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Pediatric Diabetes

Diva D De Leon, Charles A Stanley
Hypoglycemia continues to be an important cause of morbidity in neonates and children. Prompt diagnosis and management of the underlying hypoglycemia disorder is critical for preventing brain damage and improving outcomes. Congenital hyperinsulinism (HI) is the most common and severe cause of persistent hypoglycemia in neonates and children. Recent discoveries of the genetic causes of HI have improved our understanding of the pathophysiology, but its management is complex and requires the integration of clinical, biochemical, molecular, and imaging findings to establish the appropriate treatment according to the subtype...
October 18, 2016: Pediatric Diabetes
Mark D DeBoer, Daniel R Cherñavvsky, Katarina Topchyan, Boris P Kovatchev, Gary L Francis, Marc D Breton
OBJECTIVE: To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). MATERIALS AND METHODS: In a randomized, cross-over trial, adolescents with T1D age 13 - 18 years were enrolled to receive on separate days either the unmodified UVa AP (stdAP) or an AP system connected to a portable HR monitor (AP-HR) that triggered an exercise algorithm for blood glucose (BG) control...
October 13, 2016: Pediatric Diabetes
Eleanor R Gunn, Benjamin B Albert, Paul L Hofman, Wayne S Cutfield, Alistair J Gunn, Craig A Jefferies
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014...
October 11, 2016: Pediatric Diabetes
Luke Baldelli, Ben Flitter, Laura Pyle, David M Maahs, Georgeanna Klingensmith, Robert Slover, G Todd Alonso
OBJECTIVE: Pediatric patients in Colorado with new onset type 1 diabetes (T1D) presenting with diabetic ketoacidosis (DKA) increased from 29.9% to 46.2% from 1998 to 2012. The purpose of this study was to compare differences between patients with newly diagnosed T1D who presented in DKA with those who did not across three domains: sociodemographic factors, access to medical care, and medical provider factors, aiming to identify potential targets for intervention. METHODS: Sixty-one patients <17 years of age with T1D duration <6 months completed the questionnaire...
October 11, 2016: Pediatric Diabetes
Agnieszka Szypowska, Katarzyna Dżygało, Marta Wysocka-Mincewicz, Artur Mazur, Lucyna Lisowicz, Iwona Ben-Skowronek, Joanna Sieniawska, Bożenna Klonowska, Dorota Charemska, Jolanta Nawrotek, Irena Jałowiec, Artur Bossowski, Milena Jamiołkowska, Beata Pyrżak, Izabela Rogozińska, Mieczysław Szalecki
AIM: Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17. METHODS: The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. The population living in these areas accounts for 35% of the Polish population...
October 11, 2016: Pediatric Diabetes
Delphine Martin, Caroline Elie, Claire Dossier, Cécile Godot, Rémi Gagnayre, Carine Choleau, Michel Cahané, Jean-Jacques Robert
OBJECTIVE: To evaluate diabetes knowledge and skills (DKS) in adolescents (>10 year) with type 1 diabetes (T1D) and their parents, and its effect on glycemic control. METHODS: A ready-to-use program and a standardized questionnaire comprising 50 true-false questions based on this program, were elaborated by a National Committee, to help dispensing education at diagnosis of T1D. The questionnaire was completed by 2933 T1D patients (49% girls, 51% boys; 14.1 ± 2...
October 11, 2016: Pediatric Diabetes
Yukiko Hashimoto, Sumito Dateki, Masakazu Hirose, Kenichi Satomura, Hirotake Sawada, Haruo Mizuno, Shigetaka Sugihara, Koichi Maruyama, Tatsuhiko Urakami, Hidenori Sugawara, Kenji Shirai, Tohru Yorifuji
BACKGROUND: There are few reports pertaining to Asian patients with neonatal diabetes mellitus (NDM) caused by activating mutations in the ATP-sensitive potassium channel genes (KATP-NDM). OBJECTIVES: To elucidate the characteristics of Japanese patients with KATP-NDM. METHODS: By the amplification and direct sequencing of all exons and exon-intron boundaries of the KCNJ11 and ABCC8 genes, 25 patients with KATP-NDM were identified from a total of 70 patients with NDM...
September 29, 2016: Pediatric Diabetes
Małgorzata Pawłowicz, Rafał Filipów, Grzegorz Krzykowski, Anna Stanisławska-Sachadyn, Lucyna Morzuch, Julia Kulczycka, Anna Balcerska, Janusz Limon
BACKGROUND: Genotype-phenotype studies in type 1 diabetes (T1DM) patients are needed for further development of therapy strategies. OBJECTIVE: Our aims were to investigate the distribution of selected PTPN22 and FCRL3 gene polymorphisms and their associations with clinical course of disease in children with newly diagnosed T1DM from the Pomeranian region of Poland. SUBJECTS/METHODS: The prospective, longitudinal study of 147 children with newly diagnosed T1DM-autoimmune subtype was conducted...
September 12, 2016: Pediatric Diabetes
Christian Jung, Michael Lichtenauer, Daniela Strodthoff, Holger Winkels, Bernhard Wernly, Christina Bürger, Uran Kamchybekov, Esther Lutgens, Hans-Reiner Figulla, Norbert Gerdes
BACKGROUND: Obesity represents a major problem for patients and health care systems in most industrialized countries. A chronic inflammatory state in obese individuals leads to disease conditions associated with activation of cellular immune mechanisms. Here, we sought to investigate the role of Th1-, Th2-, and Th17-related cytokines in overweight adolescents and mice on a high-fat diet. METHODS: Plasma samples were obtained from 79 male adolescents aged 13-17 years...
September 6, 2016: Pediatric Diabetes
Shivani Agarwal, Katharine C Garvey, Jennifer K Raymond, Mark H Schutta
BACKGROUND: Healthcare transition from pediatric to adult care for young adults (YA) with type 1 diabetes (T1D) is associated with risk of adverse outcomes. Consensus recommendations exist from US professional societies on transition care for YA with T1D, but it is not known whether they have been widely adopted. We describe experiences, barriers, and provider characteristics associated with transition care in a national sample of pediatric endocrinologists. METHODS: US pediatric endocrinologists identified through the American Medical Association Physician Masterfile were sent an electronic survey...
August 31, 2016: Pediatric Diabetes
Kristen E McCabe, Allison J Pollock, Jennifer L Rehm, Kenneth B DeSantes
The mainstay of treatment for type 1 diabetes (T1D) is exogenous insulin. Here, we report a case in which exogenous insulin requirements were eliminated after an allogeneic hematopoietic stem cell transplant for aplastic anemia in a pediatric patient recently diagnosed with T1D, and explore the validity of this approach compared with current treatments.
August 30, 2016: Pediatric Diabetes
Karen A Landmeier, Monica Lanning, David Carmody, Siri Atma W Greeley, Michael E Msall
OBJECTIVES: Mutations in KCNJ11 are the most common cause of permanent neonatal diabetes mellitus (NDM). Approximately 25% of patients have obvious neurological dysfunction, but whether milder related problems might be more common has been unclear. We sought to assess the prevalence of parental concerns about learning, behavior, attention deficit hyperactivity disorder (ADHD), social competency, and sleep in subjects with KCNJ11-related NDM compared to unaffected sibling controls. STUDY DESIGN: Subjects or their guardians in the University of Chicago Monogenic Diabetes Registry completed a survey examining learning, behavior, ADHD and sleep...
August 24, 2016: Pediatric Diabetes
Russell M Viner, Billy White, Rakesh Amin, Catherine Peters, Amal Khanolkar, Deborah Christie, Peter C Hindmarsh
BACKGROUND: There is marked variation in diabetes outcomes for children and adolescents across the UK. We used modelling techniques to examine the independent contributions of deprivation, ethnicity, insulin pump use, and health service use on HbA1c trajectories across adolescence. METHODS: Prospective data from a large UK Paediatric & Adolescent Diabetes Service on subjects with type 1 diabetes (T1D) aged 9-17 years from January 2008 to December 2013: 2560 HbA1c datapoints were available on 384 patients [193 (50...
August 18, 2016: Pediatric Diabetes
Jessica E Phillips, Jennifer J Couper, Megan A S Penno, Leonard C Harrison
The incidence of type 1 diabetes globally has increased dramatically over the last 50 years. Proposed environmental reasons for this increase mirror the modern lifestyle. Type 1 diabetes can be viewed as part of the non- communicable disease epidemic in our modern society. Meanwhile rapidly evolving new technologies are advancing our understanding of how human microbial communities interface with the immune system and metabolism, and how the modern pro-inflammatory environment is changing these communities and contributing to the rapid rise of non-communicable disease...
August 15, 2016: Pediatric Diabetes
Doerte Hilgard, Katja Konrad, Michael Meusers, Bela Bartus, Klaus-Peter Otto, Rudolf Lepler, Edith Schober, Esther Bollow, Reinhard W Holl
BACKGROUND: The interaction between type 1 diabetes mellitus (T1DM) and attention deficit hyperactivity disorder (ADHD) in children and adolescents has been studied rarely. We aimed to analyse metabolic control in children and adolescents with both T1DM and ADHD compared to T1DM patients without ADHD. PATIENTS AND METHODS: Auxological and treatment data from 56.722 paediatric patients (<20 years) with T1DM in the multicentre DPV (Diabetes Prospective Follow-up Initiative) registry were analysed...
August 15, 2016: Pediatric Diabetes
Christine L Chan, Laura Pyle, Rose Morehead, Amy Baumgartner, Melanie Cree-Green, Kristen J Nadeau
BACKGROUND: Hyperglycemia has traditionally been considered a major contributor to insulin resistance (IR) in type 1 diabetes (T1D), yet studies examining the relationship between HbA1c and IR are conflicting. Glucose measures captured by continuous glucose monitoring (CGM) (eg, peak glucose, standard deviation, hypoglycemia) in youth have not been explored as predictors of insulin sensitivity (IS). OBJECTIVE: Assess the relationship between IS and glycemia in youth with T1D and type 2 diabetes (T2D)...
August 9, 2016: Pediatric Diabetes
Mandana Moosavi, Jade Séguin, Constantin Polychronakos
OBJECTIVE: To analyze the correlation between duration and depth of honeymoon phase in patients with type 1 diabetes (T1DM) and autoimmunity risk loci. METHODS: From a database of 567 individuals with clinical data, we selected 210 patients for whom we had dense genotyping results of single-nucleotide polymorphisms (SNPs) from our previous genome-wide association studies (GWAS) or targeted genotyping data. Using PLINK software, we analyzed the association between time spent in honeymoon phase as our quantitative trait, and 24 known autoimmunity predisposing SNPs...
August 9, 2016: Pediatric Diabetes
Avital Adler, Michal-Yackobovitz Gavan, Riva Tauman, Moshe Phillip, Shlomit Shalitin
BACKGROUND: Sleep has been shown to impact glucose regulation, and may be altered in persons with type 1 diabetes (T1D). OBJECTIVE: To assess sleep characteristics in T1D patients and the possible association between sleep disturbances and diabetes-related variables. SUBJECTS AND METHODS: In a cross-sectional study in 154 young patients with T1D and 154 age-range-matched nondiabetic controls subjective sleep characteristics were assessed using validated questionnaires: Sleep Disturbance Scale for Children (SDSC), Adolescent Sleep-Wake Scale (ASWS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS)...
August 3, 2016: Pediatric Diabetes
Alejandro F Siller, Heather Lugar, Jerrel Rutlin, Jonathan M Koller, Katherine Semenkovich, Neil H White, Ana Maria Arbelaez, Joshua Shimony, Tamara Hershey
OBJECTIVE: Differences in cognition and brain structure have been found in youth with type 1 diabetes compared with controls, even after relatively short disease duration. To determine whether severity of clinical presentation contributes to these differences, we obtained structural magnetic resonance imaging (MRI) scans in youth ages 7-17 who were either newly diagnosed with type 1 diabetes (<3.5 months from diagnosis, n  = 46) or a sibling without diabetes (n = 28). RESEARCH DESIGN AND METHODS: Severity of presentation was measured by the presence of diabetic ketoacidosis (DKA) and degree of hyperglycemia exposure [hemoglobin A1c (HbA1c)] at diagnosis...
August 2, 2016: Pediatric Diabetes
Pierluigi Marzuillo, Anna Di Sessa, Giuseppina Rosaria Umano, Luigia Nunziata, Grazia Cirillo, Laura Perrone, Emanuele Miraglia Del Giudice, Anna Grandone
BACKGROUND: The N-acetyltransferase 2 ( NAT2 ) A803G polymorphism has been associated with decreased insulin sensitivity in a large adult population with the A allele associated with insulin-resistance-related traits. OBJECTIVE: Evaluate the association of this polymorphism with anthropometric and metabolic parameters in obese children and adolescents. SUBJECTS: A total of 748 obese children and adolescents were enrolled. METHODS: Anthropometric and laboratory data were collected...
August 2, 2016: Pediatric Diabetes
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