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Pediatric Diabetes

Lara C Foland-Ross, Allan L Reiss, Paul K Mazaika, Nelly Mauras, Stuart A Weinzimer, Tandy Aye, Michael J Tansey, Neil H White
The extant literature finds that children with type 1 diabetes (T1D) experience mild cognitive alterations compared to healthy age-matched controls. The neural basis of these cognitive differences is unclear but may relate in part to the effects of dysglycemia on the developing brain. We investigated longitudinal changes in hippocampus volume in young children with early-onset T1D. Structural magnetic resonance imaging data were acquired from 142 children with T1D and 65 age-matched control subjects (4-10 years of age at study entry) at two time points, 18 months apart...
April 19, 2018: Pediatric Diabetes
Daniel Öberg, Jenny Salemyr, Eva Örtqvist, Anders Juul, Peter Bang
OBJECTIVE: To evaluate longitudinal serum IGF-I in a large cohort of children and adolescents with type 1 diabetes in relation to HbA1c, age, diabetes duration, and BMI, its association to height and retinopathy, and in comparison with healthy subject references. RESEARCH DESIGN AND METHODS: A total of 2,683 serum IGF-I values were obtained from 806 children and adolescents with T1DM, from annual blood samples for up to 6 consecutive years. RESULTS: In a multiple regression analysis IGF-I values were negatively correlated to HbA1c and diabetes duration, and positively correlated to BMI (p<0...
April 16, 2018: Pediatric Diabetes
Ling Guan, Daniel L Metzger, Pascal M Lavoie, Jean-Paul Collet
BACKGROUND AND OBJECTIVE: Type 1 diabetes (T1D) is a chronic source of metabolic and neuropsychological stress, which may eventually lead to autonomic neuropathy and other complications related to micro- and macro-vasculopathies. We aimed to investigate the relationship between T1D chronic stress and ANS response to acute stress testing that was expected being affected by chronic stress. METHODS: Twenty youths with confirmed diagnosis of T1D were assessed. Chronic stress assessment included HbA1c ≥7...
April 14, 2018: Pediatric Diabetes
Stephanie R Johnson, Ivan McGown, Udo Oppermann, Louise S Conwell, Mark Harris, Emma L Duncan
BACKGROUND: Insulin gene (INS) mutations are a rare form of maturity-onset diabetes of the young (MODY), a heterogeneous group of autosomal dominant diabetes with at least fourteen confirmed causative genes. Here we describe a family with MODY from a novel INS mutation detected using massively parallel sequencing (MPS). SUBJECTS: The proband presented aged 11 years with mild diabetic ketoacidosis. She was negative for IA2 and GAD antibodies. She had a strong family history of diabetes, including both siblings and her mother, none of whom had ketosis but who were considered to have type 1 diabetes and managed on insulin; and her maternal grandfather, who was managed for decades on sulfonylureas...
April 6, 2018: Pediatric Diabetes
George Moschonis, Odysseas Androutsos, Toine Hulshof, Maria Dracopoulou, George P Chrousos, Yannis Manios
OBJECTIVES: To explore the associations of vitamin D status with obesity and insulin resistance (IR) in children. METHODS: A sample of 2,277 schoolchildren (9-13 years old) in Greece was examined. Socio-demographic, anthropometric (weight, height), biochemical (fasting plasma glucose, serum insulin and 25(OH)D), pubertal status and physical activity data were collected, using standard methods. The "Vitamin D Standardization Program" (VDSP) protocol was applied to standardize serum 25(OH)D values...
April 2, 2018: Pediatric Diabetes
J-F Lemay, S Lanzinger, D Pacaud, P L Plener, A Fürst-Burger, T Biester, D Hilgard, E Lilienthal, A Galler, G Berger, R W Holl
BACKGROUND: A paucity of reports in the literature exists concerning the co-existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D). OBJECTIVE: To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD). METHODS: Using the German/Austrian diabetes patient follow-up registry, this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January, 2005 and March, 2017...
March 26, 2018: Pediatric Diabetes
Ines Guttmann-Bauman, Paul Thornton, Soumya Adhikari, Kent Reifschneider, Michael A Wood, Tyler Hamby, Karen Rubin
The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. RESEARCH DESIGN AND METHODS: The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. RESULTS: Ninety-three unique entries from the US were entered into analysis...
March 26, 2018: Pediatric Diabetes
Reem Al Khalifah, Lehana Thabane, Mark A Tarnopolsky, Katherine M Morrison
BACKGROUND: To address gaps in knowledge of the longitudinal trajectory of dysglycemia in children with obesity, this study aimed to: i) Describe the changes in glycemic status over 2 years; ii) Establish a predictive model for development of pre-diabetes among children with euglycemia; and iii) Evaluate the influence of change in BMI-Z score on glycemic status. METHODS: Children aged 5-17 years entered this prospective, longitudinal study at the time of entry to a weight management program...
March 26, 2018: Pediatric Diabetes
Laura B Smith, Xiang Liu, Suzanne Bennett Johnson, Roy Tamura, Helena Elding Larsson, Simi Ahmed, Riitta Veijola, Michael J Haller, Beena Akolkar, William A Hagopian, Marian J Rewers, Jeffrey Krischer, Andrea K Steck
BACKGROUND AND OBJECTIVES: Diagnosis of type 1 diabetes often causes a negative psychological impact on families. We examined whether parents and children enrolled in The Environmental Determinants of Diabetes in the Young (TEDDY) study differ in their psychological adjustment to diabetes diagnosis compared to children diagnosed with diabetes in the community. SUBJECTS AND METHODS: TEDDY follows 8,676 children at genetic risk for type 1 diabetes from birth. Fifty-four TEDDY children diagnosed with diabetes and 54 age-matched community control children diagnosed with diabetes were enrolled...
March 26, 2018: Pediatric Diabetes
C Nylander, K Lindström, N Khalifa, E Fernell
BACKGROUND: Managing modern diabetes treatment requires efficient executive functions. Patients with attention-deficit/hyperactivity disorder (ADHD) and type 1 diabetes have poor metabolic control and present with ketoacidosis more often than patients without ADHD. OBJECTIVE: To assess whether patients with type 1 diabetes and with indications of executive problems met criteria for ADHD, and to investigate whether these patients had difficulties achieving metabolic control...
March 24, 2018: Pediatric Diabetes
Christopher M Horvat, Heba M Ismail, Alicia K Au, Luigi Garibaldi, Nalyn Siripong, Sajel Kantawala, Rajesh K Aneja, Diane S Hupp, Patrick M Kochanek, Robert S B Clark
OBJECTIVE: This study examines temporal trends in treatment-related outcomes surrounding a diabetic ketoacidosis (DKA) performance improvement intervention consisting of mandated intensive care unit admission and implementation of a standardized management pathway, and identifies physical and biochemical characteristics associated with outcomes in this population. METHODS: A retrospective cohort of 1,225 children with DKA were identified in the electronic health record by International Classification of Diseases codes and a minimum pH less than 7...
March 24, 2018: Pediatric Diabetes
Cleliani de Cassia da Silva, Ana Carolina Junqueira Vasques, Mariana Porto Zambon, Daniella Fernandes Camilo, Ana Maria De Bernardi Rodrigues, Maria Ângela Reis de Góes Monteiro Antonio, Bruno Geloneze
OBJECTIVE: To evaluate the association of the sagittal abdominal diameter (SAD) with insulin resistance (IR) and metabolic syndrome (MetS) components, and to compare SAD with waist circumference (WC). SUBJECTS/METHODS: This was a multicentre, cross-sectional study of 520 adolescents (10-18 years old). IR was assessed using the homeostasis model assessment of IR (HOMA-IR) and the hyperglycaemic clamp (n = 76). RESULTS: SAD and WC were positively correlated with HOMA-IR (r = 0...
March 24, 2018: Pediatric Diabetes
Fergus J Cameron, Ellyn Russel, Julia McCombe, Michele A O'Connell, Timothy Skinner
OBJECTIVE: The purpose of this study was to estimate clinician qualities that influence metabolic outcomes in youth with type 1 diabetes. RESEARCH DESIGN AND METHODS: Data were gathered over two 3 month periods in a large tertiary diabetes center (1500 patients, 8 clinicians) from patients with type 1 diabetes who received continuous care from each clinician. Data included sex, age, diabetes duration, insulin regimen, body mass index (BMI), insulin dose and episodes of severe hypoglycemia...
March 23, 2018: Pediatric Diabetes
Giovanni Federico, Angelo Genoni, Anna Puggioni, Alessandro Saba, Daniela Gallo, Emioli Randazzo, Alessandro Salvatoni, Antonio Toniolo
At the time of the clinical onset of type 1 diabetes (T1D), we investigated 82 pediatric cases in parallel with 117 non-diabetic controls matched by age, geographic area, and time of collection. The occurrence of an enteroviral infection was evaluated in peripheral blood using a sensitive method capable of detecting virtually all human enterovirus (EV) types. While non-diabetic controls were consistently EV-negative, 65% of T1D cases carried EVs in blood. The vitamin D status was assessed by measuring the concentration of 25-hydroxyvitamin D [25(OH)D] in serum...
March 22, 2018: Pediatric Diabetes
Owen R Phillips, Alexander K Onopa, Yevgeniya V Zaiko, Manpreet K Singh
OBJECTIVE: During childhood, the brain can consume up to 65% of total calories and a steady supply of the brain's main fuel glucose needs to be maintained. Though the brain itself is not dependent on insulin for the uptake of glucose, insulin plays an important role in energy homeostasis. Thus, risk for insulin resistance during brain development may negatively impact whole brain volume. METHODS: We investigated the link between insulin resistance and whole brain volume as measured by structural MRI in 46 unmedicated depressed and overweight youth between the ages of 9 to 17 years...
March 22, 2018: Pediatric Diabetes
Ana Laura Fitas, Catarina Martins, Luís Miguel Borrego, Lurdes Lopes, Anne Jörns, Sigurd Lenzen, Catarina Limbert
AIMS/HYPOTHESIS: Type 1 diabetes (T1D) develops in distinct stages, before and after disease onset. Whether the natural course translates into different immunologic patterns is still uncertain. This study aimed at identifying peripheral immune patterns at key time-points, in T1D children undergoing remission phase. METHODS: Children with new-onset T1D and healthy age and gender-matched controls were recruited at a paediatric hospital. Peripheral blood samples were evaluated by flow cytometry at three longitudinal time-points: onset (T1), remission phase (T2) and established disease (T3)...
March 12, 2018: Pediatric Diabetes
Bartosz Słomiński, Maria Skrzypkowska, Monika Ryba-Stanisławowska, Agnieszka Brandt
BACKGROUND/OBJECTIVE: Recent studies suggest that uric acid (UA) is a mediator of diabetic nephropathy. We hypothesized that serum UA would associate with the prevalence of diabetic nephropathy in youth with type 1 diabetes (T1D), and that this relationship would differ by sex. METHODS: We examined 120 young boys and the same number of girls with T1D. C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor α (TNF-α), UA, cystatin C serum concentrations, albumin excretion rate and blood pressure were also analyzed...
March 12, 2018: Pediatric Diabetes
Elise M Faber, Paulien M van Kampen, Agnes Clement-de Boers, Euphemia Cam Houdijk, Daniëlle Cm van der Kaay
OBJECTIVE: To evaluate the effect of the order of intake of carbohydrates, protein, and fat on postprandial glucose levels in children with type 1 diabetes (T1D). Our hypothesis was that postprandial glucose levels would be lower when fat and protein are consumed prior to carbohydrates, compared to a meal where all macronutrients are combined. METHODS: A randomized, open-label, within-subject crossover study was conducted. Twenty patients aged 7 to 17 years diagnosed with T1D for >1 year consumed 2 isocaloric meals (with similar composition) in random order...
March 12, 2018: Pediatric Diabetes
Huseyin Demirbilek, Nihal Hatipoglu, Ulku Gul, Zeynep Uzan Tatli, Sian Ellard, Sarah E Flanagan, Elisa De Franco, Selim Kurtoglu
The basic helix-loop-helix(bHLH) transcription factor, NEUROD1(also known as BETA2) is involved in the development of neural elements and endocrine pancreas. Less than 10 reports of adult-onset non-insulin dependent diabetes mellitus(NIDDM) due to heterozygous NEUROD1 mutations and two cases with permanent neonatal diabetes mellitus(PNDM) and neurological abnormalities due to homozygous NEUROD1 mutations have been published.
March 9, 2018: Pediatric Diabetes
Larry C Deeb, Hélène Dulude, Cristina B Guzman, Shuyu Zhang, Barry J Reiner, Claude A Piché, Sheetal Pradhan, Xiaotian Michelle Zhang
OBJECTIVE: This multicenter, open-label study was designed to evaluate real-world effectiveness and ease of use of nasal glucagon (NG) in treating moderate or severe hypoglycemic events in children and adolescents with type 1 diabetes (T1D). METHODS: Caregivers were trained to administer NG (3 mg) to the child/adolescent with T1D during spontaneous, symptomatic moderate or severe hypoglycemic events, observe treatment response (defined as awakening or returning to normal status within 30 minutes), and measure blood glucose (BG) levels every 15 minutes...
March 7, 2018: Pediatric Diabetes
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