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Pediatric Diabetes

Kannan Kasturi, Anthony U Onuzuruike, Shwetha Kunnam, Lauren B Shomaker, Jack A Yanovski, Stephanie T Chung
BACKGROUND: During an oral glucose tolerance test (OGTT), morphological features of the glucose curve (monophasic curve, glucose peak >30mins and 1-hr glucose ≥155mg/dL) maybe associated with higher prediabetes risk, but their reproducibility and predictive ability in adolescents with obesity are unknown. DESIGN/METHODS: Nondiabetic adolescent girls with obesity underwent a multiple-sample OGTT at baseline (n=93), 6-weeks (n=83), and 1-year (n=72). Short-term reproducibility (baseline to 6-weeks) and the predictive ability for prediabetes (baseline to 1-year) for each feature were compared to standard fasting and 2-hr OGTT diagnostic criteria...
December 6, 2018: Pediatric Diabetes
César Agostinis-Sobrinho, Sonia Gómez-Martínez, Esther Nova, Aurora Hernandez, Idoia Labayen, Antonios Kafatos, Frederic Gottand, Dénes Molnár, Marika Ferrari, Luis A Moreno, Nathalie Michels, Azahara Ruperez, Jonatan R Ruiz, Ascensión Marcos
OBJECTIVE: To evaluate the association of lifestyle patterns related to physical activity (PA), sedentariness and sleep with endocrine, metabolic and immunological health biomarkers in European adolescents. METHODS: The present cross-sectional study comprised 3528 adolescents (1845 girls) (12.5 -17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence Study. Cluster analysis was performed by including body composition, PA by accelerometry, self-reported sedentary behaviors and sleep duration...
November 24, 2018: Pediatric Diabetes
Graham David Ogle, Julia Elisabeth von Oettingen, Angie Middlehurst, Ragnar Hanas, Trevor Orchard
Optimal care for children and adolescents with type 1 diabetes is well-described in guidelines such as those of the International Society for Pediatric and Adolescent Diabetes. High-income countries can usually provide this, but the cost of this care is generally prohibitive for lower-income countries. Indeed, in most of these countries, very little care is provided by government health systems, resulting in high mortality, and high complications rates in those who do survive. As lower-income countries work towards establishing guidelines-based care, it is helpful to describe the levels of care that are potentially affordable, cost-effective, and result in substantially improved clinical outcomes...
November 23, 2018: Pediatric Diabetes
Alejandro Pérez-Bey, Víctor Segura-Jiménez, Jorge Del Rosario Fernández-Santos, Irene Esteban-Cornejo, Sonia Gómez-Martínez, Oscar L Veiga, Ascensión Marcos, Francisco B Ortega, José Castro-Piñero
BACKGROUND: The combined effect of cardiorespiratory fitness (CRF) and body mass index (BMI) on cardiovascular disease (CVD) risk in young people remains to be fully determined. We examined the individual and combined associations of CRF and BMI with clustered CVD risk factors, and the mediator role of BMI in the association between CRF and clustered CVD risk factors in children and adolescents. RESEARCH DESIGN AND METHODS: 237 children (111 girls) and 260 adolescents (120 girls) were included in this cross-sectional study...
November 22, 2018: Pediatric Diabetes
Ron S Newfield, Carrie L Graves, Robert O Newbury, Jeffrey B Schwimmer, James A Proudfoot, Daphne S Say, Ariel E Feldstein
BACKGROUND: Obesity and type 2 diabetes (T2D) are risk factors for non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH). In children with T2D and liver biopsies we investigated correlations between NAFLD/NASH and transaminase activity, A1c, lipids, and histologic changes in repeat biopsies. METHODS: Liver histology of children with T2D was evaluated using the NASH CRN scoring system and NAFLD activity score (NAS). We included results ≤ 6 months from biopsy and A1c nearest biopsy...
November 22, 2018: Pediatric Diabetes
Michael C Riddell, Dessi P Zaharieva, Michael Tansey, Eva Tsalikian, Gil Admon, Zoey Li, Craig Kollman, Roy W Beck
OBJECTIVE: To evaluate the pattern of change in blood glucose concentrations and hypoglycemia risk in response to prolonged aerobic exercise in adolescents with type 1 diabetes (T1D) that had a wide range in pre-exercise blood glucose concentrations. RESEARCH DESIGN AND METHODS: Individual blood glucose responses to prolonged (~60 min) moderate-intensity exercise were profiled in 120 youth with T1D. RESULTS: The mean pre-exercise blood glucose concentration was 178±66 mg/dL, ranging from 69 to 396 mg/dL, while the mean change in glucose during exercise was -76±55 mg/dL (mean±SD), ranging from +83 to -257 mg/dL...
November 22, 2018: Pediatric Diabetes
Alexandra Monzon, Ryan McDonough, Lisa J Meltzer, Susana R Patton
Youth with type 1 diabetes mellitus (T1D) experience more sleep disturbances and shorter sleep durations compared to their healthy peers. Researchers have now uncovered the negative mental health and physical health outcomes associated with poor sleep in youth with T1D. The field of T1D sleep research currently operates under the broad notion that sleep behaviors impact treatment adherence, which ultimately lead to worse long-term health outcomes. This model however does not explain how behavior influences T1D management and sleep outcomes on a day-to-day basis, leading to difficulties in providing tailored treatment recommendations...
November 17, 2018: Pediatric Diabetes
Michelle C Gorecki, Helen J Binns
Thank you to Hagman et al for analyzing data from a past study to present the recent paper "Predictors of responses to clinic based childhood obesity care". This article is protected by copyright. All rights reserved.
November 12, 2018: Pediatric Diabetes
Nicole Glaser, Nathan Kuppermann
The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). In June 2018, the results from the Fluid Therapies Under Investigation in DKA (FLUID) Trial conducted in the Pediatric Emergency Care Applied Research Network (PECARN) were published...
November 11, 2018: Pediatric Diabetes
Katherine Silvis, Carin Andrén Aronsson, Xiang Liu, Ulla Uusitalo, Jimin Yang, Roy Tamura, Åke Lernmark, Marian Rewers, William Hagopian, Jin-Xiong She, Olli Simell, Jorma Toppari, Anette Ziegler, Beena Akolkar, Jeffrey Krischer, Suvi M Virtanen, Jill M Norris
OBJECTIVE: We investigated the association between maternal use of vitamin D and omega-3 fatty acids (n-3 FAs) supplements during pregnancy and risk of islet autoimmunity (IA) in the offspring. METHODS: The Environmental Determinants of Diabetes in the Young (TEDDY) Study is prospectively following 8676 children with increased genetic risk for type 1 diabetes in Finland, Germany, Sweden, and the US. Blood samples were collected every 3 months between 3 and 48 months of age then every 6 months thereafter to determine persistent IA...
November 8, 2018: Pediatric Diabetes
Valentino Cherubini, Rosaria Gesuita, Edlira Skrami, Ivana Rabbone, Riccardo Bonfanti, Claudia Arnaldi, Giuseppe D'Annunzio, Annapaola Frongia, Fortunato Lombardo, Elvira Piccinno, Riccardo Schiaffini, Sonia Toni, Stefano Tumini, Davide Tinti, Paola Cipriano, Nicola Minuto, Lorenzo Lenzi, Lucia Ferrito, Claudia Ventrici, Federica Ortolani, Ohad Cohen, Andrea Scaramuzza
OBJECTIVES: To assess the optimal setting of the predictive low glucose management (PLGM) algorithm for preventing exercise-induced hypoglycemia in adolescents with type 1 diabetes. METHODS: Thirty-four adolescents, 15-20 y, wearing PLGM system, were followed during 3 days exercise during a diabetes camp. PLGM threshold was set at 70 mg/dl between 8 am-10 pm and 90 mg/dl during 10 pm-8 am. Adolescents were divided in group A and B, with PLGM threshold at 90 and 70 mg/dl, respectively during exercise...
October 31, 2018: Pediatric Diabetes
Mona Hussein El-Samahy, Azza Abdel Gawad Tantawy, Amira Abdel Moneam Adly, Abeer Abdelmaksoud, Eman Abdel Rahman Ismail, Nouran Yousef Salah El-Din
BACKGROUND: Disturbances of glucose metabolism are common in β-thalassemia major (β-TM). AIM: This study was conducted to assess the pattern of glucose homeostasis in pediatric β-TM patients comparing oral glucose tolerance test (OGTT) and continuous glucose monitoring system (CGMS). METHODS: Two-hundred β-TM patients were studied and those with random blood glucose (RBG) ≥7.8 mmol/L (140 mg/dL) were subjected to OGTT, insertion of CGMS and measurement of fasting C peptide, fasting insulin and HbA1c...
October 31, 2018: Pediatric Diabetes
Holly K O'Donnell, Cari Berget, Jennalee S Wooldridge, Kimberly A Driscoll
Hypoglycemia is a common and dangerous complication of type 1 diabetes (T1D). Although some worry about hypoglycemia is adaptive, some individuals develop severe and impairing anxiety symptoms about hypoglycemic episodes. This presentation, known as severe fear of hypoglycemia (FOH), is similar to a specific phobia, and becomes problematic when it interferes with one's quality of life or T1D management. Although FOH is common, there have not yet been any treatment studies to address severe and impairing levels of FOH in the T1D population...
October 28, 2018: Pediatric Diabetes
Iain P Fraser, Naomi D Neufeld, Larry A Fox, Mark S Kipnes, Tracie L Miller, Philip S Zeitler, Henry Rodriguez, Jocelyn H Gilmartin, Susan J Lee, Jaclyn K Patterson, Xiujiang S Li, Lata Maganti, Wen-Lin Luo, Daniel A Tatosian, S Aubrey Stoch
OBJECTIVE: To evaluate the single-dose pharmacokinetics, pharmacodynamics and safety of sitagliptin in pediatric patients with type 2 diabetes mellitus (T2DM) STUDY DESIGN: This was a randomized, placebo-controlled, double-blind evaluation of sitagliptin in 35 patients 10-17 years old with T2DM at 7 clinical research sites. The safety, tolerability, pharmacokinetics and pharmacodynamics (dipeptidyl peptidase-4 inhibition and aspects of glucose metabolism) of single doses of 50, 100, and 200 mg were assessed...
October 22, 2018: Pediatric Diabetes
Rebecca J Crochiere, Amy Hughes Lansing, Ann Carracher, Catherine Stanger
Adolescents with type 1 diabetes may be at elevated risk for somatic problems. This study used cross-sectional, baseline data from an intervention to examine if problems with executive function (EF) were associated with greater somatic problems independent of poor adherence and disease severity in adolescents with type 1 diabetes and above target glycemic control. In addition, it examined whether certain types of EF skills, i.e., metacognitive and behavior regulation, accounted for variance in somatic problems...
October 22, 2018: 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 J Cameron, Moore Bryanna, Gillam Lynn
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 (ITPs). 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 ITPs 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
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
BACKGROUND/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
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