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Pediatric Diabetes

Ilse Ekman, Tytti Vuorinen, Mikael Knip, Riitta Veijola, Jorma Toppari, Heikki Hyöty, Tuure Kinnunen, Jorma Ilonen, Johanna Lempainen
AIMS/HYPOTHESIS: Evidence of the role of cytomegalovirus (CMV) infection in the pathogenesis of type 1 diabetes (T1D) has remained inconclusive. Our aim was to elucidate the possible role of CMV infection in the initiation of islet autoimmunity and in the progression to clinical T1D among children with HLA-conferred T1D risk. METHODS: A total of 1402 children from the prospective Type 1 Diabetes Prediction and Prevention (DIPP) study were analyzed for CMV-specific IgG antibodies during early childhood...
October 18, 2018: Pediatric Diabetes
Fergus Cameron, Bryanna Moore, Lynn Gillam
Families of children with diabetes increasingly obtain health information from a variety of sources. Doctor patient relationships have accordingly become more fluid and dynamic with input from other parties. These outside parties include representatives from the diabetes health care industry- industry third parties (ITP's). This review is an exploration of the ethical principles and cognitive processes involved when doctors and patients negotiate around health care practices and the role of ITP's in that dialogue...
October 12, 2018: Pediatric Diabetes
John I Malone, Barbara C Hansen
Obesity is believed to be a promoter of type 2 diabetes mellitus (T2DM). Reports indicate that severe obesity in childhood and adolescence increases the risk of type 2 diabetes in youth and young adults. Type 2 diabetes, which is commonly asymptomatic, frequently is not recognized until random blood glucose is measured. Screening blood glucose levels measured in obese individuals are more effective for identifying undiagnosed persons, than screening the general population and therefore introduces a selection bias for discovery...
October 12, 2018: Pediatric Diabetes
Esther Mueller-Godeffroy, Reinhard Vonthein, Carmen Ludwig-Seibold, Bettina Heidtmann, Claudia Boettcher, Miriam Kramer, Nicole Hessler, Doerte Hilgard, Eggert Lilienthal, Andreas Ziegler, Verena M Wagner
OBJECTIVE: Continuous subcutaneous insulin infusion (CSII) is on the rise among pediatric patients with type 1 diabetes mellitus. Metabolic effects alone cannot explain this rising popularity. From the patient's perspective, the main benefits of CSII may be found in subjective psychosocial health outcomes (patient-reported outcomes [PRO]). SUBJECTS AND METHODS: In a multicenter open randomized controlled trial, children and adolescents aged 6 to16 years currently treated with multiple daily injections (MDI) were randomized 1:1, stratified by center, to either starting with CSII immediately after the baseline interview or to continuing MDI while waiting 6 months for transmission to CSII...
October 10, 2018: Pediatric Diabetes
Mélanie Henderson, Andraea Van Hulst, Julia E Von Oettingenn, Andrea Benedetti, Gilles Paradis
BACKGROUND: Normal weight metabolically unhealthy (NWMU) adults are at increased risk of cardiometabolic disease, however little is known regarding NWMU children. OBJECTIVES: We examined the associations between existing definitions of NWMU in children aged 8-10 years and insulin sensitivity (IS) and secretion 2 years later. METHODS: Data stem from the QUALITY cohort of 630 Caucasian youth, 8-10 years old at baseline, with at least one obese biological parent...
October 8, 2018: Pediatric Diabetes
Gabriele Berger, Thomas Waldhoer, Irene Barrientos, Daniela Kunkel, Birgit M Rami-Merhar, Edith Schober, Andreas Karwautz, Gudrun Wagner
OBJECTIVE: The aim of this study was to systematically assess the association of insulin-manipulation (intentional under- and/or overdosing of insulin), psychiatric comorbidity and diabetes complications. METHODS: Two diagnostic interviews (Diabetes-Self-Management-Patient-Interview and Children's-Diagnostic-Interview for Psychiatric Disorders) were conducted with 241 patients (age 10-22) with type 1 diabetes (T1D) from 21 randomly selected Austrian diabetes care centers...
September 28, 2018: Pediatric Diabetes
Silvia Valadares Duarte, Juliana de Souza Rajão, José Felippe Pinho, Luzia Maria Dos Santos, Claúdia Marotta Neves, Giselle Santos Magalhães, Antônio Ribeiro de Oliveira, Maria da Glória Rodrigues-Machado
INTRODUCTION: Type 1 diabetes mellitus (DM1) presents important risk factors for cardiovascular events. OBJECTIVE: To compare the components of the aortic pulse wave (APW) and the hemodynamic parameters among children and adolescents with DM1 and healthy individuals. METHODS: This is a cross-sectional study, with 36 children and adolescents diagnosed with DM1 (11.9±3.2 years) matched by sex and age with the control group (n=36, 12.4±2.9 years)...
September 27, 2018: Pediatric Diabetes
Beata Małachowska, Krystyna Wyka, Zuzanna Nowicka, Marcin Adam Bartłomiejczyk, Wojciech Młynarski, Wojciech Fendler
BACKGROUND: In type 1 diabetes mellitus (T1DM) the introduction of insulin is typically followed by a brief remission period, with subsequent gradual decline in beta cell function. Several studies described altered profile of circulating microRNAs in T1DM patients and proposed them as biomarkers of associated pathologic processes. HYPOTHESIS: Serum microRNA expression profile reflects residual beta cell function and autoimmunity in T1DM. SUBJECTS: The profiling group included patients with: GCK-MODY (N=13), T1DM (N=9) and 10 healthy controls...
September 27, 2018: Pediatric Diabetes
Mohammad Almari, Saad Alsaedi, Anwar Mohammad, Ali H Ziyab
BACKGROUND: Prediabetes, a high-risk state for developing diabetes, has become more prevalent among children and adolescents in recent decades. This study sought to estimate the prevalence of prediabetes and assess its association with adiposity among adolescents in Kuwait. Also, to determine whether maternal and paternal history of diabetes associate with offspring prediabetes in a sex-specific manner. METHODS: A cross-sectional study was conducted by enrolling students (n=1,959; aged 14-19 years) attending high schools across Kuwait...
September 25, 2018: Pediatric Diabetes
Melanie Cree-Green, Ninghe Cai, Jessica E Thurston, Gregory V Coe, Lindsay Newnes, Yesenia Garcia-Reyes, Amy D Baumgartner, Laura Pyle, Kristen J Nadeau
BACKGROUND: Polycystic ovarian syndrome (PCOS) includes insulin resistance (IR) and impaired glucose tolerance (IGT) in youth, and a greatly elevated risk of type 2 diabetes in adulthood. Identifying IR is challenging and documenting IGT requires an oral glucose tolerance test (OGTT). OBJECTIVE: Identify an easily applied surrogate measures for IR and IGT in girls with PCOS. METHODS: We studied 28 girls with PCOS [BMI percentile 98 (83,99); 15...
September 23, 2018: Pediatric Diabetes
Emilia Hagman, Lior Hecht, Limor Marko, Henny Azmanov, Leif Groop, Nicola Santoro, Sonia Caprio, Ram Weiss
BACKGROUND/OBJECTIVE: Lifestyle modification is the therapy of choice for childhood obesity, yet the response rate is variable and may be affected by genetic factors. We aimed to investigate predictors of poor response to lifestyle modification obesity treatment in children. METHODS: A prospective cohort study of 434 youths (64.5% females) between 4 and 20 years of age undergoing a standard care of lifestyle modification obesity management for 35.9 ± 20.8 months at Yale Childhood Obesity Clinic, USA...
September 17, 2018: Pediatric Diabetes
Mary Ellen Vajravelu, Ron Keren, David R Weber, Ritu Verma, Diva D De León, Michelle R Denburg
OBJECTIVE: To determine the incidence of and risk factors for development of celiac disese (CD) in individuals with type 1 diabetes. METHODS: Cohort study using The Health Improvement Network (THIN), a United Kingdom primary care database of >13 million people. Individuals with incident type 1 diabetes diagnosed at 1-35 years of age between 1995 and 2015 with no previous diagnosis of CD were included. Cox regression was used to identify risk factors for CD, including age at diabetes diagnosis and sex, while adjusting for year of diagnosis to control for potential rising incidence in CD over time...
September 12, 2018: Pediatric Diabetes
Michelle L Katz, Zijing Guo, Alina Cheema, Lori M Laffel
Hypertension and dyslipidemia are often suboptimally managed in teens with type 1 diabetes (T1D). Teen and parent perspectives on hypertension and dyslipidemia management need further study in order to enhance the development of CVD risk factor management plans. We sought to describe barriers to and strategies for CVD risk factor management. Teens with T1D with and without dyslipidemia and parents of teens with T1D with and without dyslipidemia underwent one-on-one semi-structured interviews conducted by trained personnel at a diabetes center; interviews continued until thematic saturation was reached...
September 12, 2018: Pediatric Diabetes
Pierluigi Marzuillo, Giulia Bellini, Francesca Punzo, Anna Di Sessa, Stefano Guarino, Giuseppina R Umano, Roberto Toraldo, Emanuele Miraglia Del Giudice, Francesca Rossi
BACKGROUND: The non-classical HLA-class I molecule-g (HLA-G) gene shows a deletion/insertion (del/ins) polymorphism of a 14-base-pair sequence (14 bp) in the exon 8 at the 3' untranslated region. The presence of the 14 bp insertion allele has been associated to lower soluble HLA-G protein production, a protein with anti-inflammatory activities. So far, no studies have investigated the relationship between HLA-G 14 bp del/ins polymorphism and metabolic features of obese children and adolescents...
September 10, 2018: Pediatric Diabetes
Andrea Lukács, Krisztina Mayer, Péter Sasvári, László Barkai
BACKGROUND: Adolescents with type 1 diabetes (T1D) can be faced with deterioration in glycemic control (GC), reduced health-related quality of life (HRQoL), and other psychosocial problems. It is important to understand how the disease and its clinical conditions influence HRQoL and how adolescents are able to overcome the life adjustment difficulties. OBJECTIVE: To assess HRQoL of adolescents with T1D from demographic, clinical, personal, and behavioral point of view...
September 10, 2018: Pediatric Diabetes
Stephanie R Johnson, Jonathan J Ellis, Paul Leo, Lisa K Anderson, Uma Ganti, Jessica E Harris, Jacqueline A Curran, Aideen McInerney-Leo, Nirubasini Paramalingam, Xiaoxia Song, Louise S Conwell, Mark Harris, Timothy W Jones, Matthew A Brown, Elizabeth A Davis, Emma L Duncan
BACKGROUND: Maturity-onset diabetes of the young (MODY) is caused by autosomal dominant mutations in one of thirteen confirmed genes. Estimates of MODY prevalence vary widely, as genetic screening is usually restricted based on clinical features, even in population studies. We aimed to determine prevalence of MODY variants in a large and unselected pediatric diabetes cohort. METHODS: MODY variants were assessed using massively parallel sequencing in the population-based diabetes cohort (n=1363) of the sole tertiary pediatric diabetes service for Western Australia (population 2...
September 7, 2018: Pediatric Diabetes
Alexia S Peña, Gerald Liew, Jemma Anderson, Lynne C Giles, Roger Gent, Tien Y Wong, Jennifer J Couper
BACKGROUND/OBJECTIVE: Adolescents with type 1 diabetes have early macrovascular changes (increased intima-media thickness [IMT]) and early retinal changes that predict clinical disease in adulthood. We hypothesized that early changes in the macrovascular and retinal microvascular beds develop in parallel before retinopathy develops. We therefore aimed to investigate the relationship between changes in atherosclerosis (carotid and aortic IMT) and retinal vascular geometry cross-sectionally and longitudinally in adolescents with type 1 diabetes...
September 2, 2018: Pediatric Diabetes
Bryan Padraig Finn, Claire Power, Niamh McSweeney, Dorothy Breen, Gerald Wyse, Susan M O'Connell
Diabetic Ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new onset type 1 diabetes (T1DM). Children have a higher rate of neurological complications from DKA when compared to adults. The differential for sudden focal neurological deterioration in the setting of DKA is cerebral oedema followed by ischaemic and haemorrhagic stroke. Spontaneous intracranial haemorrhages can present with non-specific features frequently e.g. impaired consciousness, even when biochemical parameters are improving in the setting of DKA...
September 2, 2018: Pediatric Diabetes
William V Tamborlane, Peiyao Chang, Craig Kollman, Georgeanna J Klingensmith, Katrina Ruedy, Robin L Gal, Michelle Van Name, Fida Bacha, Steven Willi, Roy W Beck
BACKGROUND/OBJECTIVE: Restrictive eligibility criteria have hampered enrollment into trials for new drugs for youth with type 2 diabetes (T2D). We utilized Pediatric Diabetes Consortium (PDC) T2D Registry enrollment data to estimate the percentage of patients who would be excluded from current T2D trials based on out-of-range HbA1c levels. We also examined whether well-controlled patients could be included because baseline HbA1c would rise during a 6 to 12-month study if assigned to control group...
September 2, 2018: Pediatric Diabetes
Toby P Candler, Osama Mahmoud, Richard M Lynn, Abdalmonen A Majbar, Timothy G Barrett, Julian Ph Shield
BACKGROUND: Type 2 Diabetes (T2DM) is increasing in childhood especially among females and South-Asians. OBJECTIVE: To report outcomes from a national cohort of children and adolescents with T2DM one year following diagnosis SUBJECTS AND METHODS: Clinician reported, one-year follow-up of a cohort of children (<17years) diagnosed with T2DM reported through British Paediatric Surveillance Unit (April 2015-April 2016). RESULTS: One hundred (94%) of 106 baseline cases were available for review...
September 2, 2018: Pediatric Diabetes
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