Background:Type 1 diabetes (T1D) incidence is rising globally, particularly in low- and middle-income countries (LMICs) that face major gaps in access and treatment and high levels of preventable mortality. We developed READY-T1D (Research and Service Delivery Readiness in Type 1 Diabetes) to assess service provision and research preparedness in clinics providing T1D services to children and adolescents as part of the Global Collaborative for Changing Diabetes in Children (GC-CDiC). Methods:From November 15th, 2024, to November 14th, 2025, we conducted a cross-sectional online survey of clinics caring for individuals living with T1D aged ≤20 years across 21 countries participating in GC-CDiC. The tool enabled assessment and scoring in two domains, Service Provision and Research Preparedness, each made up of five components (score on 0-4 scale, where 4 = highest readiness). Descriptive statistics were generated for clinic characteristics, item-level metrics, component scores, and domain scores, and compared across countries. Findings:We analysed 244 clinics (69% CDiC centres, 14% satellites, 17% non-CDiC) across 21 countries. Mean scores were 2.5 (SD 0.6) for Service Provision and 1.8 (SD 0.8) for Research Preparedness, with substantial variation within countries. While resource management and accessibility scored highly, testing facilities and staffing were weaker. Basic care (HbA1c, complication screening) was common, but advanced diagnostics and continuous glucose monitoring were rare. In research, clinics reported high scheduled visit frequency, but often lacked secure data systems, funding, and ethical governance. Interpretation:Clinics providing care for children and adolescents with T1D in GC-CDiC participating countries possess core care elements and report frequent scheduled patient contact but lack comprehensive readiness for service delivery and research. Capacity varies widely both within and between countries. Priorities for investment for capacity development to improve care in studied clinics include multidisciplinary staffing, digital infrastructure, and research governance to support the Global T1D Cohort Study. Funding:The study was supported by an unrestricted grant from Novo Nordisk, which had no role in study design, protocol development, data collection, analysis, interpretation, or writing of the report.

Diabetes mellitus is a highly prevalent human endocrine disorder. Skin lesions are reported in approximately one-third of all diabetes mellitus patients. The clinical presentation and frequency vary according to the subtype of diabetes mellitus, metabolic control, and clinical course, with certain skin diseases occurring before diagnosing hyperglycemia. In this regard, the correct definition of cutaneous manifestations associated with diabetes mellitus can help define the etiology of hyperglycemia as well as the need to optimize glycemic control. In this narrative review, the most common cutaneous diseases observed in diabetes mellitus are discussed, including pruritus, acanthosis nigricans, necrobiosis lipoidica, bullosis diabeticorum, scleroderma diabeticorum, granuloma annulare, diabetic dermopathy, skin reactions due to device use, diabetic foot ulcers, recurrent cutaneous infections in diabetes mellitus and other dermatoses associated with hyperglycemia. The epidemiology, pathophysiology, differential diagnosis, and treatment of this disease are discussed. Therefore, knowledge and recognition of the most common dermatological lesions in patients with diabetes mellitus are essential for both endocrinologists and primary care physicians.

The purpose of this paper is to describe the development of a low-cost insulin infusion pump software simulator. The simulator was built using Java programming language and replicates the interface and functions of a real low-cost insulin infusion pump currently under development. Potential users participated in a remote session, and assessment was conducted using a standard usability scale (SUS). With a sample size of 34 participants possessing different levels of knowledge regarding diabetes and infusion pumps, the mean SUS score obtained was 67.43. While the insulin infusion pump is a specialised device and its system may not be immediately familiar to all users, the results suggest that usability can improve with appropriate training and clinical support. Employing a simulation model during the development of the physical prototype may provide advantages for system design, safety, and effectiveness in health care technology delivery.

ABSTRACT Objective: The aim of the study was to evaluate the association between triglycerides/high-density lipoprotein-cholesterol (TG/HDL) ratio and cardiometabolic risk factors in children of mothers who had gestational diabetes (GDM). Methods: This retrospective cohort study involved 227 offspring aged 2–14 years, born to mothers with GDM. Data was collected during routine antenatal care, and the offspring were evaluated 2–14 years later. TG/HDL ratio was stratified into tertiles. Cardiometabolic risk factors were defined according to the World Health Organization (WHO) criteria for children: obesity, overweight, elevated waist circumference, elevated blood pressure and hypertension, dysglycemia, low HDL-cholesterol, and elevated TG. The association of TG/HDL ratio and cardiometabolic risk factors was evaluated through comparative and linear regression analysis. Results: There were higher mean levels of some markers of cardiometabolic risk factors according to TG/HDL ratio tertiles. We observed higher frequencies of elevated HbA1c from 2 to 4 years (0 vs. 3.7 vs. 12.9%, p-linear-by-linear <0.001); higher prevalence of overweight/obesity from 5 to 9 years (39.1 vs. 47.2 vs. 75.0%, p-linear-by-linear<0.001), and higher frequencies of elevated low density lipoprotein-cholesterol from 10 to 14 years (33.3 vs. 66.6 vs. 77.7%, p-linear-by-linear=0.044) according to TG/HDL ratio tertiles. TG/HDL ratio was associated with homeostasis model assessment-insulin resistance from 5 to 9 years (β0.11 [95% confidence interval (95%CI) 0.00–0.23]) and from 10 to 14 years (β0.10 [95%CI 0.02–0.18]), after adjustments for sex and body mass index. Conclusions: Our results show that higher levels of TG/HDL ratio are associated with worse cardiometabolic profile and insulin resistance in offspring from mothers who had gestational diabetes mellitus and can be a good marker to identify those at higher cardiometabolic risk.

BACKGROUND:Diabetic macular edema (DME) affects millions worldwide. Intraocular injections of expensive anti-vascular endothelial growth factor (VEGF) inhibitors associated with complications are standard therapy. Lamivudine, an inexpensive oral drug, inhibits inflammasome activation, which is implicated in DME. This randomized, double-blind, placebo-controlled trial compared oral lamivudine to placebo for improving visual acuity in center-involved DME (CI-DME). METHODS:Twenty-four adults enrolled between February 2022 and September 2023 with 1 or 2 eyes with CI-DME and a best-corrected visual acuity (BCVA) of less than 69 letters (Brazilian Registry of Clinical Trials RBR-87b6r5s) were randomized to lamivudine (150 mg twice daily; 10 participants; 16 eyes) or placebo (14 participants; 21 eyes) for 8 weeks. Participants were assigned intravitreous bevacizumab (1.25 mg) at week 4. Co-primary outcomes were mean changes in BCVA from baseline to weeks 4 and 8. Comparisons to anti-VEGF drugs used synthetic controls from DRCR.net Protocol T. Secondary outcomes included retinal thickness and adverse events. FINDINGS:At 4 weeks, BCVA improved 9.8 letters with lamivudine and decreased 1.8 letters with placebo (p < 0.001). At 8 weeks, BCVA improved 16.9 letters with lamivudine and bevacizumab and 5.3 letters with placebo and bevacizumab (p < 0.001). Lamivudine was associated with greater BCVA improvement than bevacizumab or ranibizumab (p < 0.05) and was not different from aflibercept (p = 0.5). There was no significant difference in retinal thickness or adverse events between groups. CONCLUSIONS:Lamivudine, an oral inflammasome inhibitor, significantly improved vision in patients with CI-DME. FUNDING:This work was supported by Universidade Federal de São Paulo, Latinofarma, UVA SIF, and NIH.

AIM:This study compared the performances of the Steno Type 1 Risk Engine (ST1RE) and the Scottish-Swedish risk model in a predominantly young and ethnically diverse type 1 diabetes (T1D) cohort. METHODS:This retrospective study included 435 adults with T1D and no prior cardiovascular disease (CVD). The comparative performance of the models in predicting 10-year CV events was assessed using Kaplan-Meier analysis, ROC curves, the Hosmer-Lemeshow test, and Cohen's kappa coefficient. RESULTS:Participants had a median age of 25 years (IQR: 21-32) and a T1D duration of 13 years (IQR: 9-18). The Scottish-Swedish model classified 75.2 % as low, 13.1 % as moderate, and 11.7 % as high risk. In contrast, the ST1RE classified 84.1 % as low, 10.8 % as moderate, and 5.1 % as high risk. Agreement between the models was moderate (κ = 0.550; 95 % CI: 0.468-0.632). Over a follow-up period of 9.2 years, 24 participants (5.5 %) experienced CV events. The C-statistic for the Scottish-Swedish model was comparable to that of the ST1RE (p = 0.986). Both models demonstrated good calibration. CONCLUSIONS:In this ethnically mixed and predominantly young T1D cohort, both the ST1RE and the Scottish-Swedish models demonstrated good discriminative ability and calibration for 10-year CV risk prediction.

Abstract Aims This study aimed to investigate whether the response to adding metformin to insulin in young adults with type 1 diabetes (T1D) differs according to weight phenotype and insulin sensitivity index. Methods A prospective pilot study was conducted over 26 weeks in which insulin plus metformin (2 g/day) was administered to 35 individuals, ranging from normal weight (NW) to overweight (OW) to obese (OB) T1D individuals, to correlate insulin sensitivity indices and other clinical variables. Results At the end of the follow-up period, all groups showed an increase in the eGDR (NW: 7.37 vs 8.16, p = 0.002; OW: 7.28 vs 8.24, p < 0.001; OB: 6.33 vs 7.52 p < 0.001). KITT and SEARCH SCORE improved only in the OB group (2.15 vs 3.14, p < 0.001 and 5.26 vs 5.72, p = 0.007, respectively). Furthermore, HbA1c and BMI were significantly greater in the OB group (− 0.62%, p < 0.001; − 1.12 kg/m2, p = 0.031, respectively). Regression analysis revealed that the serum levels of triglycerides and uric acid were significantly (0.059, p = 0.013; 0.076, p = 0.001) associated with insulin sensitivity indices. Conclusions The study showed that eGDR improved independently of basal weight after metformin treatment. However, the KITT and SEARCH indices improved only in the obese group. Triglycerides and uric acid are associated with insulin sensitivity indices. These results highlight the heterogeneity of the mechanisms underlying insulin resistance and its response to metformin in individuals with T1D.

Objective:To evaluate the association between neck circumference (NC) measured during pregnancy and markers of glucose metabolism measured 2-6 months postpartum in women with overweight/obesity with and without gestational diabetes (GDM). Subjects and methods:This prospective study enrolled 100 pregnant women (including 50 with GDM) with pregestational body mass index (BMI) >= 25 kg and < 40 kg/m(2). The cohort was stratified according to NC tertiles during pregnancy. Glucose metabolism was assessed in the postpartum period. The association between NC during pregnancy and markers of glucose metabolism postpartum was tested using linear regression analysis. Results:Participants with NC in the third tertile, compared with those with NC in the second and first tertiles, had higher levels of glycated hemoglobin (HbA1c; 5.6 +/- 0.4% versus 5.4 +/- 0.3% versus 5.3 +/- 0.2%, respectively, p = 0.006), fasting insulin (13.2 +/- 6.6 IU/mL versus 11.1 +/- 5.8 mu IU/mL versus 9.5 +/- 4.9 mu IU/mL, respectively, p = 0.035), homeostasis model for insulin resistance (HOMA-IR; 3.1 +/- 1.7 versus 2.5 +/- 1.3 versus 2.1 +/- 1.2, respectively, p = 0.035) and triglyceride-glucose index (TyG; 4.6 +/- 0.2 versus 4.5 +/- 0.2 versus 4.5 +/- 0.3, respectively, p = 0.010). In crude linear regression analysis, NC measured during pregnancy was significantly associated with levels of fasting plasma glucose, 2-hour glucose, HbA1c, log HOMA-IR, and TyG index. The association remained after adjustment for age, family history of diabetes, and number of pregnancies. When adjusted for pregestational BMI and gestational weight gain, NC remained independently associated with fasting plasma glucose and HbA1c levels. Conclusion:The NC measured during pregnancy was positively associated with worse glucose metabolic profile in the postpartum among women with obesity/overweight with and without GDM. The NC measurement may be a feasible tool for early identification of women at a higher risk of developing type 2 diabetes mellitus.

Nitric oxide and renin angiotensin system are involved in the pathophysiology and progression of diabetes mellitus chronic complications. To evaluate angiotensin-converting enzyme activity on nitric oxide levels in patients with type 2 diabetes mellitus. Were recruited 20 patients and 20 health volunteers. Blood and urine samples were collected to measure: fasting blood glucose, glycated hemoglobin, plasmatic Na+, K+, urea, creatinine, total cholesterol, triglycerides, thiobarbituric acid reactive substances, nitric oxide levels, angiotensin-converting enzyme activity and microalbuminuria.The mean arterial pressure and body mass index were obtained from the medical records. The results were considered significant when p<0.05. Fasting blood glucose, glycated hemoglobin, body mass index, nitric oxide, urinary thiobarbituric acid reactive substances, angiotensin-converting enzyme activity and microalbuminuria were increased and total cholesterol was reduced in diabetic vs. controls; meanwhile MAP, Na+, triglycerides, urea and creatinine were similar between these two groups. Our study showed that although the angiotensin-converting enzyme was elevated, favored by the high oxidative stress level, demonstrating that there was protection on the cardio-renal axis. Our data suggest that maybe angiotensin-converting enzyme inhibitors acted on AT2, demonstrated by increased nitric oxide and stable blood pressure, revealing how dynamic the renin angiotensin system is and reacts to treatment.

Abstract Background Low adherence to the number of insulin injections and glycemic variability are among the challenges of insulin therapy in type 1 diabetes (T1D). The TOP1 study investigated the effect of switching from twice-daily (BID) basal insulin to once daily (OD) insulin glargine 300 U/mL (Gla-300) on glycemic control and quality of life. Methods In this 28-week, phase 4 trial, people with T1D aged ≥ 18 years, who were treated with BID basal insulin in combination with prandial rapid-acting insulin for at least 1 year, and had HbA1c between 7.5% and 10.0%, were switched to Gla-300 OD as basal insulin. The present study aimed to evaluate the impact of this change on HbA1c, glycemic profile, treatment satisfaction and safety. The change in HbA1c from baseline to Week 24 was the primary endpoint. Results One hundred and twenty-three people with T1D (mean age 37 ± 11 years; 54.5% female) were studied. The disease duration was 20.0 ± 9.8 years, baseline HbA1c and fasting plasma glucose (FPG) were 8.6 ± 0.7% and 201 ± 80.3 mg/dL, respectively. After switching from BID to OD insulin regimen, no significant change in HbA1c was observed from baseline to Week 24 (p = 0.873). There were significant reductions in fasting self-monitoring blood glucose (SMBG) from baseline to Week 24 (175 ± 42 vs. 156 ± 38 mg/dL; p < 0.0001), and in glycemic profile (8-point SMBG) at several time points. There was a significant decrease in the proportion of patients with at least one hypoglycemic event (p = 0.025), in numbers of hypoglycemic events per patient-years of any type (p = 0.036), symptomatic (p = 0.007), and confirmed ≤ 70 mg/dL events (p = 0.049) from run-in to the last 4 weeks on treatment. There were significant improvements in treatment satisfaction (p < 0.0001), perceived hyperglycemia (p < 0.0001) scores and satisfaction with the number of injections between post-run-in and Week 24, and a significant decrease in fear of hypoglycemia. Conclusions Switch from BID basal insulin to OD Gla-300 as part of basal bolus therapy in T1D resulted in similar glycemic control as measured by HbA1c, but provided significant improvements in SMBG, daily glucose profile, a lower incidence of hypoglycemia and increased patient satisfaction. Trial registration NCT03406000.

Introduction The present study aimed to evaluate the associations between the clinical and biochemical characteristics of women with gestational diabetes (GDM) and the incidence of large for gestational age (LGA) babies. Methods This cohort study included data collected during prenatal follow-up of GDM women from January 2008 to August 2022. Clinical and biochemical variables were compared among small (SGA), adequate (AGA), or large for gestational age (LGA) babies. Associations of the main variables with the incidence of LGA were determined by multiple regression analysis. Results Out of 659 women, 56 had LGA, 547 had AGA, and 56 had SGA babies. We observed differences in the means of age, pregestational body mass index (BMI), high-density lipoproteins-cholesterol (HDL-C) levels, gestational weight gain (GWG), and gestational age at birth according to LGA, AGA, and SGA (p < 0.05). All other variables were not different between the groups. The frequencies (%) and relative risk (RR) of LGA babies were evaluated according to HDL-C in the first tertile and/or obesity, with 12.2% and risk ratio (RR)=2.77 (95% confidence interval (CI) 1.35-5.69, p=0.005) if the women had obesity and HDL in the first tertile, 11.3% and RR=2.27 (95% CI 1.03-5.03, p=0.042) if only HDL in the first tertile was present, 10.9% and RR=2.68 (95% CI 1.31-5.48, p=0.007) if the women had only obesity, using as a reference group those women without obesity or HDL-C in the first tertile (4.6% and RR=1) adjusted for age, age at birth and GWG. Conclusion In women with GDM, lower levels of HDL-cholesterol during pregnancy, as well as pregestational obesity, seem to be good predictors of the occurrence of LGA babies.

Lipodystrophies are characterized by complete or selective loss of adipose tissue and can be acquired or inherited. Familial partial lipodystrophy (FPLD) is a hereditary lipodystrophy commonly caused by mutations in the LMNA gene. Herein, we report two cases of FPLD associated with podocytopathies. Patient 1 was diagnosed with FPLD associated with the heterozygous p.Arg482Trp variant in LMNA and had normal glucose tolerance and hyperinsulinemia. During follow-up, she developed nephroticrange proteinuria. Renal biopsy was consistent with minimal change disease. Patient 2 was diagnosed with FPLD associated with a de novo heterozygous p.Arg349Trp variant in LMNA. Microalbuminuria progressed to macroalbuminuria within 6 years and tonephrotic range proteinuria in the last year. He remained without diabetes and with hyperinsulinemia. Renal biopsy revealed focal segmental glomerulosclerosis not otherwise specified. This report provides further evidence of variable features of lipodystrophy associated with LMNA variants and the importance of long-term follow-up with evaluation of kidney dysfunction.

The Steno Type 1 Risk Engine (ST1RE) was developed to aid clinical decisions in primary prevention for individuals with type 1 diabetes (T1D), as existing cardiovascular (CV) risk models for the general population and type 2 diabetes tend to underestimate CV risk in T1D. However, the applicability of ST1RE in different populations remains uncertain, as prediction models developed for one population may not accurately estimate risk in another. This study aimed to evaluate the performance of the ST1RE in predicting CV events among ethnically mixed T1D individuals and its association with the progression of microangiopathy complications. A retrospective survey of 435 adults with T1D who were free of CV events at baseline was assessed by ST1RE and chronic diabetes complications at 5 and 10 years of follow-up. The estimated CV risk rates were compared with the observed rates at 5 and 10 years using statistical analyses, including Receiver Operating Characteristic (ROC) curve analysis, Hosmer-Lemeshow test, Kaplan-Meier curves analysis and Cox-regression models. Among 435 patients (aged 25 years; interquartile range [IQR]: 21–32) with a median T1D duration of 13 years (IQR: 9–18), only 5

PurposeTo evaluate the performance of artificial intelligence (AI) systems embedded in a mobile, handheld retinal camera, with a single retinal image protocol, in detecting both diabetic retinopathy (DR) and more-than-mild diabetic retinopathy (mtmDR).DesignMulticenter cross-sectional diagnostic study, conducted at three diabetes care and eye care facilities.ParticipantsA total of 327 individuals with diabetes mellitus (Type 1 or Type 2) underwent a retinal imaging protocol enabling expert reading and automated analysis.MethodsParticipants underwent fundus photographs using a portable retinal camera (Phelcom Eyer). The captured images were automatically analysed by deep learning algorithms RAS (retinal alteration score) and DRAS (diabetic retinopathy alteration score), consisting of convolutional neural networks trained on EyePACS datasets and fine-tuned using datasets of portable device fundus images. The ground truth was the classification of DR corresponding to adjudicated expert reading, performed by three certified ophthalmologists.Main Outcome MeasuresPrimary outcome measures included the sensitivity and specificity of the AI system in detecting DR and/or mtmDR using a single-field, macula-centered fundus photograph for each eye, compared to a rigorous clinical reference standard comprising reading center grading of 2-field imaging protocol using the ICDR severity scale.ResultsOf 327 analysed patients (age 57.0 + 16.8 years, diabetes duration 16.3 + 9.7 years), 307 completed the study protocol. Sensitivity and specificity of the AI system were high in detecting any DR with DRAS (sensitivity: 90.48%; 95% CI, 84.99% – 94.46% and specificity 90.65%; 95% CI, 84.54%-94.93%) and mtmDR with the combination of RAS and DRAS (sensitivity: 90.23%; 95% CI, 83.87%-94.69% and specificity: 85.06%; 95% CI, 78.88%-90.00%). The area under the ROC curve was 0.94 for any DR and 0.89 for mtmDR.ConclusionsThis study showed a high accuracy for the detection of DR in different levels of severity with a single retinal photo per eye in an all-in-one solution, composed of a portable retinal camera powered by AI. Such a strategy holds great potential for increasing coverage rates of screening programs, contributing to tackle avoidable blindness.

Objectives: To evaluate the accuracy of routinely available parameters in screening for GCK maturityonset diabetes of the young (MODY), leveraging data from two large cohorts - one of patients with GCK-MODY and the other of patients with type 1 diabetes (T1D). Materials and methods:The study included 2,687 patients with T1D, 202 patients with clinical features of MODY but without associated genetic variants (NoVar), and 100 patients with GCK-MODY (GCK). Area under the receiver-operating characteristic curve (ROC-AUC) analyses were used to assess the performance of each parameter - both alone and incorporated into regression models - in discriminating between groups. Results: The best parameter discriminating between GCK-MODY and T1D was a multivariable model comprising complications, previous diabetic ketoacidosis, and family history of diabetes. This model had a ROCAUC value of 0.980 (95% confidence interval [CI] 0.974-0.985) and positive (PPV) and negative (NPV) predictive values of 43.74% and 100%, respectively. The best model discriminating between GCK and NoVar included HbA1c, age at diagnosis, hypertension, and triglycerides and had a ROC-AUC value of 0.850 (95% CI 0.783-0.916), PPV of 88.36%, and NPV of 97.7%; however, this model was not significantly different from the others. A novel GCK variant was also described in one individual with MODY (7-44192948-T-C, p.Ser54Gly), which showed evidence of pathogenicity on in silico prediction tools. Conclusions: This study identified a highly accurate (98%) composite model for differentiating GCKMODY and T1D. This model may help clinicians select patients for genetic evaluation of monogenic diabetes, enabling them to implement correct treatment without overusing limited resources.

Background: Lactation is known to improve insulin resistance, but this phenomenon remains poorly understood. Our goal was to evaluate whether subclinical inflammation could mediate the association between breastfeeding (BF) and improvement in glucose metabolism and markers of insulin resistance (MIRs) in the postpartum. Methods: A total of 95 adult women (≥18 years) with a BMI ≥ 25 kg/m2 from the outpatient clinic of the Federal University of São Paulo were followed from early pregnancy until 60 to 180 days postpartum. The patients were divided based on their BF status: BF and non-BF groups. A latent variable termed SubInf was created incorporating inflammation-related biomarkers: adiponectin, E-selectin, branched-chain amino acids, zonulin, copeptin, and lipopolysaccharides. The association of BR with MIRs in the postpartum was evaluated through linear regression analysis, and mediation analysis was performed to evaluate the role of SubInf in this association. Results: The groups were similar regarding gestational diabetes mellitus (GDM) prevalence, pre-gestational BMI, caloric intake, physical activity, and postpartum weight loss. The BF group presented lower levels of triglycerides (TGs), fasting glucose, fasting insulin, TG/HDLcholesterol ratio (TG/HDL), TyG index, and HOMA-IR compared to the non-BF group. A linear regression analysis adjusted for scholarity, parity, pre-gestational BMI, GDM, weight gain during pregnancy, and mode of delivery revealed an inverse association between BF and fasting glucose [−6.30 (−10.71 to −1.89), p = 0.005), HOMA-IR [−0.28 (−0.50 to −0.05), p = 0.017], TyG index [−0.04 (−0.06 to −0.01), p = 0.002], and TG/HDL ratio [−0.23 (−0.46 to −0.01), p = 0.001]. In the mediation analysis, SubInf did not mediate the indirect effect of BF on MIRs. Conclusions: In overweight and obese women, an association between BF and improvement in MIRs in the postpartum was seen, corroborating that BF should be stimulated, especially in these cardiometabolic high-risk women. Subclinical inflammation did not seem to mediate this association.

Abstract Background Persistence of β cell-function in Type 1 diabetes (T1D) is associated with glycaemia stability and lower prevalence of microvascular complications. We aimed to assess the prevalence of residual C- peptide secretion in long-term Brazilian childhood onset T1D receiving usual diabetes care and its association to clinical, metabolic variables and microvascular complications. Methods A cross-sectional observational study with 138 T1D adults with ≥ 3 years from the diagnosis by routine diabetes care. Clinical, metabolic variables and microvascular complications were compared between positive ultra-sensitive fasting serum C-peptide (FCP +) and negative (FCP-) participants. Results T1D studied had ≥ 3 yrs. of diagnosis and 60% had FCP > 1.15 pmol/L. FCP + T1D were older at diagnosis (10 vs 8 y.o; p = 0.03) and had less duration of diabetes (11 vs 15 y.o; p = 0.002). There was no association between the FCP + and other clinical and metabolic variable but there was inversely association with microalbuminuria (28.6% vs 13.4%, p = 0.03), regardless of HbA1c. FCP > 47 pmol/L were associated with nephropathy protection but were not related to others microvascular complications. Conclusion Residual insulin secretion is present in 60% of T1D with ≥ 3 years of diagnosis in routine diabetes care. FCP + was positively associated with age of diagnosis and negatively with duration of disease and microalbuminuria, regardless of HbA1c.

We evaluated whether there was an association between fathers’ nutritional status and children's birth weight (BW) considering weight-matched mothers with and without gestational diabetes mellitus (GDM). In total, 86 trios of women, infants, and fathers were evaluated. BW was not different between the groups of obese and non-obese parents, frequency of maternal obesity, or GDM. The percentage of infants who were large for gestational age (LGA) was 25% in the obese group and 14% in the non-obese group (p = 0.44). There was a borderline significance for higher body mass index (p = 0.09) of the father in the LGA group compared with the adequate for gestational age group. These results corroborate the hypothesis that the father's weight can also be relevant for the occurrence of LGA.