Mameli C, Mazzantini S, Ben Nasr M, Fiorina P, Scaramuzza AE, Zuccotti GV. Explaining the increased mortality in type 1 diabetes. World J Diabetes 2015; 6(7): 889-895 [PMID: 26185597 DOI: 10.4239/wjd.v6.i7.889]
Corresponding Author of This Article
Andrea E Scaramuzza, MD, Department of Pediatrics, Azienda Ospedaliera Luigi Sacco, University of Milan, Via G.B. Grassi 74, 20154 Milan, Italy. scaramuzza.andrea@hsacco.it
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jul 10, 2015; 6(7): 889-895 Published online Jul 10, 2015. doi: 10.4239/wjd.v6.i7.889
Explaining the increased mortality in type 1 diabetes
Chiara Mameli, Sara Mazzantini, Moufida Ben Nasr, Paolo Fiorina, Andrea E Scaramuzza, Gian Vincenzo Zuccotti
Chiara Mameli, Sara Mazzantini, Gian Vincenzo Zuccotti, Department of Pediatrics, “Ospedale dei Bambini V. Buzzi”, University of Milan, 20154 Milan, Italy
Moufida Ben Nasr, Paolo Fiorina, Division of Nephrology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, United States
Moufida Ben Nasr, Paolo Fiorina, Transplant Medicine, Ospedale San Raffaele, 20132 Milano, Italy
Andrea E Scaramuzza, Department of Pediatrics, Azienda Ospedaliera Luigi Sacco, University of Milan, 20154 Milan, Italy
Author contributions: Mameli C, Mazzantini S, Ben Nasr M, Fiorina P, Scaramuzza AE and Zuccotti GV conceived and designed this paper and drafted the report; all authors participated in critical review of the report; all authors had seen and approved the final version.
Supported by JDRF Career Development Award and an ADA Mentor-based Fellowship grant; The Harvard Stem Cell Institute grant (“Diabetes Program” DP-0123-12-00); Italian Ministry of Health grant RF-2010-2303119 and RF-2010-2314794 (all to Fiorina P).
Conflict-of-interest statement: We declare that all authors have any competing interest related to the present paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Andrea E Scaramuzza, MD, Department of Pediatrics, Azienda Ospedaliera Luigi Sacco, University of Milan, Via G.B. Grassi 74, 20154 Milan, Italy. scaramuzza.andrea@hsacco.it
Telephone: +39-2-39042791 Fax: +39-2-39042254
Received: February 13, 2015 Peer-review started: February 14, 2015 First decision: March 20, 2015 Revised: April 7, 2015 Accepted: April 16, 2015 Article in press: April 20, 2015 Published online: July 10, 2015 Processing time: 147 Days and 3.5 Hours
Abstract
Despite large improvements in the management of glucose levels and in the treatment of cardiovascular risk factors, the mortality rate in individuals with type 1 diabetes (T1D) is still high. Recently, Lind et al found that T1D individuals with glycated hemoglobin levels of 6.9% or lower had a risk of death from any cause or from cardiovascular causes that is twice as high as the risk for matched controls. T1D is a chronic disease with an early onset (e.g., pediatric age) and thus in order to establish a clear correlation between death rate and the glycometabolic control, the whole history of glycemic control should be considered; particularly in the early years of diabetes. The switch from a normo- to hyperglycemic milieu in an individual with T1D in the pediatric age, represents a stressful event that may impact outcomes and death rate many years later. In this paper we will discuss the aforementioned issues, and offer our view on these findings, paying a particular attention to the several alterations occurring in the earliest phases of T1D and to the many factors that may be associated with the chronic history of T1D. This may help us to better understand the recently published death rate data and to develop future innovative and effective preventive strategies.
Core tip: Despite large improvements in the management of glucose levels and in the treatment of cardiovascular risk factors, the mortality rate in individuals with type 1 diabetes (T1D) is still high. A better understanding of the several different alterations occurring in the earliest phases of T1D and of the many factors that may be associated with a chronic history of T1D may help us to develop future innovative and effective preventive strategies.
