Promoting health in families of children with type 1 diabetes mellitus

This paper presents a study of families of children with type 1 diabetes mellitus, emphasizing the identification of social supports and networks to strengthen interventions aimed at health promotion. The approach selected was a qualitative research, using a case study design. Four families of children with diabetes type 1 were studied, totalling seven participants. Data were collected between April and June 2007, through in-depth interviews and the construction of a genogram and an ecomap. The results presented the families` characterization and testimonies grouped in the following categories: social support, social networks and family roles. To promote care in practice, there is a need to identify the characteristics of each family and resources available that provide better living conditions. We concluded that identifying supports and social networks allows for more personalized care delivery to each family with a view to health promotion.

Periodontal disease in gestational and type 1 diabetes mellitus pregnant women

Objective: The present study evaluated the relationship between periodontal disease and its clinical variables in Brazilian non-diabetic pregnant women (C), gestational diabetes mellitus (GDM), or type 1 diabetes mellitus (T1DM). Subjects and methods: A periodontal exam was performed in one hundred and sixty-one pregnant women (GDM:80; T1DM:31; C:50) by a single-blinded calibrated examiner who recorded plaque index (PI), gingival index (GI), bleeding index (BI), gingival margin location (GM), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and tooth mobility index (MI). The medical variables were age, pregestational body mass index (pre-BMI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA(1c)). Results: The GI, GM, PD, CAL, BOP, and MI were significantly higher (P < 0.01) among GDM and T1DM than for C. The PI was higher in GDM and similar between C and T1DM. The Adjusted Final Model for medical variables to evaluate the effects of groups on periodontal parameters confirmed these results. Conclusions: The presence of periodontal disease was significantly higher in Brazilian diabetic pregnancies (GDM and T1DM) when compared to non-diabetic pregnant women (C). The degree of periodontal disease was similar between the GDM and T1DM groups. Age, pregestational BMI, and HbA(1c) were factors related to CAL development in these two types of diabetes mellitus.

Incidence of type 1 diabetes mellitus in Passo Fundo, RS, Brazil

To establish the incidence of type 1 diabetes among children (infants to 14 years of age) in the city of Passo Fundo, Rio Grande do Sul, Brazil (population under 15 years = 50,098), during the period of January to December 1996, a retrospective and prospective population-based registry was established, using physician reports of newly diagnosed patients under 15 years of age with type 1 diabetes as the primary source of case identification. Primary and nursery schools and a general call through the media (newspapers, radio and television) was the secondary source. Data were calculated according to the methods recommended by the WHO (1990). Six new cases were identified. Case ascertainment was estimated at 100%. The incidence of type 1 diabetes in the year 1996 was 12/100,000 inhabitants. These data indicate that the incidence of childhood type 1 diabetes in a subtropical region in the Southern part of Brazil was similar to that observed in developed countries throughout the world. The inability to demonstrate the North-South gradient is probably due to the European origin of inhabitants of the city.

Prevalence and antifungal resistance profile of Candida spp. oral isolates from patients with type 1 and 2 diabetes mellitus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Residual ß-cell function and microvascular complications in type 1 diabetic patients

To determine the influence of residual ß-cell function on retinopathy and microalbuminuria we measured basal C-peptide in 50 type 1 diabetic outpatients aged 24.96 ± 7.14 years, with a duration of diabetes of 9.1 ± 6.2 years. Forty-three patients (86%) with low C-peptide (<0.74 ng/ml) had longer duration of diabetes than 7 patients (14%) with high C-peptide (³0.74 ng/ml) (9 (2-34) vs 3 (1-10) years, P = 0.01) and a tendency to high glycated hemoglobin (HBA1) (8.8 (6-17.9) vs 7.7 (6.9-8.7)%, P = 0.08). Nine patients (18%) had microalbuminuria (two out of three overnight urine samples with an albumin excretion rate (AER) ³20 and <200 µg/min) and 13 (26%) had background retinopathy. No association was found between low C-peptide, microalbuminuria and retinopathy and no difference in basal C-peptide was observed between microalbuminuric and normoalbuminuric patients (0.4 ± 0.5 vs 0.19 ± 0.22 ng/ml, P = 0.61) and between patients with or without retinopathy (0.4 ± 0.6 vs 0.2 ± 0.3 ng/ml, P = 0.43). Multiple regression analysis showed that duration of diabetes (r = 0.30, r2 = 0.09, P = 0.031) followed by HBA1 (r = 0.41, r2 = 0.17, P = 0.01) influenced basal C-peptide, and this duration of diabetes was the only variable affecting AER (r = 0.40, r2 = 0.16, P = 0.004). In our sample of type 1 diabetic patients residual ß-cell function was not associated with microalbuminuria or retinopathy.

Description de l’évolution du profil socio-cognitif et clinique d’une cohorte d’adolescents diabétiques de type 1 ayant suivi un programme d’éducation thérapeutique

Thèse réalisée en cotutelle entre Aix-Marseille Université et l'Université de Montréal

Att leva med diabetes typ 1- En litteraturöversikt om barn och ungdomar samt deras föräldrars upplevelser

Bakgrund: Diabetes typ 1 ökar bland barn och ungdomar, Sverige har den näst högsta insjuknandefrekvensen i hela världen. Diabetes typ 1 är en kronisk autoimmun sjukdom vilket innebär att kroppens immunförsvar angriper de egna insulinproducerande cellerna i pankreas. Patienter med diabetes typ 1 löper stor risk att drabbas av komplikationer och följdsjukdomar. Syfte: Syftet med denna studie är att beskriva barn och ungdomar samt deras föräldrars upplevelser av att leva med diabetes typ 1. Metod: En litteraturstudie genomfördes med totalt 15 artiklar utifrån studiens syfte, sökningarna har skett i databaserna Cinahl och PubMed. Artiklarna poängsattes med hjälp av Högskolan Dalarnas modifierade version av granskningsmallar för kvantitativa och kvalitativa artiklar. Resultat: Analysen av artiklarna resulterade i fyra kategorier som beskriver barn och ungdomars upplevelser: begränsningar i vardagen, stöd från föräldrar och sjukvården var centralt, rädsla för komplikationer samt att vara annorlunda. Två kategorier beskriver föräldrarnas upplevelser: oro rädsla och frustration samt att våga släppa kontrollen. Slutsats: Barn och ungdomar med diabetes typ 1 upplevde sitt liv som begränsat. Sjukdomen påverkar dem i skolan, under fysisk aktivitet, tillsammans med vänner, och i sociala sammanhang. Föräldrar till barn och ungdomar med diabetes typ 1 upplevde rädsla och oro över sitt barns sjukdom.

Upplevelser av stöd från diabetessjuksköterskan hos personer med diabetes typ 1 : – Sekundäranalys av en kvalitativ intervjustudie

Introduction: Type 1 diabetes is a chronic disease that affects the individual in everyday life. The diabetes team sets the treatment goals together with the patient aiming for a good quality of life and to prevent complications. The diabetes nurse should include in-depth knowledge of the daily life of people with diabetes, and have respect for the individual's choices and life situation. Aim: To describe how people with type 1 diabetes experience the support from the diabetes nurse. Method: A qualitative content analysis with an inductive approach has been used. A secondary analysis including semi-structured interviews with 15 adults (> 18 years) with type 1 diabetes was conducted. Result: The result was summarized with an overall theme "At the clinic - experience of the support offered" describes how people experience the support from their diabetes nurse. The theme constituted three categories "Access to the diabetes nurse", "The diabetes nurse - a source of information and knowledge that might need to be complemented with the support from other professionals" and,"Mutual trust - the patient's experience of the district nurse as a discussion partner and support". Conclusion: The results showed that the accessibility to diabetes nurses was experienced as good. It was simple and easy to make contact. The diabetes nurses were experienced to be engaged and provide good support to the patients. A good dialogue with the diabetes nurse and commitment from the diabetes nurse were mentioned as important factors that made the visits to be experienced as good and important. There were requests for greater access and expanded opportunities for help from counselors, as well as an increased focus on how the person is feeling.

Anhörigperspektivet utifrån föräldrars erfarenheter då barnet har diabetes typ 1 : En litteraturöversikt

Bakgrund: Den största delen av behandlingen vid diabetes typ 1 är egenvård. När ett barn insjuknar i diabetes är det föräldrarna som huvudsakligen ansvarar för egenvården. Detta kan vara både psykiskt och fysiskt påfrestande. Det behövs mer kunskap om föräldrars upplevelser och deras erfarenheter av att vårda ett barn med diabetes. Syfte: Syftet med denna litteraturstudie är att belysa anhörigperspektivet utifrån föräldrars erfarenheter då barnet har diabetes typ 1 samt hur sjuksköterskan kan ge stöd till anhöriga. Metod: En litteraturöversikt. Resultat: Resultatet visar att egenvården skiljer sig mellan små barn och ungdomar, att föräldrar upplever känslor av oro och stress när deras barn fått diagnosen och att sjuksköterskan kan hjälpa och öka sin förståelse genom att stödja. Slutsats: Författarna kan dra slutsatsen att ökad kunskap och förståelse om egenvård vid diabetes typ 1 hos barn, kan bidra till en hjälp för sjuksköterskor att ge föräldrarna ett bra stöd och bemötande i vården.

Differential coronary resistance microvessel remodeling between type 1 and type 2 diabetic mice: Impact of exercise training

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Adesão ao tratamento por pacientes portadores de diabetes tipo 1 e tipo 2: efeitos do treino de discriminação de dicas internas e externas

O presente trabalho pretende comparar resultados de treinos de discriminação de sintomas e de ações relativas ao tratamento do diabetes Tipo 1 e Tipo 2, avaliando a eficácia desses treinos para a estimativa do índice glicêmico e para a promoção de adesão ao tratamento. Inúmeras pesquisas realizadas na área de psicologia da saúde têm o objetivo de proporcionar a melhora no tratamento ao paciente diabético. Parte dessas pesquisas utiliza um procedimento denominado de- automonitoração, a qual consiste em habilidades de observação, aferição e registro de aspectos relevantes no tratamento do diabetes. como: (a) índice glicêmico (IG) (b) sintomas (dicas internas -DI); e (c) ações envolvidas no tratamento nas áreas da medicação, alimentação e atividade física (dicas externas -DE). Estudos têm demonstrado que com a automonitoração o paciente diabético melhora o nível de discriminação das alterações glicêmicas. Essa.literatura não é clara em definir qual o melhor tipo de dica para melhorar a discriminação dos estados glicêmicos e afirm que o desenvolvimento desta habilidade não favorece a melhora na adesão ao tratamento. Esse estudo compreendeu três fases: (a) Entrevista inicial e de linha de Base; (b ) Entrevistas de Treino e (c) Entrevista Final e Devolutiva. A fase de treino está dividida em duas etapas Dicas Internas (DI) e Dicas Externas (DE). Nas etapas de treino os participantes estimaram e atribuíram causa para taxa de glicose sangüínea medida por um reflectômetro em cada entrevista. Na etapa DE. os participantes também recebiam feedback do pesquisador acerca do relato de seguimento das orientações, com base nas orientações recebidas em consulta e compiladas do prontuário do paciente. Foi calculado o índice de adesão (IA) nas duas primeiras fases. As entrevistas da fase de treino foram realizadas na residência do participante, em intervalos de três dias, nos quais o participante registrava a ocorrência de eventos correspondentes a etapa que estava realizando. Os resultados demonstram que independente do tipo de treino realizado os participantes estimaram os seus estados glicêmicos com base em dicas externas. Os sintomas' relatados na etapa DI nem sempre estavam associados ao Ia medido. Os participantes portadores de diabetes. Tipo 1 alcançaram maior precisão nas estimativas no treino de DE. A maioria dos participantes alcançaram melhor adesão quando iniciaram o treino por DE. Os resultados sugerem que: (a) relatos de sintomas não são os melhores indicadores para avaliar o estado glicêmico e a adesão ao tratamento (b) o melhor tipo de treino para promoção da adesão ao tratamento é o que envolve as dicas externas.

Extracción de conocimientos de la diabetes tipo 1 utilizando la metodología de "Data Mining"

La diabetes mellitus es un trastorno en la metabolización de los carbohidratos, caracterizado por la nula o insuficiente segregación de insulina (hormona producida por el páncreas), como resultado del mal funcionamiento de la parte endocrina del páncreas, o de una creciente resistencia del organismo a esta hormona. Esto implica, que tras el proceso digestivo, los alimentos que ingerimos se transforman en otros compuestos químicos más pequeños mediante los tejidos exocrinos. La ausencia o poca efectividad de esta hormona polipéptida, no permite metabolizar los carbohidratos ingeridos provocando dos consecuencias: Aumento de la concentración de glucosa en sangre, ya que las células no pueden metabolizarla; consumo de ácidos grasos mediante el hígado, liberando cuerpos cetónicos para aportar la energía a las células. Esta situación expone al enfermo crónico, a una concentración de glucosa en sangre muy elevada, denominado hiperglucemia, la cual puede producir a medio o largo múltiples problemas médicos: oftalmológicos, renales, cardiovasculares, cerebrovasculares, neurológicos… La diabetes representa un gran problema de salud pública y es la enfermedad más común en los países desarrollados por varios factores como la obesidad, la vida sedentaria, que facilitan la aparición de esta enfermedad. Mediante el presente proyecto trabajaremos con los datos de experimentación clínica de pacientes con diabetes de tipo 1, enfermedad autoinmune en la que son destruidas las células beta del páncreas (productoras de insulina) resultando necesaria la administración de insulina exógena. Dicho esto, el paciente con diabetes tipo 1 deberá seguir un tratamiento con insulina administrada por la vía subcutánea, adaptado a sus necesidades metabólicas y a sus hábitos de vida. Para abordar esta situación de regulación del control metabólico del enfermo, mediante una terapia de insulina, no serviremos del proyecto “Páncreas Endocrino Artificial” (PEA), el cual consta de una bomba de infusión de insulina, un sensor continuo de glucosa, y un algoritmo de control en lazo cerrado. El objetivo principal del PEA es aportar al paciente precisión, eficacia y seguridad en cuanto a la normalización del control glucémico y reducción del riesgo de hipoglucemias. El PEA se instala mediante vía subcutánea, por lo que, el retardo introducido por la acción de la insulina, el retardo de la medida de glucosa, así como los errores introducidos por los sensores continuos de glucosa cuando, se descalibran dificultando el empleo de un algoritmo de control. Llegados a este punto debemos modelar la glucosa del paciente mediante sistemas predictivos. Un modelo, es todo aquel elemento que nos permita predecir el comportamiento de un sistema mediante la introducción de variables de entrada. De este modo lo que conseguimos, es una predicción de los estados futuros en los que se puede encontrar la glucosa del paciente, sirviéndonos de variables de entrada de insulina, ingesta y glucosa ya conocidas, por ser las sucedidas con anterioridad en el tiempo. Cuando empleamos el predictor de glucosa, utilizando parámetros obtenidos en tiempo real, el controlador es capaz de indicar el nivel futuro de la glucosa para la toma de decisones del controlador CL. Los predictores que se están empleando actualmente en el PEA no están funcionando correctamente por la cantidad de información y variables que debe de manejar. Data Mining, también referenciado como Descubrimiento del Conocimiento en Bases de Datos (Knowledge Discovery in Databases o KDD), ha sido definida como el proceso de extracción no trivial de información implícita, previamente desconocida y potencialmente útil. Todo ello, sirviéndonos las siguientes fases del proceso de extracción del conocimiento: selección de datos, pre-procesado, transformación, minería de datos, interpretación de los resultados, evaluación y obtención del conocimiento. Con todo este proceso buscamos generar un único modelo insulina glucosa que se ajuste de forma individual a cada paciente y sea capaz, al mismo tiempo, de predecir los estados futuros glucosa con cálculos en tiempo real, a través de unos parámetros introducidos. Este trabajo busca extraer la información contenida en una base de datos de pacientes diabéticos tipo 1 obtenidos a partir de la experimentación clínica. Para ello emplearemos técnicas de Data Mining. Para la consecución del objetivo implícito a este proyecto hemos procedido a implementar una interfaz gráfica que nos guía a través del proceso del KDD (con información gráfica y estadística) de cada punto del proceso. En lo que respecta a la parte de la minería de datos, nos hemos servido de la denominada herramienta de WEKA, en la que a través de Java controlamos todas sus funciones, para implementarlas por medio del programa creado. Otorgando finalmente, una mayor potencialidad al proyecto con la posibilidad de implementar el servicio de los dispositivos Android por la potencial capacidad de portar el código. Mediante estos dispositivos y lo expuesto en el proyecto se podrían implementar o incluso crear nuevas aplicaciones novedosas y muy útiles para este campo. Como conclusión del proyecto, y tras un exhaustivo análisis de los resultados obtenidos, podemos apreciar como logramos obtener el modelo insulina-glucosa de cada paciente. ABSTRACT. The diabetes mellitus is a metabolic disorder, characterized by the low or none insulin production (a hormone produced by the pancreas), as a result of the malfunctioning of the endocrine pancreas part or by an increasing resistance of the organism to this hormone. This implies that, after the digestive process, the food we consume is transformed into smaller chemical compounds, through the exocrine tissues. The absence or limited effectiveness of this polypeptide hormone, does not allow to metabolize the ingested carbohydrates provoking two consequences: Increase of the glucose concentration in blood, as the cells are unable to metabolize it; fatty acid intake through the liver, releasing ketone bodies to provide energy to the cells. This situation exposes the chronic patient to high blood glucose levels, named hyperglycemia, which may cause in the medium or long term multiple medical problems: ophthalmological, renal, cardiovascular, cerebrum-vascular, neurological … The diabetes represents a great public health problem and is the most common disease in the developed countries, by several factors such as the obesity or sedentary life, which facilitate the appearance of this disease. Through this project we will work with clinical experimentation data of patients with diabetes of type 1, autoimmune disease in which beta cells of the pancreas (producers of insulin) are destroyed resulting necessary the exogenous insulin administration. That said, the patient with diabetes type 1 will have to follow a treatment with insulin, administered by the subcutaneous route, adapted to his metabolic needs and to his life habits. To deal with this situation of metabolic control regulation of the patient, through an insulin therapy, we shall be using the “Endocrine Artificial Pancreas " (PEA), which consists of a bomb of insulin infusion, a constant glucose sensor, and a control algorithm in closed bow. The principal aim of the PEA is providing the patient precision, efficiency and safety regarding the normalization of the glycemic control and hypoglycemia risk reduction". The PEA establishes through subcutaneous route, consequently, the delay introduced by the insulin action, the delay of the glucose measure, as well as the mistakes introduced by the constant glucose sensors when, decalibrate, impede the employment of an algorithm of control. At this stage we must shape the patient glucose levels through predictive systems. A model is all that element or set of elements which will allow us to predict the behavior of a system by introducing input variables. Thus what we obtain, is a prediction of the future stages in which it is possible to find the patient glucose level, being served of input insulin, ingestion and glucose variables already known, for being the ones happened previously in the time. When we use the glucose predictor, using obtained real time parameters, the controller is capable of indicating the future level of the glucose for the decision capture CL controller. The predictors that are being used nowadays in the PEA are not working correctly for the amount of information and variables that it need to handle. Data Mining, also indexed as Knowledge Discovery in Databases or KDD, has been defined as the not trivial extraction process of implicit information, previously unknown and potentially useful. All this, using the following phases of the knowledge extraction process: selection of information, pre- processing, transformation, data mining, results interpretation, evaluation and knowledge acquisition. With all this process we seek to generate the unique insulin glucose model that adjusts individually and in a personalized way for each patient form and being capable, at the same time, of predicting the future conditions with real time calculations, across few input parameters. This project of end of grade seeks to extract the information contained in a database of type 1 diabetics patients, obtained from clinical experimentation. For it, we will use technologies of Data Mining. For the attainment of the aim implicit to this project we have proceeded to implement a graphical interface that will guide us across the process of the KDD (with graphical and statistical information) of every point of the process. Regarding the data mining part, we have been served by a tool called WEKA's tool called, in which across Java, we control all of its functions to implement them by means of the created program. Finally granting a higher potential to the project with the possibility of implementing the service for Android devices, porting the code. Through these devices and what has been exposed in the project they might help or even create new and very useful applications for this field. As a conclusion of the project, and after an exhaustive analysis of the obtained results, we can show how we achieve to obtain the insulin–glucose model for each patient.

Antioxidant And Anti-diabetic Potential Of Passiflora Alata Curtis Aqueous Leaves Extract In Type 1 Diabetes Mellitus (nod-mice).

Leaves of Passiflora alata Curtis were characterized for their antioxidant capacity. Antioxidant analyses of DPPH, FRAP, ABTS, ORAC and phenolic compounds were made in three different extracts: aqueous, methanol/acetone and ethanol. Aqueous extract was found to be the best solvent for recovery of phenolic compounds and antioxidant activity, when compared with methanol/acetone and ethanol. To study the anti-inflammatory properties of this extract in experimental type 1 diabetes, NOD mice were divided into two groups: the P. alata group, treated with aqueous extract of P. alata Curtis, and a non-treated control group, followed by diabetes expression analysis. The consumption of aqueous extract and water ad libitum lasted 28 weeks. The treated-group presented a decrease in diabetes incidence, a low quantity of infiltrative cells in pancreatic islets and increased glutathione in the kidney and liver (p<0.05), when compared with the diabetic and non-diabetic control-groups. In conclusion, our results suggest that the consumption of aqueous extract of P. alata may be considered a good source of natural antioxidants and compounds found in its composition can act as anti-inflammatory agents, helping in the control of diabetes.

Exercise Increases Pancreatic β-cell Viability In A Model Of Type 1 Diabetes Through Il-6 Signaling.

Type 1 diabetes (T1D) is provoked by an autoimmune assault against pancreatic β cells. Exercise training enhances β-cell mass in T1D. Here, we investigated how exercise signals β cells in T1D condition. For this, we used several approaches. Wild-type and IL-6 knockout (KO) C57BL/6 mice were exercised. Afterward, islets from control and trained mice were exposed to inflammatory cytokines (IL-1β plus IFN-γ). Islets from control mice and β-cell lines (INS-1E and MIN6) were incubated with serum from control or trained mice or medium obtained from 5-aminoimidazole-4 carboxamide1-β-d-ribofuranoside (AICAR)-treated C2C12 skeletal muscle cells. Subsequently, islets and β cells were exposed to IL-1β plus IFN-γ. Proteins were assessed by immunoblotting, apoptosis was determined by DNA-binding dye propidium iodide fluorescence, and NO(•) was estimated by nitrite. Exercise reduced 25, 75, and 50% of the IL-1β plus IFN-γ-induced iNOS, nitrite, and cleaved caspase-3 content, respectively, in pancreatic islets. Serum from trained mice and medium from AICAR-treated C2C12 cells reduced β-cell death, induced by IL-1β plus IFN-γ treatment, in 15 and 38%, respectively. This effect was lost in samples treated with IL-6 inhibitor or with serum from exercised IL-6 KO mice. In conclusion, muscle contraction signals β-cell survival in T1D through IL-6.-Paula, F. M. M., Leite, N. C., Vanzela, E. C., Kurauti, M. A., Freitas-Dias, R., Carneiro, E. M., Boschero, A. C., and Zoppi, C. C. Exercise increases pancreatic β-cell viability in a model of type 1 diabetes through IL-6 signaling.

Association Of Single Nucleotide Polymorphisms In The Gene Encoding Glut1 And Diabetic Nephropathy In Brazilian Patients With Type 1 Diabetes Mellitus.

Mesangial cells subject to high extracellular glucose concentrations, as occur in hyperglycaemic states, are unable to down regulate glucose influx, resulting in intracellular activation of deleterious biochemical pathways. A high expression of GLUT1 participates in the development of diabetic glomerulopathy. Variants in the gene encoding GLUT1 (SLC2A1) have been associated to this diabetic complication. The aim of this study was to test whether polymorphisms in SLC2A1 confer susceptibility to diabetic nephropathy (DN) in Brazilian type 1 diabetes patients. Four polymorphisms (rs3820589, rs1385129, rs841847 and rs841848) were genotyped in a Brazilian cohort comprised of 452 patients. A prospective analysis was performed in 155 patients. Mean duration of follow-up was 5.6±2.4years and the incidence of renal events was 18.0%. The rs3820589 presented an inverse association with the prevalence of incipient DN (OR: 0.36, 95% CI: 0.16 - 0.80, p=0.01) and with progression to renal events (HR: 0.20; 95% CI: 0.03 - 0.70; p=0.009). AGGT and AGAC haplotypes were associated with the prevalence of incipient DN and the AGAC haplotype was also associated with the prevalence of established/advanced DN. In conclusion, rs3820589 in the SLC2A1 gene modulates the risk to DN in Brazilian patients with inadequate type 1 diabetes control.