribution of IR and NAFLD to CVD. If NAFLD contributes to CVD, its early detection and treatment may affect prognosis.
The impact of a patient-tailored multi-biomarker device to improve glucose control for people with type 1 diabetes.
AbstractIn type 1 diabetes mellitus (T1DM), insulin-producing beta-cells of the pancreas are being destroyed, resulting in excessive glucose levels and permanent need of insulin therapy. Living with T1DM is challenging. It requires intensive monitoring of glycaemia and titration of insulin in order to obtain near-normal glycaemia to reduce the risk of complications. More and more people with T1DM are being treated with insulin pumps and continuous glucose monitoring (CGM) sensors. CGM improves metabolic control and quality of life and decreases hypoglycaemia. However, currently available CGM devices also have shortcomings. They do not warn about impending ketoacidosis and do not provide information on lactate levels which can be produced during intensive exercise. Adding lactate and ketones to the equation will provide additional information on glucose fluctuations. There is an urgent need for a patient-tailored multi-biomarker device to protect against hypoglycaemia or ketoacidosis, to improve quality of life and to increase the possibilities to exercise freely. The latter is important as people with T1DM often do not perform exercise because of fear of hypoglycaemia. The main research question of this project is to evaluate the added value of measuring other biomarkers (ketones, lactate) besides glucose, in people with T1DM in daily life, but also while performing different types of exercise (anaerobic, aerobic). This will result in better algorithms to improve glycaemic control.
Relation between residual beta cell function and glycemic variability in (pre)type 1 diabetes.
AbstractThe established clinical network and the developed dynamic function tests and biological markers provide us with the unique opportunity to identify sufficiently large groups of high-risk first-degree relatives (> 50% risk of diabetes) of a proband with type 1 diabetes and of recent-onset type 1 diabetic patients with the overall aim to investigate the correlation between functional beta cell mass and glycemic variability in relation to metabolic outcome in order to determine thresholds of residual function below which: - glucose tolerance starts to decline sharply in relatives - the risk of deteriorating metabolic control and (severe) hypoglycemic events strongly increases in patients
- Promotor: De Block Christophe