Katherine Desjardins

Institut de recherches cliniques de Montréal | IRCM · Clinic and Clinical Research

Aim: Self-management guidelines for non-severe hypoglycemia (NS-H) in type 1 diabetes recommend 15g simple carbohydrates (CHO) at 15-minute intervals. Since automated insulin delivery (AID) preventively reduce or suspend insulin infusion for imminent hypoglycemia, we aimed to assess if guidelines were excessive during AID. Methods: Secondary ana...

AIMS: Data on the clinical course of patients with cystic fibrosis (CF) from childhood to CF-related diabetes (CFRD) diagnosis in adulthood are limited. We evaluate whether childhood trajectories of parameters of interest in CF are associated with the risk of abnormal glucose tolerance (AGT) in early adulthood. Methods: Pediatric and adult data fro...

Background: Cystic fibrosis (CF)-related diabetes (CFRD) is a common comorbidity in CF. In CFRD, fasting blood glucose level is often normal, but post-prandial glycaemia (PPG) is problematic. Elevated PPG has been associated to a higher risk of developing CFRD, a worst clinical state and a lower pulmonary function. Interventional studies in type 2...

Aims/hypothesisCystic fibrosis-related diabetes (CFRD) affects up to 50% of adults with cystic fibrosis (CF) and its presence is associated with adverse effects on nutritional status and pulmonary function. Early diagnosis could minimise CFRD morbidity, yet current methods of an OGTT at 0 and 2 h yield unreliable results. Our aim was to determine w...

People with T1D (PWT1D) use many strategies to avoid nocturnal hypoglycemia (NH), however, the current evidence on these strategies is limited. Technologies such as continuous subcutaneous insulin infusion (CSII) or continuous glucose monitors (CGM) could help reduce NH and possibly alter PWT1D’ management behaviors. Aim: To describe PWT1D’ preferr...

Objective To report the clinical profile associated with G60 and I60 over a 4-year prospective observational period in 2 large cohorts of adult patients with CF. Methods 319 patients were included (210 Canadian and 119 French) and classified according to their inclusion G60 (≥ or < 11.1 mmol/L) and the median inclusion I60 (≥ or < 24 mU/I). Forced...

AIMS Study objectives were to document the screening rate for cystic fibrosis-related diabetes (CFRD) in children followed at a cystic fibrosis (CF) clinic in Canada and evaluate the accuracy of various glycated hemoglobin (A1C) cut-offs to screen for CFRD and impaired glucose tolerance (IGT) in a pediatric CF population. METHODS The CFRD screenin...

Background and aims There is debate over the independent and combined effects of caloric restriction (CR) and physical activity (PA) on reduction in fat mass and in epicardial fat thickness. We compared the impact of a similar energy deficit prescription by CR or by CR combined with PA on total fat mass, epicardial fat thickness, and cardiometaboli...

The BETTER registry launched in April 2019 aims to understand the burden (frequency, severity) of hypoglycemia from people with T1D’s perspective and to evaluate the role of technologies in its prevention and management. Methods: BETTER registry includes several online surveys and is being conducted in Quebec, Canada. Preliminary results of the 2nd...

Background: Aging cystic fibrosis (CF) patients are at high risk of developing CF-related diabetes (CFRD). Decrease in insulin secretion over time is the main hypothesis to explain this increasing prevalence but mechanisms are still not well elucidated. The objective is to assess evolution of glucose tolerance and insulin secretion/sensitivity in...

Cystic fibrosis (CF)-related diabetes is associated with increased mortality. We analysed the clinical and glycemic profiles of two cohorts of patients treated according to the same guidelines in France and Canada. To investigate incidence differences in phenotypic and glucose abnormalities and to explore the evolution over a 4-year follow-up perio...

Aims: Mild-to-moderate hypoglycemia (blood glucose < 4.0 mmol/L) is recommended to be treated with 15 g of carbohydrates and to repeat the treatment if hypoglycemia persists after 15 min. This recommendation was established before intensive insulin therapy and based on studies using insulin with different pharmacokinetic profiles from actual insul...

Aims: Characterize adult patients with diabetes on intensive insulin therapy in terms of: (a) practices and perceived difficulties relative to carbohydrate counting (CC) and diabetes treatment, and (b) their perceptions and expectations relative to CC. Methods: Participants completed a 30-question web-based questionnaire. Results: Participants...

Nearly 50% of adult patients with cystic fibrosis (CF) have diabetes. The occurrence of CF-related diabetes (CFRD) is preceded and is associated with deterioration of lung function and nutritional status. Microvascular complications can occur, but the main cause of death is respiratory failure rather than cardiovascular causes as in type 1 or type...

Objectives: To determine the modifiable factors affecting glucose variability in people with cystic fibrosis (CF). CF-related diabetes (CFRD) is the most common complication of CF, and its presence increases morbidity and mortality in patients. Patients with CF (with and without CFRD) have potentially harmful glucose fluctuations and glucose excur...

Objectives: 1) To characterize the nutritional treatment of hypoglycemia in adult patients with type 1 diabetes mellitus and 2) to compare the characteristics of participants who follow the recommendations with the characteristics of those who do not. Methods: A total of 121 adults with type 1 diabetes were included in this cross-sectional analy...

Background: Reduced insulin secretion is a key factor to explain high prevalence of glucose intolerance in patients with cystic fibrosis (CF). However, the role of insulin sensitivity remains unclear. The aim of this study is to investigate the association of insulin secretion and sensitivity with the evolution of glucose tolerance. Methods: A t...

Résumé Près de 50% des patients adultes atteints de mucoviscidose (MV) sont diabétiques. La survenue du diabète secondaire à la MV (DSMV) est précédée, et associée, à une détérioration de la fonction pulmonaire et de l’état nutritionnel. Les complications microvasculaires peuvent survenir, mais la cause de mortalité est l’insuffisance respiratoire,...

Introduction Le défaut de la sécrétion d'insuline, suite à la fibrose pancréatique, joue un rôle majeur dans la survenue des anomalies de la tolérance au glucose chez les patients atteints de M V. Le rôle de la sensibilité à l'insuline demeure débattu. L'objectif est d'investiguer les rôles respectifs de la diminution de la sécrétion d'insuline et...

With improved life expectancy of cystic fibrosis (CF) patients, CF-related diabetes (CFRD) has become a major complication. The oral glucose tolerance test (OGTT) is the standard test to detect it. However, the use of OGTT is controversial, in addition to being a burden for patients and the treatment team. Research to find alternative ways of testi...

The Mediterranean-style dietary pattern has been associated with several cardiometabolic benefits, yet no study has assessed the potential benefits of this diet in adults with type 1 diabetes mellitus (T1DM). The objective of the present study was to examine the association between cardiometabolic profile and alignment of the diet with 1) Canadian...

Little is known about lifestyle habits of adults with type 1 diabetes (T1D) and their association with cardiometabolic risk (CMR) factors. The aims of the present study were to determine the prevalence of adults with T1D who adopted a healthy lifestyle and to explore the association between a healthy lifestyle and the cardiometabolic profile. This...

Aims To describe (i) current bedtime nutritional practices and (ii) the association between post-dinner dietary intake and the occurrence of non-severe nocturnal hypoglycemia (NH) in real-life conditions among adult patients with type 1 diabetes using insulin analogues. Methods One hundred adults (median [interquartile range]: age 46.4 [36.0-55.8]...

Physical inactivity is highly common in adults with type 1 diabetes (T1D) as specific barriers (i.e., hypoglycemia) may prevent them from being active. The objective of this study was to examine the efficacy of the Physical Exercise Promotion program in type 1 diabetes (PEP-1) program, a group program of physical activity (PA) promotion (interventi...

Over the past decades, there has been a major upward shift in the prevalence of cardiometabolic risk (CMR) factors (central obesity, insulin resistance, hypertension and dyslipidemia) in patients with type 1 diabetes, which could have either an additive or a synergistic effect on risk for cardiovascular disease. These metabolic changes are occurrin...

Hypoglycaemia remains the major limiting factor for adequate diabetes control for patients with type 1 diabetes (T1D), especially during the night-time. Although nutritional strategies for nocturnal hypoglycaemia (NH) prevention are regularly suggested in clinical practice, there is no evidence-based recommendation for the usefulness and optimal co...

Introduction L’hypoglycémie est une barrière majeure à l’atteinte d’un contrôle glycémique optimal chez les patients atteints de diabète de type 1 (DbT1). L’hypoglycémie nocturne (HN) représente une part importante du problème avec plus de 50 % des épisodes sévères d’hypoglycémie survenant durant le sommeil. L’objectif de cette étude observationnel...

Aims: Carbohydrate counting is an established approach used by patients with type 1 diabetes to improve their glycemic control. The aims of this study were to evaluate, in real life conditions, the accuracy of meal carbohydrate estimate and its impact on glycemic variability. Methods: In this cross-sectional study, we observed the ability of 50...

Les adultes atteints de diabète de type 1 ont des défis spécifiques, comme la crainte de l’hypoglycémie, qui peuvent limiter la pratique d’activité physique (AP). Le programme PEP-1 a été développé dans le but d’améliorer la pratique d’AP. Ce programme est basé sur une meilleure gestion des fluctuations glycémiques, une réduction de la perception d...

Perceived barriers are one determinant of physical activity. Depending on the study population, these barriers can vary. The aim of this study was to assess the reliability and predictive validity of the 'Barriers to Physical Activity in Type 1 Diabetes' (BAPAD-1) scale, developed by Dubé et al. A total of 77 adults (48% women; age: 43.5±10.4; body...