Due to a growing demand and need for faster results, effectivization as a concept has been pushed to the forefront of medical research. Here, a method transfer between 2 fully automized ELISA instruments is highlighted. The instruments were the Tecan Freedom EVOlyzer and the Dynex DSX.  The Tecan instrument is a more modern instrument with a more extensive LIMS integration, better automatization and increased capacity for samples and assays. The method being transferred was an Anti-GAD ELISA for the diagnosis of Type 1 Diabetes Mellitus. The study design was a result comparison of 20 samples with varying Anti-GAD concentration and 15 replicates of a single sample for a precision study. To successfully transfer the method, acceptance criteria concerning percentual difference in result, intermediate precision, and repeatability had to fall below 20 %. The assay was set up as a sandwich ELISA in accordance with the kit used at the laboratory (Euroimmun), where each sample was set as duplicates. Preliminary programming and testing was performed to ensure proper function. An average bias of +33 % was reported, as was an intra-run variation and an inter-run variation of ca 11 %. Additionally, a recurring issue with samples and calibrators in specific locations on the plate was reported. The issue was deemed systemic and possible solutions include changing programming parameters, or instrument part replacement. Ultimately the method transfer was left incomplete, and several technical details must be overcome before taking Anti-GAD analysis into routine use on the instrument.

Background: Type 1 diabetes mellitus is the most common autoimmune disease among children and adolescents worldwide. The diagnosis leads to lifestyle change. Parents are mainly responsible for self-care. Nurses can support parents in this life adjustment through patient participation and family-focused nursing. Aim: The aim was to illustrate parents' experience of living with a child diagnosed with type 1 diabetes mellitus. Method: A literature review based on 13 scientific studies with a qualitative method, analyzed with thematic analysis. Results: 2 themes with 6 sub-themes were identified. 1) Time after diagnosis: Emotions that arise during diagnosisand Lack of support and understanding from others. 2) A new normal: Changes in everyday life, The relationship with their child, Fear of child's health and Letting go of control. Parents experienced difficulty sleeping, worry, anxiety and stress living with children with type 1 diabetes mellitus. Conclusions: Parents initially experienced feelings such as anxiety and worrying. The family's life changes with new routines. The diagnosis affects parents' health and quality of life. Further research on the experience of living with chronically ill children is needed to optimize and improve treatment in health care. / Bakgrund: Diabetes mellitus typ 1 är den vanligaste autoimmuna sjukdomen bland barn och ungdomar i världen. Diagnostisering innebär en livsstilsförändring i vardagen. Huvudansvaret för egenvården av sjukdomen ligger hos föräldrarna. Sjuksköterskan kan stötta föräldrarna i livsomställningen genom patientdelaktighet och familjefokuserad omvårdnad.  Syfte: Syftet var att belysa föräldrars upplevelse av att leva med barn diagnostiserad med diabetes mellitus typ 1. Metod: Allmän litteraturöversikt baserad på 13 vetenskapliga originalartiklar med kvalitativ ansats som analyserades med tematisk analysmetod.  Resultat: Föräldrars upplevelser beskrivs utifrån 2 teman med 6 subteman. 1) Tiden efter diagnosen: Känslor som uppkommer vid diagnostisering och Bristen av stöd och förståelse från andra. 2) Ett nytt normalt: Förändringar i vardagen, Relationen till sitt barn, Rädslan för barnets hälsa och Släppa kontrollen. Föräldrar upplevde varierande grad av sömnsvårigheter och ångest av att leva med barn med diabetes mellitus typ 1.  Slutsats: Föräldrar upplevde känslor som ångest, oro och stress inledningsvis, men även livet ut. Familjens livssituation förändras när nya rutiner införs. Diagnosen påverkar föräldrars hälsa samt livskvalitet. Vidare forskning om upplevelsen att leva med kroniskt sjuka barn behövs för att optimera och förbättra bemötandet i hälso- och sjukvården.

Mucosal immune system comprises not only the major compartment of the immune system but also important interface with the outer environment. It is responsible in maintaining an intricate balance with the danger and non-danger stimuli of the outer world by employing specific anatomical features and unique functional mechanisms. Mucosal immune system has been long understudied, perhaps due to the limited accessibility, and its biological importance is thus still underevaluated. However, it has become evident that it is important to study mucosal immune system not only in local mucosal affections but also when uncovering pathogenic mechanisms and novel prevention strategies of organ specific autoimmune diseases such as type 1 diabetes. Thus, the first, more clinically oriented part of this thesis is focused on mucosal immune system of the upper respiratory tract in disease conditions - in nasal polyposis (NP). Because there is a substantial accumulation of eosinophils and neutrophils in the most frequent type of NP, we investigated and described increased expression of chemokine receptors CCR1 and CCR3 in NP versus nasal mucosa. Both innate immune mechanisms as well as homeostasis of epithelial cells may participate in NP. We have documented increased numbers of iNOS-positive and insulin-like growth...

Introduction: Type 1 diabetes mellitus is a chronic metabolic disease caused by autoimmune destruction of pancreatic beta cells. The theory of the disease onset is derived from study of a disease course in non-obese diabetic (NOD) mice, in which the diabetes occurs due to a dysregulation of the immune system. Experimental and clinical studies showed that the autoimmunity may be abrogated by immune intervention, which if initiated early enough may at least slow down the ongoing beta cells lost and preserve residual insulin secretion. But immune intervention alone is not sufficient to restore normoglycemia in the majority of cases. Several interventional studies showed that stimulation of proliferation and/or regeneration of beta cells are necessary to restore normoglycemia in animal models. Aim of the study: To find out, if the combination of a potent immunosuppression (murine anti-thymocyte globulin (mATG), gusperimus) together with stimulation of islet regeneration (sitagliptin) will be able to slow down or reverse the course of the disease. Another aim is to identify the mechanism by which the substances act. Material and methods: All experiments were performed in female NODShiLtJ (H2g7 ) mice. The following parameters were examined at day 0, 7, 14 and 28: blood glucose, subpopulations of...

Typ 1-diabetes mellitus är en kronisk sjukdom som orsakas av en försämrad insulinproduktion som på sikt leder till total insulinbrist och kräver därmed livslång behandling med insulin. Typ 1-diabetes mellitus debuterar främst under barn- eller tonåren. Att leva med sjukdomen kräver att individen ska själv kunna hantera och utföra egenvården. Övergången från barn till tonåring kan därmed vara en svår period då ansvaret för egenvården förflyttas från föräldrarna till tonåringen, samtidigt som fysiologiska, psykologiska samt sociala förändringar sker. / Type 1-diabetes mellitus is a chronic disease caused by impaired insulin production which eventually leads to insulin deficiency and thus requires lifelong treatment with insulin. Type 1-diabetes mellitus debuts mainly during childhood or adolescence. Living with the disease requires the individual to be able to manage and perform self-care. The transition from child to adolescent can thus be a difficult period when the responsibility for self-care is transferred from the parents to the adolescent. While at the same time physiological, psychological and social changes take place.

Introduction: The diploma thesis deals with the issue of compensation of type 1 diabetes mellitus during pregnancy and its relation to the health of mother and child. It further summarizes and describes the variable factors that may have a direct effect on current glycemic variability and long- term compensation of diabetes. Aims: The theoretical part describes the characteristics of type 1 diabetes mellitus and the possibilities of therapy in pregnancy. Subsequently, factors influencing the compensation of diabetes in this period are summarized and described in more detail, especially food composition and possibilities of influencing postprandial glycemia, effects of type and intensity of physical activity and psychosocial aspects related mainly to stress from potential negative effects of glycaemia on the fetus. At the end of the theoretical part, the risks and complications for the mother and the fetus arising from long-term unsatisfactory compensation of diabetes are presented. The aim of the practical part of the thesis was to determine the extent of women's knowledge about the compensation of diabetes in pregnancy, followed by determining the effect of the extent of knowledge on long-term compensation, expressed by glycated hemoglobin. Methods: Data for the diploma thesis were obtained on the...

Bakgrund: Diabetes typ- 1 är en kronisk sjukdom och en av de största folksjukdomarna i världen som blir allt vanligare i Sverige. Sjukdomen påverkar kroppen genom att blodsockernivån är för hög eftersom kroppen saknar förmåga att producera insulin. Metod: En litteraturstudie baserad på 10 vetenskapliga artiklar som granskats utifrån Fribergs analysmodell. Syfte: Att belysa vuxna individers upplevelser av att leva med diabetes typ- 1.Resultat: Analysen resulterade i 3 teman med 8 underteman: (1) En förändrad livsstil med underteman; begränsad vardag, daglig prioritering, utanförskap. (2) Upplevelse av stöd med underteman; att sakna stöd, att känna stöd. (3) Inställning till sjukdomen med underteman; bristande acceptans, individuell egenvård, betydelsen av framtidstro. Resultatet redovisar att individerna behöver få visad förståelse och stöttning i sin sjukdom för att bli mer delaktiga i sin egenvård. Konklusion: Diabetes typ- 1 påverkar individers liv på flera olika sätt. Sjukdomen leder till många tankar, känslor och fysisk påverkan, eftersom sjukdomen skapar en ofrivillig och förändrad livsstil. Sjuksköterskans engagemang är betydelsefullt då det kan bidra till en god livskvalitet för individen. / Background: Type 1 diabetes is a chronic disease and one of the most common diseases in the world and it’s becoming more common in Sweden. The disease affects the body because the blood sugar levels are too high as a result of the body’s inability to produce insulin. Method: A literature study based on 10 scientific articles that was analyzed using Friberg’s analysis model. Aim: To shed light on adults’ experiences of living with type 1 diabetes. Findings: The analysis resulted in 3 themes with 8 subthemes. (1) Changed lifestyle with subthemes, limited everyday life, daily priorities, exclusion. (2) The importance of support with subthemes; lack of support, to feel support. (3) Attitude towards the disease with subthemes; lack of acceptance, individual self-care, the importance of faith in the future. The results show that the adults need to be shown understanding and support in their illness to become more involved in their self-care. Conclusion: The study shows that type 1 diabetes is a disease that affects an individual’s life in several different ways. The disease leads to, among other things, many thoughts, feelings and somatic impact, as the disease creates an involuntary and changed lifestyle. The nurse's commitment is important as it can contribute to a good quality of life for the individual.

<p>Type 1 Diabetes Mellitus (T1D), a chronic disease affecting over 1.5 million Americans, is characterized by the autoimmune destruction of insulin-producing β-cells within pancreatic islets. Islet/β-cell replacement therapies, where replenishable β-cell sources are implanted within protective microenvironments, have the potential to provide a long-term solution for individuals with T1D by restoring glucose-sensitive, insulin release and overall glycemic control. However, most conventional encapsulation materials elicit an immune reaction, known as a foreign body response (FBR), which compromises β-cell health and function. In this dissertation, we designed and evaluated various formulations of a polymerizable collagen, namely type I oligomeric collagen (Oligomer), as encapsulation materials for minimally invasive, subcutaneous delivery of replacement β-cells. Preclinical validation in chemically-induced diabetic mice demonstrated rapid (within 24 hours) reversal of diabetes for beyond 90 days with no signs of rejection or FBR after subcutaneous delivery of both allogeneic and xenogeneic (rat) islets. To further define this uncommon mechanism of protection, the tissue response to Oligomer, in comparison to commercial synthetic and collagen-based materials, was evaluated following subcutaneous implantation within rats, a well-established biocompatibility model. Histological and transcriptomics analyses were used to define the immune response at both cellular and molecular levels. Interestingly, Oligomer showed minimal and transient activation of innate immune cells similar to the sham surgical control, with no evidence of foreign body giant cell formation, inflammatory-mediated bioresorption, or fibrosis. Overall, this work evaluates preclinical efficacy and demonstrates mechanistic understanding of immune tolerance for Oligomer materials for β-cell replacement therapy and other regenerative medicine applications.</p>

Bakgrund: Förekomsten av diabetes typ 1 ökar i de nordiska länderna och i synnerhet i Sverige. Som förälder till barn med en nyligen diagnostiserad diabetes typ 1 kan den aktuella situationen upplevas som ett trauma, vilket kan påverka hela familjens livssituation och innebära stora förändringar och omställningar i livet. En adekvat patientutbildning med familjecentrerad vård är nyckeln till en framgångsrik behandling av livslång kronisk sjukdom.Syfte: Syftet är att undersöka upplevelser av patientutbildning hos familjer med barn som diagnostiserats med diabetes typ 1 i Skandinavien.Metod: En litteraturöversikt baserad på 16 kvalitativa artiklar från fyra olika länder.Resultat: Resultatet sammanställdes i tre olika huvudkategorier. De olika kategorierna beskriver föräldrarnas, barnets och syskons upplevelser av patientutbildning. De underkategorier som framkom i analysen var barn och föräldrars upplevelse av vårdpersonal och sjukhusmiljöns påverkan på patientutbildning samt hur tekniska hjälpmedel kan underlätta patientutbildning. Vidare avslöjar resultatet att stödjande miljöer påverkar barnet samt att hjälpmedel i vardagen underlättar livssituationen för familjen.Slutsats: Resultatet påvisar att patientutbildning upplevs för generell och saknar anpassning på familj- och individnivå samt att familjen har svårt att förlita sig på vårdpersonalens kompetens. Familjens livssituation med aktiviteter och spontanitet underlättas med hjälpmedel såsom insulinpump, dock upplever familjen att det tar lång tid att känna sig bekväm och självsäker med hanteringen av insulinpumpen. Vidare framkommer vikten av att hela familjen inklusive syskon involveras i utbildningen för att skapa förståelse för barnets behov och konsekvensen av vad en felbehandlad sjukdom kan medföra. / Background: The incidence of type 1 diabetes is increasing in the Nordic countries, and especially in Sweden. As a parent of a child with a newly diagnosed type 1 diabetes, the current situation can be experienced as a trauma, which can affect the whole family's life situation and involve major changes and adjustments in life. An adequate patient education with a family-centered approach is the key to successful treatment of lifelong chronic illness.Aim: The aim is to investigate the experiences of patient education in families with children diagnosed with diabetes type 1 in Scandinavian.Method: A literature review based on 16 qualitative research articles from four different countries.Results: The results were compiled into three different main categories. The different categories describe the parents’, child’s and siblings’ experiences of patient education. The subcategories that emerged in the analysis were children’s and parents’ experiences of professionals and the hospital environment’s impact on patient education, as well as how technical aids can facilitate patient education. Furthermore, the results reveal that supportive environments affect the child and that aids in everyday life make the life situation easier for the family.Conclusion: The results show that patient education is perceived as general and lacks adaptation at family and individual level and that many families have difficulties relying on professional competence. The family’s life situation, with activities and spontaneity, is facilitated with aids such as the insulin pump. However, families experience that it takes a long time to feel comfortable and confident with the handling of the insulin pump. Furthermore, the involvement of the whole family, including siblings, is of great importance in the education to create an understanding of the patient’s needs and the understanding of the consequences of a mistreated illness.

Background: Type 1 diabetes mellitus is a chronic condition that affects many adolescents around the world. Living with type 1 diabetes places expectations and demands, especially onadolescents who are in a phase of development and changes, which can affect their ability to perform proper self-care. The nurse plays an important role in the health-promoting work with a person-centered approach based on autonomy. Aim: The aim of this literature review was to investigate experiences of self-care in diabetes type 1 from the perspective of the adolescent. Method: A literature review with a qualitative approach, based on 11 original scientificarticles. Results: The results are presented as four themes: ”challenges with self-care”, ”the importance of support”, ”barriers to knowledge” and ”increased independence”. Conclusion: Self-care is part of the treatment for type 1 diabetes and expectations of the adolescents and the environment becomes crucial factors in compliance. By bringing knowledge, support andguidance based on a person-centered approach, nurses can contribute to promoting adolescents’ health, equal care and increased quality of life. Further research is required toensure that good nursing can be applied by the nurse, to understand adolescents' experiences of self-care in connection with the development phases, conditions and lifestyles. / Bakgrund: Diabetes mellitus typ 1 är ett kroniskt sjukdomstillstånd som drabbar många ungdomar i världen. Att leva med diabetes typ 1 medför utmaningar och krav, speciellt hos ungdomar som befinner sig i en fas av utveckling och förändringar, som kan påverka dennes förmåga att utföra korrekt egenvård. Sjuksköterskan spelar en viktig roll vid dethälsofrämjande arbetet med ett personcentrerat förhållningssätt med självbestämmande som grund. Syfte: Syftet med denna litteraturöversikt var att undersöka erfarenheter av egenvård vid diabetes typ 1 ur ungdomarnas perspektiv. Metod: En litteraturöversikt med kvalitativ ansats, som baserats på 11 vetenskapliga originalartiklar. Dataanalysen utfördes med tematisk analys av Braun och Clarke. Resultat: Resultatet presenteras som fyra teman: ”utmaningar med egenvård”, ”stödets betydelse”, ”kunskapsbarriärer” och ”ökad självständighet”. Slutsats: Egenvård utgör en del av behandlingen för diabetes typ 1 och förväntningar på ungdomarna och omgivningen blir avgörande faktorer vid följsamheten. Genom att medföra kunskap, stöd och vägledning utifrån ett personcentrerat förhållningssätt kan sjuksköterskor bidra med att främja ungdomars hälsa, jämlik vård och ökad livskvalitet. Fortsatt forskning krävs för att säkerställa att en god omvårdnad kan tillämpas avsjuksköterskan, för att förstå ungdomars erfarenheter av egenvården i samband medutvecklingsfaserna, förutsättningar och levnadssätt.