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Type 1 diabetes in adolescent

James W Varni, Alan M Delamater, Korey K Hood, Kimberly A Driscoll, Jenise C Wong, Saleh Adi, Joyce P Yi-Frazier, Ellen K Grishman, Melissa A Faith, Sarah D Corathers, Jessica C Kichler, Jennifer L Miller, Jennifer K Raymond, Elena M Doskey, Vincent Aguirre, Robert W Heffer, Don P Wilson
OBJECTIVES: The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYA) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. METHODS: The PedsQL 3.2 Diabetes Module 15-item Diabetes Symptoms Summary Score, 18-item Diabetes Management Summary Score and PedsQL 4...
June 21, 2018: Pediatric Diabetes
Zuzana Snahnicanova, Andrea Mendelova, Marian Grendar, Veronika Holubekova, Martina Kostkova, Katarina Pozorciakova, Maria Jancinová, Ivana Kasubova, Jarmila Vojtkova, Peter Durdik, Zora Lasabova, Miriam Ciljakova, Peter Banovcin
AIMS: The aim of our study was to investigate possible associations between three SNPs: rs4673 in the CYBA gene; rs1041740 in the SOD1 gene; and rs1001179 in the CAT gene, and type 1 diabetes (T1D) or diabetic peripheral neuropathy (DPN) in T1D patients. MATERIALS AND METHODS: Allelic variants of the selected SNPs were determined by allelic discrimination assays in 114 T1D patients enrolled in the study group and in 90 healthy individuals from a control group. Associations between each of the three SNPs were tested in subgroups of T1D patients divided according to the presence of DPN...
June 20, 2018: Genetic Testing and Molecular Biomarkers
Georgeanna J Klingensmith, Stefanie Lanzinger, William V Tamborlane, Sabine E Hofer, Peiyao Cheng, Carine de Beaufort, Robin L Gal, Thomas Reinehr, Craig Kollman, Reinhard W Holl
OBJECTIVE: To examine and compare the clinical characteristics and treatment of youth with type 2 diabetes (T2D) in two registries: one in Europe and one in the USA. RESEARCH DESIGN AND METHODS: Youth with onset of T2D at 10-18 years of age with current age <20 and an office visit after diabetes duration >1 year were identified in the European (DPV) and USA (PDC) databases. Demographic, physical and clinical characteristics and treatment at diagnosis as well as physical characteristics, treatment, laboratory data, and diabetes adverse events at most recent visit were analyzed from both registries...
June 20, 2018: Pediatric Diabetes
Daniel J DeSalvo, Kellee M Miller, Julia M Hermann, David M Maahs, Sabine E Hofer, Mark A Clements, Eggert Lilienthal, Jennifer L Sherr, Martin Tauschmann, Reinhard W Holl
BACKGROUND: To assess change in rates of pediatric real time or intermittent scanning CGM use over the past 5 years, and how it impacts glycemic control, data from 2 registries were compared: the US-based T1DX and the German/Austrian DPV. METHODS: Registry participants aged <18 years with T1D duration ≥ 1 year encompassed 29,007 individuals in 2011 and 29,150 participants in 2016. Demographic data, CGM use and HbA1c were obtained from medical records. RESULTS: CGM use increased from 2011 to 2016 in both registries across all age groups, regardless of gender, ethnic minority status or insulin delivery method...
June 20, 2018: Pediatric Diabetes
Mojdeh Rahmanian, Mohsen Hojat, Naima Seyed Fatemi, Abbas Mehran, Soroor Parvizy
INTRODUCTION: Self-management leads to blood glucose control and reduced morbidity and mortality in adolescents with type 1 diabetes. Different factors affect the self-management whose role and effect are still unknown. Among the influential factors whose effect is vague are spiritual intelligence, and this study aims to investigate the predictive role of spiritual intelligence in diabetes management. MATERIALS AND METHODS: In this descriptive-correlation study, 200 adolescents with type 1 diabetes were enrolled...
2018: Journal of Education and Health Promotion
Korey K Hood, Esti Iturralde, Joseph Rausch, Jill Weissberg-Benchell
OBJECTIVE: The aim is to report 1-year outcomes of the Supporting Teens Problem Solving (STePS) study, a randomized controlled trial comparing a distress and depression prevention program with a diabetes education program for adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: With 264 adolescents in two locations (Chicago and San Francisco Bay Area), a randomized controlled trial was conducted comparing the Penn Resilience Program for type 1 diabetes (PRP T1D) to Advanced Diabetes Education...
June 19, 2018: Diabetes Care
David Rodbard
Glycemic variability (GV) is a major consideration when evaluating quality of glycemic control. GV increases progressively from prediabetes through advanced T2D and is still higher in T1D. GV is correlated with risk of hypoglycemia. The most popular metrics for GV are the %Coefficient of Variation (%CV) and standard deviation (SD). The %CV is correlated with risk of hypoglycemia. Graphical display of glucose by date, time of day, and day of the week, and display of simplified glucose distributions showing % of time in several ranges, provide clinically useful indicators of GV...
June 2018: Diabetes Technology & Therapeutics
Carly S Filgueira, Giacomo Bruno, Zachary W Smith, Corrine Ying Xuan Chua, Andrea Ballerini, Marco Folci, April L Gilbert, Priya Jain, Jagannadha K Sastry, Pramod N Nehete, Kathryn A Shelton, Lori R Hill, Areeba Ali, Keith A Youker, Alessandro Grattoni
With nearly 40% of U.S. adults obese, and childhood and adolescent rates rising, obesity and associated comorbidities are serious public health concerns with massive societal costs. Often, lifestyle interventions do not offer sufficient weight loss to improve health, requiring surgery and medications as adjunct management strategies. Here, we present a 4-month case study in which the sustained, low-dose, and constant administration of the thyroid receptor β selective agonist GC-1 (sobetirome) from a novel nanochannel membrane implant was assessed in an obese, pre-diabetic rhesus macaque...
June 18, 2018: Biomedical Microdevices
Tamara S Hannon, Sara E Watson, Hasnaa E Jalou, Sangeeta Chakravorty, Kieren J Mather, Silva A Arslanian
Background: It is not known if dysglycemia and sleep-disordered breathing are linked in adolescents, as in adults. Objective: To perform a pilot study evaluating measures of sleep-disordered breathing across the spectrum of glucose tolerance in obese adolescents. We hypothesized that dysglycemia would be associated with sleep-disordered breathing. Participants/methods: This was a prospective, cross-sectional clinical pilot study that included 57 adolescents [body mass index (BMI) 38...
2018: Frontiers in Endocrinology
Tina Costacou, Jamie Crandell, Anna R Kahkoska, Angela D Liese, Dana Dabelea, Jean M Lawrence, David J Pettitt, Kristi Reynolds, Elizabeth J Mayer-Davis, Amy K Mottl
OBJECTIVE: We assessed the association between diet quality and microalbuminuria in youth-onset type 1 diabetes using three indices: a modified Mediterranean diet score for children and adolescents (mKIDMED), the Dietary Approaches to Stop Hypertension (DASH), and the Healthy Eating Index-2010 (HEI). RESEARCH DESIGN AND METHODS: Youth and young adults from the SEARCH (Search for Diabetes in Youth) Nutrition Ancillary Study diagnosed with type 1 diabetes in 2002-2008, who had repeated dietary assessments at baseline and follow-up visits and urine albumin-to-creatinine ratio (UACR) measured at the outcome visit (2012-2015) ( n = 461), were selected for study...
June 14, 2018: Diabetes Care
N Saoji, M Palta, H N Young, M A Moreno, V Rajamanickam, E D Cox
AIM: Families of children and adolescents with Type 1 diabetes experience self-management challenges that negatively impact diabetes control. This study assesses whether self-management challenges are also associated with quality of life (QOL) for children and adolescents with Type 1 diabetes and their parents. METHODS: Children aged 8-12 years (n = 135), adolescents aged 13-16 years (n = 132) and their parents completed QOL assessments (diabetes-specific QOL from the PedsQL Diabetes Module or the Family Impact Module, both scaled 0-100) and a validated survey of up to six self-management barriers [PRISM; scaled 1 (low) to 5 (high)]...
June 14, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Amanda Liu, Margaret Marcon, Esther Assor, Farid H Mahmud, Justine Turner, Diana Mager
The study purpose was to describe dietary intake and the factors influencing micronutrient supplements (MS) use in Celiac Disease (CD) ± Type 1 Diabetes (T1D). Three-day food records collected from parents of youth (3-18 years) with CD (n = 14) ± T1D (n = 10) were assessed for macro and micronutrient intake, diet quality (DQ), glycemic index (GI), glycemic load (GL), and food group intake. Focus group methodology and thematic concept analysis were conducted to determine factors influencing adolescent MS use...
June 12, 2018: Canadian Journal of Dietetic Practice and Research
Ivana Rabbone, Nicola Minuto, Sonia Toni, Fortunato Lombardo, Dario Iafusco, Marco Marigliano, Riccardo Schiaffini, G Maltoni, Anna Paola Frongia, Marco Scardapane, Antonio Nicolucci, Valentino Cherubini, Riccardo Bonfanti, Andrea E Scaramuzza
AIMS: Incidence of insulin pump failures in a cohort of children and adolescents with type 1 diabetes was evaluated prospectively during a 1-yr follow-up. MATERIALS AND METHODS: Insulin pump breakdown and infusion set failures were prospectively registered in a cohort of 1046 children and adolescents from 25 tertiary pediatric diabetes centers (50% males, mean age 12.2±4.1 yrs), with type 1 diabetes since 6.7±3.6 yrs, and using insulin pump since 3.3±2.2 yrs...
June 12, 2018: Diabetes, Obesity & Metabolism
Harmony Thompson, Helen Lunt, Cate Fleckney, Steven Soule
An adolescent with type 1 diabetes and a history of self-harm, which included intentional overdoses and insulin omission, presented with an insulin degludec overdose. She had been commenced on the ultra-long-acting insulin, degludec, with the aim of reducing ketoacidosis episodes in response to intermittent refusal to take insulin. Insulin degludec was administered under supervision as an outpatient. Because it was anticipated that she would attempt a degludec overdose at some stage, the attending clinicians implemented a proactive management plan for this (and related) scenarios...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Katharine Garvey, Lori Laffel
Adolescence and young adulthood are times of multiple developmental changes, including physiological, social, emotional, cognitive, and behavioral transformations. The adolescent or young adult living with type 1 or type 2 diabetes must navigate the vicissitudes of these developmental stages while managing the rigors and self-care demands of these conditions. Diabetes in children is managed by adults, mainly by parents. As the child matures, diabetes management tasks transition from parents to the developing teen...
2018: Endocrine Development
Sabine Malivoir, Karinne Gueniche
Considering the patient's transition from child to adolescent to adult and its psychological aspects in endocrinology and diabetology, it is necessary to recall the child's psycho-affective development when he enters adolescence. Indeed, adolescence appears paradigmatic of the "child-adult" transition; it is a specific and decisive psychic process which allows the child to become an adult, that is to say autonomous and subject to his desire. In our paper, we study the resonance of a chronic disease in young people; type 1 diabetes is chosen...
2018: Endocrine Development
Shelagh A Mulvaney, Sarah Vaala, Korey K Hood, Cindy Lybarger, Rachel Carroll, Laura Williams, Douglas C Schmidt, Kevin Johnson, Mary S Dietrich, Lori Laffel
BACKGROUND: Integration of momentary contextual and psychosocial factors within self-management feedback may provide more specific, engaging, and personalized targets for problem solving. METHODS: Forty-four youth ages 13-19 with type 1 diabetes (T1D) were provided a Bluetooth meter and completed the 30-day protocol. Participants were randomized to "app + meter" or "meter-only" groups. App + meter participants completed mealtime and bedtime assessment each day...
June 8, 2018: Diabetes Technology & Therapeutics
Helle Raun Andersen, Jeanette Tinggaard, Philippe Grandjean, Tina K Jensen, Christine Dalgård, Katharina M Main
BACKGROUND: Pesticide exposure has been associated with increased risk of diabetes mellitus in adults, but potential effects of prenatal exposure on glucose regulation have not been investigated. The aim of this study was to investigate if maternal occupational pesticide exposure in pregnancy was associated with glycated haemoglobin A1c (HbA1c) in adolescents and whether an association was modified by sex and paraoxonase-1 (PON1) Q192R polymorphism. METHODS: A prospective cohort study of children whose mothers were either occupationally exposed or unexposed to pesticides in early pregnancy...
June 4, 2018: Environmental Research
Sinem Akgül, Ayfer Alikaşifoğlu, Alev Özon, Nazlı Gönç, Yasemin Düzçeker, Sine Örs, Orhan Derman, Nuray Kanbur
BACKGROUND: Adolescents with type 1 diabetes mellitus (T1DM) are at an increased risk of eating disturbances. The aim of this study was to evaluate whether the risk of a disordered eating behavior (DEB) also applies to the well sibling sharing the same environment. METHODS: Well siblings were included if they were 10-18 years old, had a sibling with a T1DM diagnosis for at least 6 months and lived with the sibling during the illness. The control group was comprised of healthy participants recruited from the outpatient clinic with no family history of T1DM...
June 6, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Kathryn W Weaver, Irl B Hirsch
Achievement of well-controlled blood glucose is essential for preventing complications in patients with type 1 diabetes. Since the inception of continuous subcutaneous insulin infusion, the aim has been to develop an artificial pancreas, with the ability to use an automated algorithm to deliver one or more hormones in response to blood glucose with the intent to keep blood sugar as close to a prespecified target as possible. Development and rapid improvement of continuous glucose sensor technology has recently allowed swift progress toward a fully closed-loop insulin delivery system...
June 6, 2018: Diabetes Technology & Therapeutics
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