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Pediatric Diabetes

F J Cameron, K Garvey, K K Hood, C L Acerini, E Codner
-Pre-conceptional counseling should begin early during puberty -New recommendations for type of contraception that should be used for girls are made. -Transition programs and care for young adults are now included. -Mental health problems that may be associated with poor metabolic control should be treated early. -Adherence remains that greatest impediment to successful deployment of diabetes-related technologies. This article is protected by copyright. All rights reserved.
June 13, 2018: Pediatric Diabetes
Joseph I Wolfsdorf, Nicole Glaser, Michael Agus, Maria Fritsch, Ragnar Hanas, Arleta Rewers, Mark A Sperling, Ethel Codner
Recommendations concerning fluid management have been modified to reflect recent findings from a randomized controlled clinical trial showing no difference in cerebral injury in patients rehydrated at different rates with either 0.45% or 0.9% saline. This article is protected by copyright. All rights reserved.
June 13, 2018: Pediatric Diabetes
Sarah C Nyirjesy, Saba Sheikh, Denis Hadjiliadis, Diva D De Leon, Amy J Peleckis, Jack N Eiel, Christina Kubrak, Darko Stefanovski, Ronald C Rubenstein, Michael R Rickels, Andrea Kelly
BACKGROUND: Patients with pancreatic insufficient cystic fibrosis (PI-CF) meeting standard criteria for normal glucose tolerance display impaired β-cell secretory capacity and early-phase insulin secretion defects. We sought evidence of impaired β-cell secretory capacity, a measure of functional β-cell mass, amongst those with early glucose intolerance (EGI), defined as 1-hour OGTT glucose ≥155mg/dL (8.6 mmol/L). METHODS: A cross-sectional study was conducted in the Penn and CHOP Clinical & Translational Research Centers...
June 8, 2018: Pediatric Diabetes
Erica Burry, Noah Ivers, Farid H Mahmud, Rayzel Shulman
BACKGROUND: Diabetes registries contain vast amounts of data that can be used for quality improvement (QI) and are foundational elements of learning health systems; infrastructure to share data, create knowledge rapidly and inform decisions to improve health outcomes. QI interventions using adult diabetes registries are associated with improved glycemic control, complication screening rates, and reduced hospitalizations; pediatric data are limited. OBJECTIVE: To evaluate the effects of QI strategies that use pediatric diabetes registry data on care processes, organization of care, and patient outcomes...
June 7, 2018: Pediatric Diabetes
Mary B Abraham, Timothy W Jones, Diana Naranjo, Beate Karges, Abiola Oduwole, Martin Tauschmann, David M Maahs
The ISPAD Hypoglycemia guidelines have been harmonized with the International Hypoglycemia Study Group (IHSG). This article is protected by copyright. All rights reserved.
June 5, 2018: Pediatric Diabetes
Maaret Turtinen, Taina Härkönen, Anna Parkkola, Jorma Ilonen, Mikael Knip
OBJECTIVE: This study tested the hypothesis that girls have a more aggressive disease process than boys at the diagnosis of type 1 diabetes (T1D). SUBJECTS AND METHODS: Demographic and clinical characteristics, the humoral autoantibody profile and the genetic risk assessed by the presence of HLA DR-DQ haplotypes were analyzed by sex in 4993 children and adolescents diagnosed with T1D between January 2003 and December 2016. RESULTS: A clear male preponderance (56...
June 3, 2018: Pediatric Diabetes
Stuart Chalew, Mahmoud Hamdan
INTRODUCTION: Blacks have been reported to have higher HbA1c than Whites even after adjustment for differences in blood glucose levels. Potentially glucose-independent racial disparity in HbA1c is an artifact of glucose ascertainment methods. In order to test this possibility we examined the relationship of HbA1c with race after adjustment for concurrent fructosamine level as a surrogate for mean blood glucose (MBG). METHODS: Youth with T1D self-identified as either Black or White had blood drawn for HbA1c, fructosamine CBC, ferritin, and soluable transferrin receptor (sTfR) at a clinic visit...
May 28, 2018: Pediatric Diabetes
Merav Margolis-Gil, Michal Yackobovitz-Gavan, Moshe Phillip, Shlomit Shalitin
BACKGROUND/AIMS: Childhood obesity and associated metabolic comorbidities is a major global health concern. Metabolically healthy obesity (MHO) may represent a subgroup of individuals in which excessive body fat accumulation does not lead to adverse metabolic effects. We aimed to determine the prevalence of MHO among obese Israeli children and adolescents and to find predictors for metabolically unhealthy obesity (MUO). METHODS: In a retrospective study, demographic, anthropometric, lifestyle, and cardiometabolic data were retrieved from medical records of patients with a BMI >95th percentile aged 6-17...
May 26, 2018: Pediatric Diabetes
Alison K Calkins-Smith, Arwen M Marker, Mark A Clements, Susana R Patton
Adherence to treatment regimen is associated with improved glycemic control and is particularly problematic during adolescence for those with type 1 diabetes mellitus (T1DM). Both glycemic control and adherence may be negatively impacted by poor psychological outcomes in adolescence, such as depressive symptoms and low hopefulness. The purpose of this study was to examine associations between the mealtime insulin bolus score (BOLUS), a more robust proxy measure of adherence than frequency of blood glucose monitoring or self-report, with depressive symptoms, hope, and hemoglobin A1c (HbA1c)...
May 24, 2018: Pediatric Diabetes
N H Birkebaek, J Kahlert, R Bjarnason, A K Drivvoll, A Johansen, E Konradsdottir, A Pundziute-Lyckå, U Samuelsson, T Skrivarhaug, J Svensson
BACKGROUND: Intensified insulin therapy may increase body weight and cause obesity. This study compared body mass index standard deviation score (BMISDS) and obesity rate in children with type 1 diabetes (T1D) in Denmark, Iceland, Norway and Sweden, and uncovered predictors for increasing BMISDS. METHODS: Data registered in the Nordic national childhood diabetes databases during the period 2008-2012 on children below 15 years with T1D for more than 3 months were compiled, including information on gender, age, diabetes duration, hemoglobin A1c (HbA1c ), insulin dose, severe hypoglycemia (SH), treatment modality, height and weight...
May 21, 2018: Pediatric Diabetes
Tamara S Hannon, Chandan Saha, Aaron E Carroll, Kelly N B Palmer, Erin O'Kelly Phillips, David G Marrero
INTRODUCTION: Trials in adults have demonstrated that interventions targeting lifestyle are effective in preventing or delaying type 2 diabetes (T2D). To address this need in youth, we developed ENCOURAGE Healthy Families (ENCOURAGE), based on the US Diabetes Prevention Program (DPP). STUDY DESIGN: Here we present results of the ENCOURAGE randomized, comparative effectiveness trial in which we evaluated ENCOURAGE delivered to 1) mothers only, and 2) mothers with added content delivered to their children...
May 20, 2018: Pediatric Diabetes
Cathy Anne Pinto, Jeanette M Stafford, Tongtong Wang, R Ravi Shankar, Jean M Lawrence, Grace Kim, Catherine Pihoker, Ralph B D'Agostino, Dana Dabelea
OBJECTIVE: The aim of the study was to describe recent medication patterns and changes in medication patterns and glycemic control in adolescents and young adults with incident type 2 diabetes (T2D). METHODS: Using data from the SEARCH for Diabetes in Youth Study, we conducted a cross-sectional analysis of treatments for adolescents and young adults with incident T2D in two periods (2002-2005 vs. 2008/2012), and a longitudinal analysis of medications and glycemic control for a subset with baseline and follow-up visits...
May 15, 2018: Pediatric Diabetes
Niral J Patel, Kimberly L Savin, Sachini N Kahanda, Beth A Malow, Lauren A Williams, Gray Lochbihler, Sarah S Jaser
OBJECTIVE: To describe adolescents' sleep on school and weekend nights using multiple methods, and to examine the links between sleep variability, quality and duration with diabetes indicators. METHODS: Adolescents with type 1 diabetes (N=65, mean age=15.0, 52.3% female, mean HbA1c=8.9% or 74 mmol/mol) wore an actigraph and kept daily diaries recording sleep, activities, and blood glucose monitoring (BGM) habits for at least 7 days. Average daily BGM and blood glucose levels (BG) were obtained through glucometer downloads...
April 30, 2018: Pediatric Diabetes
Chao Li, Ralph B D'Agostino, Dana Dabelea, Angela D Liese, Elizabeth J Mayer-Davis, Russell Pate, Anwar T Merchant
BACKGROUND: Few studies have evaluated the prospective association of eating frequency with HbA1c levels and cardiovascular disease risk markers among youth with diabetes. OBJECTIVE: To examine the 5-year longitudinal association of eating frequency with HbA1c and serum lipid levels among youth with type 1 diabetes (T1D) or type 2 diabetes (T2D). METHODS: 1,049 youth (≥10 years old) with incident T1D (n=821) or T2D (n=228) who participated in the SEARCH for Diabetes in Youth Study were included...
April 30, 2018: Pediatric Diabetes
Marie-Ève Robinson, Ketly Altenor, Christopher Carpenter, Ric Bonnell, Eddy Jean-Baptiste, Julia von Oettingen
BACKGROUND: Ophthalmic complications of pediatric diabetes are rare, and rates are unknown in Haitian youth. OBJECTIVES: Determine the prevalence and predictors of diabetic retinopathy (DR) and cataracts in a cohort of Haitian youth with insulin-treated diabetes. METHODS: We performed a cross-sectional retrospective review of pediatric patients with diabetes from a pediatric chronic disease center in Haiti, from Dec 1, 2012 to Nov 1, 2016...
April 26, 2018: Pediatric Diabetes
T M Kapellen, S Müther, A Schwandt, J Grulich-Henn, B Schenk, K O Schwab, W Marg, R W Holl
OBJECTIVE: There is evidence that transition from pediatric to adult health care is frequently associated with deterioration of health in youths with type 1 diabetes (T1D). The aim of this study was to compare metabolic control, acute complications and microvascular complications in adolescents and young adults before and after transfer to an adult treatment center with respect to the time between first visit in the adult center and last visit in pediatric treatment. METHODS: All data were collected during routine care and retrieved from the German/Austrian DPV database...
April 25, 2018: Pediatric Diabetes
Caiqi Du, Cai Zhang, Wei Wu, Yan Liang, Anru Wang, Shimin Wu, Yue Zhao, Ling Hou, Qin Ning, Xiaoping Luo
BACKGROUND AND AIMS: A novel bioactive peptide, mitochondrial-derived peptide (MOTS-c), has recently attracted attention as a potential prevention or therapeutic option for obesity and type 2 diabetes mellitus (T2DM). MOTS-c profiles have not yet been reported in human obesity and T2DM. We aimed to determine circulating MOTS-c levels in obesity and explore the association between MOTS-c levels and various metabolic parameters. METHODS: In this case-control study, 40 obese children and adolescents (27 males) and 57 controls (40 males) were recruited in the Hubei Province of China in 2017...
April 25, 2018: Pediatric Diabetes
Kevin R Short, Lauren V Pratt, April M Teague
We measured the effect of an aerobic exercise session on postprandial glucose control in adolescents with habitually low-physical activity. The goal was to determine if the acute or residual response of exercise was altered in people who are overweight/obese (OW/Ob). Eleven normal weight, body mass index (NW, BMI = 48 ± 13 percentile) and 12 OW/Ob (BMI = 91 ± 5 percentile) participants completed 3 trials. In the no exercise (No Ex) trial, participants rested quietly before and after consuming a test meal...
April 23, 2018: Pediatric Diabetes
Mohamed Abo El-Asrar, Eman Abdel Rahman Ismail, Rasha Adel Thabet, Ashraf Sayed Kamel, Sameh NehmedAllah
BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with serious micro-vascular and macro-vascular complications. Osteopontin (OPN) has emerged as a strong predictor of incipient diabetic nephropathy and a first-ever cardiovascular event in adults with T1DM. OPN is linked to coronary atherosclerosis in type 2 diabetes. The aim of the study was to test the hypothesis that OPN could be a potential marker for micro-vascular complications in children and adolescents with T1DM and we assessed its relation to carotid and aortic intima media thickness (CIMT and AIMT) as non-invasive index for subclinical atherosclerosis...
April 23, 2018: 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 mellitus (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 2 time points, 18 months apart...
April 19, 2018: Pediatric Diabetes
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