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Pediatric Diabetes

Paulina Ortiz Rubio, Adeolu Oladunjoye, Michael S D Agus, Garry M Steil
BACKGROUND: Increased daytime activity in children with type I diabetes mellitus (T1DM) is associated with increased risk of hypoglycemia. OBJECTIVE: To determine whether an automated weekly review of accelerometer, continuous glucose monitoring (CGM), and insulin pump data, could be used to identify children with increased risk of nighttime hypoglycemia and preemptively adjust the nighttime basal insulin profile according to daytime activity. RESEARCH AND DESIGN METHODS: Clinical trial of children with T1DM on insulin pump and CGM therapy...
August 17, 2018: Pediatric Diabetes
Jannet Svensson, Anke Schwandt, Daniele Pacaud, Jacques Beltrand, Niels Birkebaek, Roque Cardona-Hernandez, Kristina Castell, Sofia Castro, Valentino Cherubini, Declan Cody, Naama Fisch, Dhruvi Hasnani, Olga Kordonouri, Ioanna Kosteria, Andrea Luczay, Auste Pundziute-Lyckå, Claudio Maffeis, Barbara Piccini, Poran Luxmi, Zdenek Sumnik, Carine de Beaufort
OBJECTIVE: To describe the association between height, demographics and treatment in youths with Type 1 Diabetes participating in an international network for pediatric diabetes centers (SWEET). METHODS: Data were collected from 55 centers with documented patients' height. All subjects below 20 years of age, diabetes duration >1 year, and without celiac disease were included. WHO growth charts were used to calculate height and BMI z-scores. Multiple hierarchic regression models adjusting for known confounders were applied...
August 13, 2018: Pediatric Diabetes
Tatsuhiko Urakami, Midori Miyata, Kei Yoshida, Yusuke Mine, Remi Kuwabara, Masako Aoki, Junichi Suzuki
OBJECTIVE: To analyze changes in the annual incidence of school students with type 2 diabetes detected by urine glucose screening at schools in the Tokyo Metropolitan Area during 1975-2015. METHODS: Trend in temporal changes in the annual incidence rate were analyzed using a joinpoint regression model and the joinpoints. Annual percent change (APC) was calculated for each segmented line regression. Average annual percent change (AAPC) was also calculated for the whole period analyzed...
August 12, 2018: Pediatric Diabetes
Danya A Fox, Nazrul Islam, Shazhan Amed
BACKGROUND AND OBJECTIVES: To access care, pediatric type 1 diabetes (T1D) patients living in British Columbia (BC), Canada, travel to the sole tertiary pediatric hospital (BC Children's Hospital; BCCH), or they receive community care from pediatric endocrinologists and/or pediatricians. We sought to determine whether HbA1C and patient reported outcomes were associated with (i) distance to clinic and (ii) tertiary vs. community care. METHODS: Patients were recruited from T1D clinics across BC...
August 12, 2018: Pediatric Diabetes
Melanie Heinrich, Nicole Maison, Peter Achenbach, Robin Assfalg, Sonja Braig, Dominik Böcker, Desiree Dunstheimer, Uwe Ermer, Antonia Gavazzeni, Eva-Maria Gerstl, Sandra Hummel, Kerstin Kick, Herbert Müller, Nicole Nellen-Hellmuth, Christian Ockert, Marina Sindichakis, Stefanie Tretter, Katharina Warncke, Anette-Gabriele Ziegler, Andreas Beyerlein
AIMS: In children with presymptomatic type 1 diabetes, intermittent hyperglycemia and rising HbA1c levels are a known signal of progression towards insulin-dependency. Episodes of hypoglycemia, however, have also been reported in one published case. We investigated the prevalence of hypoglycemia and its association with disease progression in children with presymptomatic type 1 diabetes. METHODS: We compared the frequency of hypoglycemic fasting blood glucose levels (<60 mg/dl) in 48 autoantibody negative and 167 multiple beta-cell autoantibody positive children aged 2-5 years...
August 11, 2018: Pediatric Diabetes
Antoinette Moran, Kubendran Pillay, Dorothy Becker, Andrea Granados, Shihab Hameed, Carlo L Acerini
Cystic fibrosis (CF) is the most common lethal genetic autosomal recessive disease in Caucasians, with a worldwide prevalence of 1 in ~2500 live births. Cystic fibrosis related diabetes (CFRD) is the most common co-morbidity in CF. There are important pathophysiologic differences between CFRD and type 1 and type 2 diabetes Table 1, which necessitate a unique approach to diagnosis and management. Factors specific to CF which impact glucose metabolism include the loss of total islets leading to both insulin and glucagon deficiency, chronic and acute inflammation and infection which cause fluctuating insulin resistance, a requirement for high caloric intake because of increased energy expenditure and malabsorption, risk of life-threatening malnutrition, and gut abnormalities including delayed gastric emptying, altered intestinal motility, and liver disease...
August 9, 2018: Pediatric Diabetes
Natasa Bratina, Gun Forsander, Francesca Annan, Tim Wysocki, Jessica Pierce, Luis Eduardo Calliari, Danièle Pacaud, Peter Adolfsson, Klemen Dovč, Angie Middlehurst, Peter Goss, Jennifer Goss, Staffan Janson, Carlo L Acerini
The average global incidence rates of children newly diagnosed with type 1 diabetes (T1D) is increasing by 3 to 4% per annum (1). Many countries have also reported that children are much younger at the time of diagnosis (2), with the greatest increases in incidence rate observed in the those aged under 5 years (3). This article is protected by copyright. All rights reserved.
August 7, 2018: Pediatric Diabetes
Lori M Laffel, Catarina Limbert, Helen Phelan, Anju Virmani, Jamie Wood, Sabine E Hofer
The tried and true "Back to the Future" approach of frequent monitoring of glucose and ketones, preferably of blood over urine ketones, with timely administration of supplemental insulin along with 24 hour, 7 day a week access to expert health care team advice can successfully manage sick days and prevent progression to DKA in young persons with insulin treated diabetes. This article is protected by copyright. All rights reserved.
August 6, 2018: Pediatric Diabetes
Kim C Donaghue, Loredana Marcovecchio, R Paul Wadwa, Emily Y Chew, Tien Wong, Eduardo Calliari, Bedowra Zabeen, M Mona Salem, Maria E Craig
Clinically evident diabetes-related vascular complications are rare in childhood and adolescence. However, early functional and structural abnormalities may be present a few years after the onset of the disease. This article is protected by copyright. All rights reserved.
August 5, 2018: Pediatric Diabetes
Susanne M Bechtold, Tilman R Rohrer, Klemens Raile, Sabine Hofer, Angelika Thon, Claudia Boettcher, Katja Konrad, Robert Dalla Pozza, Esther Bollow, Reinhard W Holl
INTRODUCTION: Post-transplantation diabetes mellitus (PTDM) increases the risk of cardiovascular disease, graft loss, and decreased survival. Follow-up treatment after solid organ transplantation (SOT) needs to focus on, inter alia, maintaining balanced glucose metabolism. This study aimed to ascertain the prevalence of PTDM and describe patient characteristics in the large DPV pediatric diabetes database. METHODS: DPV data of 71,902 patients from the 01/1995-04/2015 period were analyzed for patients with and without cystic fibrosis (CF) after SOT (kidney, liver, heart, and lung)...
August 1, 2018: Pediatric Diabetes
Farid H Mahmud, Nancy S Elbarbary, Elke Fröhlich-Reiterer, Reinhard W Holl, Olga Kordonouri, Mikael Knip, Kimber Simmons, Maria E Craig
Monitoring of anthropometric measurements and physical development, using age- appropriate standards and taking mid-parental height into account, is a crucial element in the care of children and adolescents with diabetes. This article is protected by copyright. All rights reserved.
July 31, 2018: Pediatric Diabetes
Carmel E Smart, Francesca Annan, Laurie A Higgins, Elisabeth Jelleryd, Mercedes Lopez, Carlo L Acerini
Nutritional management is one of the cornerstones of diabetes care and education. Different countries and regions have widely varying cultures and socio- economic status that influence and dominate dietary habits. Although there is strong evidence for nutritional requirements in young people the scientific evidence base for many aspects of diabetes dietary management is still emerging and it is important to individualize nutrition interventions and meal plans. This article is protected by copyright. All rights reserved...
July 30, 2018: Pediatric Diabetes
Alan M Delamater, Maartje de Wit, Vincent McDarby, Jamil A Malik, Marisa E Hilliard, Elisabeth Northam, Carlo L Acerini
A substantial research base developed over the past thirty years provides evidence for the significant role of psychosocial factors in the management of type 1 diabetes (T1D) in children and adolescents (3-7). We review the main findings from studies of psychological adjustment, psychiatric disorders, neurocognitive and educational functioning, family dynamics, social support, stress and coping, quality of life, and behavioral interventions in children and adolescents with T1D. This article is protected by copyright...
July 29, 2018: Pediatric Diabetes
Linda A DiMeglio, Carlo L Acerini, Ethel Codner, Maria E Craig, Sabine E Hofer, Kubendran Pillay, David M Maahs
HbA1c reflects mean BG over the prior three to four months and is currently the only long-term glycemic control measure with robust outcome data. Multiple studies in diverse populations have shown that elevated HbA1c values are associated with chronic complications of diabetes. Intensive management resulting in lower HbA1c concentrations is associated with fewer and delayed development of microvascular and macrovascular chronic complications 1-5 , see Chapter 18 (ref). Additionally, lower HbA1c shortly after diagnosis is associated with a lower risk of subsequent complications 6,7 ...
July 29, 2018: Pediatric Diabetes
Fiona M Campbell, Nuala P Murphy, Caroline Stewart, Torben Biester, Olga Kordonouri
BACKGROUND AND OBJECTIVE: Outcomes of using flash glucose monitoring have been reported in adults. This trial evaluated use in children and teenagers with type 1 diabetes. METHODS: Prospective, single arm, non-inferiority multi-center study to demonstrate equivalence of time in range (TIR [70-180mg/dL]) by comparing 14-day masked sensor wear (baseline) with self-monitored blood glucose (SMBG) testing to the final 14-days of 8-week open-label system use for diabetes self-management including insulin dosing...
July 28, 2018: Pediatric Diabetes
Jenny J Couper, Michael J Haller, Carla J Greenbaum, Anette-G Ziegler, Diane K Wherrett, Mikael Knip, Maria E Craig
Individuals with a first degree relative with type 1 diabetes have an approximately 15-fold increased relative life time risk of type 1 diabetes1,3,6 . However at least 85% of children who develop type 1 diabetes do not have a family history of type 1 diabetes. This article is protected by copyright. All rights reserved.
July 26, 2018: Pediatric Diabetes
Craig Jefferies, Erinn Rhodes, Marianna Rachmiel, Agwu Juliana Chizo, Thomas Kapellen, Mohamed Ahmet Abdulla, Sabine E Hofer
The management of diabetes in children now includes a wide array of insulin analogs, insulin delivery devices, insulin regimens, different types of insulin pumps, continuous and intermittent glucose monitoring. Safe management of the child with diabetes in the perioperative period requires not only an understanding of the pathophysiology of the condition requiring surgery but also a thoughtful consideration of each child's specific diabetes treatment regimen, glycemic control, anticipated postoperative course and the nature of the environment into which they will be discharged...
July 24, 2018: Pediatric Diabetes
Jennifer L Sherr, Martin Tauschman, Tadej Battelino, Martin de Bock, Gregory Forlenza, Rossana Roman, Korey K Hood, David M Maahs
Numerous milestones mark the advance of diabetes care since the discovery of insulin in 1921. Glucose monitoring has progressed from urine to blood to interstitial fluid measurements every 5-15 minutes with continuous glucose monitors (CGM). Similarly, advances in insulin formulations and their delivery include rapid acting and basal insulins as well as insulin pumps to more effectively dose insulin. This article is protected by copyright. All rights reserved.
July 23, 2018: Pediatric Diabetes
Claudio Maffeis, Niels H Birkebaek, Maia Konstantinova, Anke Schwandt, Andriani Vazeou, Kristina Casteels, Sujata Jali, Catarina Limbert, Auste Pundziute-Lycka, Peter Toth-Heyn, Carine de Beaufort, Zdenek Sumnik, Valentino Cherubini, Jannet Svensson, Daniele Pacaud, Christina Kanaka-Gantenbein, Shlomit Shalitin, Natasa Bratina, Ragnar Hanas, Guy Todd Alonso, Poran Luxmi, Ana Lopes Pereira, Marco Marigliano
No abstract text is available yet for this article.
July 23, 2018: Pediatric Diabetes
Juanjuan Zhang, Min Hu, Bokai Wang, Jie Gao, Li Wang, Li Li, Sisi Chen, Bin Cui, Weiqiong Gu, Weiqing Wang, Guang Ning
OBJECTIVE: We aimed to investigate T-cell receptor (TCR) repertoires in type 1 diabetes (T1D) patients receiving autologous hematopoietic stem cell transplantation (AHSCT) treatment. METHODS: High-throughput deep TCR beta chain (TCRB) sequencing was performed to assess millions of individual TCRs in 5 T1D patients receiving AHSCT treatment and another 5 patients receiving insulin treatment during 12 months of follow-up. RESULTS: No significant changes in TCRB sequence reads, complementarity-determining region 3 (CDR3) sequences, or the usage of TCRB VJ gene-segments were observed at 12 months after AHSCT...
July 19, 2018: Pediatric Diabetes
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