Oana Albai

Background and Objective: It is known that several viruses are involved in the pathogenesis of type 1 diabetes. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new worldwide spread virus that may act as a trigger for the autoimmune destruction of the β-cells, as well, and thus lead to an increase in the incidence of type 1 diabetes. Material and Methods: The Romanian National Organization for the Protection of Children and Adolescents with Diabetes (ONROCAD) has collected information regarding new cases of type 1 diabetes in children aged 0 to 14 years from all over the country since 1996 and has computed the incidence of type 1 diabetes in this age group. Results: We observed a marked increase in the incidence of type 1 diabetes in the first year of the COVID-19 pandemic, with 16.9%, from 11.4/100,000 in 2019 to 13.3/100,000 in 2020, much higher compared to previous years (mean yearly increase was 5.1% in the period 1996–2015 and 0.8% in the interval 2015–2019). The proportion of newly diagnosed cases was significantly higher in the second half of 2020 compared to the second half of the previous years (57.8 vs. 51%, p < 0.0001). Conclusions: All these aspects suggest the role that SARS-CoV-2 could have in triggering pancreatic autoimmunity. To confirm this, however, collecting information from larger populations from different geographical regions, monitoring the incidence curves over a period of several years, and gathering background information on COVID-19 and/or data on COVID-19 specific antibodies are needed.

Hypertriglyceridemia, an important and independent risk factor for acute pancreatitis in patients with type 2 diabetes mellitus Oana Albai,1 Deiana Roman,2 Mirela Frandes2 1Second Department of Internal Medicine, 2Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Purpose: Acute pancreatitis (AP) is a frequent inflammatory disease of the pancreas with multiple causes, among which high triglyceride (TG) level is the most common. The main purpose of this study has been to research the prevalence of AP in patients with diabetes mellitus (DM) and to underline the importance of hypertriglyceridemia (HTG) as a risk factor in triggering AP. The possible link between AP and glycemic control has been studied also, alongside some cardiovascular risk factors and long-term diabetes complications.Patients and methods: The patient cohort comprised 1,586 patients with DM, admitted to the Internal Medicine Clinic of Diabetes, Nutrition and Metabolic Disease within the Emergency Hospital in Timisoara between January and August 2016. Following a series of clinical and biological investigations, these patients were diagnosed with AP. The patients’ antidiabetic treatment and chronic diabetes-related complications have also been recorded.Results: The prevalence of pancreatitis in this group of patients was 3.7%. The presence of pancreatitis was associated with a higher HbA1c (8.5% vs 7.7%; P<0.001), fasting glycemia (167.5 vs 95 mg/dL; P<0.001), postprandial glycemia (244.5 vs 118 mg/dL; P<0.001), total cholesterol (256.5 vs 189.5 mg/dL; P<0.001), low-density lipoprotein cholesterol (LDLc) (208.7 vs 112.8 mg/dL; P<0.001), and TGs (495 vs 161 mg/dL; P<0.001). HDL cholesterol (HDLc) was found to be a significant protective factor against the risk of pancreatitis. On the contrary, high LDLc values were a significant risk factor for pancreatitis along with high non-HDLc and high TG values, respectively.Conclusion: The development of AP events in patients with DM is associated with unsatisfactory glycemic control, HTG, hypertension, and the presence and severity of DM chronic complications. In this study, the prevalence of AP events in patients with DM was 3.7%. Keywords: diabetes mellitus, hypertriglyceridemia, acute pancreatitis, insulin resistance

Background and aims Diabetes mellitus (DM) is one of the leading causes of end-stage chronic kidney disease (CKD). Patients with DM and CKD have a 10 or even 20 times higher cardiovascular risk (CVR) than the general population. Lipid metabolism disorders are more frequent in these patients, dyslipidemia being aggravated by the presence of hyperglycemia and insulin resistance. The main purpose of our study was to identify possible correlations between lipid profile parameters and altered renal function in patients with DM. We have also analyzed the correlations between lipid parameters, CKD, quality of glycemic control and CVR. Material and method: The study was performed on 2732 patients with DM which received medical treatment and care at the Center for Diabetes Timisoara, for a 6-month period from March to October 2016, 1508 women (55.2%) and 1224 men (44.8%), mean age 63.7 ± 9.1 (33-78) years and mean diabetes duration 12.4 ± 6.8 (6-33) years. The study group included 312 patients (11.4%) with T1DM and 2420 patients (88.6%) with T2DM. Results: The prevalence of CKD (GFR 60 ml/min). Conclusion: Analyzed data showed a strong correlation between CKD, dyslipidemia and CVR in patients with DM. Impaired renal function was strongly correlated with age, duration of DM and weight status of these patients.

Objective: Despite the diversity of antidiabetic medication currently available, lessthan half of the patients with type 2 diabetes meet the therapeutic targetsrecommended by the guidelines: HbA1c investigate the efficacy and safety of sitagliptin in patients with type 2 diabetesmellitus, with inadequate glycemic control, as well as the effects on cardiovascularrisk factors. Material and method: The study included 348 patients, 161 men(46.3%) and 187 women (53.7%), with mean age of 56.1 ± 6.2 years, who startedtreatment with sitagliptin, combined with either metformin, sulphonylurea or both.Results and discussions: Sitagliptin improved glycemic control reducing averageHbA1c with 1.1%; the average weight decreased with 1.7 kg after 24 weeks oftreatment, and the lipid profile improved significantly. Conclusions: Sitagliptinoffers a new therapeutic option in patients with type 2 diabetes mellitus, with theadvantage of a single dose oral administration.