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Type 1 diabetes paediatric

K Farrell, R Fernandez, Y Salamonson, R Griffiths, D J Holmes-Walker
AIMS: To identify a) determinants of glycated haemoglobin (HbA1c) at 18 and 30 months following transition in young people with Type 1 diabetes mellitus (T1DM) to a youth-specific diabetes service; and to b) evaluate the impact of the service on acute admissions with diabetic ketoacidosis (DKA) over a 14-year period. METHODS: An audit of records of youth with T1DM referred from paediatric services to the multidisciplinary transition service at Westmead Hospital, from 2001-2012, and followed-up to 2014...
March 10, 2018: Diabetes Research and Clinical Practice
Ana Laura Fitas, Catarina Martins, Luís Miguel Borrego, Lurdes Lopes, Anne Jörns, Sigurd Lenzen, Catarina Limbert
AIMS/HYPOTHESIS: Type 1 diabetes (T1D) develops in distinct stages, before and after disease onset. Whether the natural course translates into different immunologic patterns is still uncertain. This study aimed at identifying peripheral immune patterns at key time-points, in T1D children undergoing remission phase. METHODS: Children with new-onset T1D and healthy age and gender-matched controls were recruited at a paediatric hospital. Peripheral blood samples were evaluated by flow cytometry at three longitudinal time-points: onset (T1), remission phase (T2) and established disease (T3)...
March 12, 2018: Pediatric Diabetes
Radhika Patwardhan, Susan Gorton, Venkat N Vangaveti, Jason Yates
BACKGROUND: Diabetic Ketoacidosis (DKA) is an acute life threatening, resource intensive preventable complication of type 1 diabetes which has major biopsychosocial effects on patients and families. Incidence of paediatric DKA has been studied nationally and internationally in metropolitan centres. This study analysed the DKA incidence at first presentation of type 1 diabetes at Townsville Hospital, before and after an educational intervention. This is the first study of its kind in a regional centre in Queensland, Australia...
February 27, 2018: Pediatric Diabetes
Petter Bjornstad, Kim C Donaghue, David M Maahs
Cardiovascular disease remains the leading cause of mortality in patients with type 1 diabetes. Although cardiovascular disease complications are rare until adulthood, pathology and early markers can manifest in adolescence. Whereas advances have been made in the management of microvascular complications of type 1 diabetes, similar progress in reducing macrovascular complications has not been made. The reasons for the absence of progress remain incompletely understood, but most likely relate to the long time needed for cardiovascular disease to manifest clinically and hence for risk factor management to show a clinical benefit, thus allowing inertia to prevail for diagnosis and particularly for targeting risk factors...
February 20, 2018: Lancet Diabetes & Endocrinology
Anda Mihaela Naciu, Paolo Pozzilli
Therapy for type 1 diabetes (T1D) is mainly restricted to insulin treatment. The management of paediatric patients with T1D should tackle not only glucose control, but also insulin resistance, beta-cell preservation, quality of life and cardiovascular disease risk factors, which are increasingly recognized to occur in adolescents with T1D. Areas covered: This review examines the recently published literature from PubMed on non-insulin agents for the management of T1D in paediatric patients. Expert opinion: Few paediatric patients with T1D are achieving their metabolic targets...
February 20, 2018: Expert Opinion on Pharmacotherapy
T P Candler, O Mahmoud, R M Lynn, A A Majbar, T G Barrett, J P H Shield
AIMS: To estimate the incidence of Type 2 diabetes in children aged <17 years, compare this with similar data 10 years ago, and characterize clinical features at diagnosis in the UK and Republic of Ireland. METHODS: Using the British Paediatric Surveillance Unit reporting framework, cases of Type 2 diabetes diagnosed in children aged <17 years between 1 April 2015 and 30 April 2016 were reported each month. RESULTS: A total of 106 cases were reported, giving a UK incidence of 0...
February 20, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Giuseppe Lepore, Riccardo Bonfanti, Lutgarda Bozzetto, Vincenzo Di Blasi, Angela Girelli, Giorgio Grassi, Dario Iafusco, Luigi Laviola, Ivana Rabbone, Riccardo Schiaffini, Daniela Bruttomesso
BACKGROUND AND AIM: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII). METHODS AND RESULTS: Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy...
December 9, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Helen Quirk, Cris Glazebrook, Holly Blake
BACKGROUND: This study describes the development and feasibility evaluation of a physical activity intervention for children with type 1 diabetes called 'Steps to Active Kids with Diabetes' (STAK-D). It aims to explore the feasibility and acceptability of the intervention and study design. METHODS: Thirteen children aged 9-11 years and their parents were recruited from one paediatric diabetes clinic. A process evaluation was conducted alongside a two-arm randomised feasibility trial, including assessment of rate of recruitment, adherence, retention, data completion and burden, implementation fidelity and adverse events...
February 7, 2018: BMC Pediatrics
Dragana Bojanin, Tatjana Milenkovic, Jelena Vekic, Rade Vukovic, Aleksandra Zeljkovic, Jelena Janac, Jasmina Ivanisevic, Sladjana Todorovic, Ilijana Mazibrada, Vesna Spasojevic-Kalimanovska
OBJECTIVE: Paediatric patients with type 1 diabetes mellitus (T1DM) frequently develop other autoimmune disorders; most commonly autoimmune thyroiditis (ATD) and celiac disease (CD). In this study we evaluated whether co-existing autoimmune diseases had significant impact on lipid and lipoprotein subclasses, as known cardiovascular risk factors in T1DM. DESIGN AND METHODS: Study included 201 subjects with T1DM (14.1 ± 2.9 years) and 141 age- and gender-matched controls...
February 1, 2018: Clinical Biochemistry
G Forsander, S Stallknecht, U Samuelsson, C Marcus, M Bøgelund
AIM: To test the possibility of using a discrete choice experiment model, on a national level in adolescents with Type 1 diabetes, in order to obtain a better understanding of drivers of and barriers to diabetes self-care. METHODS: A survey instrument was constructed and tested on a small group of the target population: adolescents aged 15 to <18 years with Type 1 diabetes. All individuals in Sweden belonging to this target group (N=2112) were then identified via the Swedish paediatric diabetes quality registry SWEDIABKIDS, and were sent an invitation to answer an online questionnaire...
January 30, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
S Agarwal, J K Raymond, S Isom, J M Lawrence, G Klingensmith, C Pihoker, S Corathers, S Saydah, R B D'Agostino, D Dabelea
AIM: To describe factors associated with transfer from paediatric to adult care and poor glycaemic control among young adults with Type 2 diabetes, using the SEARCH for Diabetes in Youth study. METHODS: Young adults with Type 2 diabetes were included if they had a baseline SEARCH visit while in paediatric care at < 18 years and ≥ 1 follow-up SEARCH visit at 18-25 years. At each visit, HbA1c , BMI, self-reported demographic and healthcare provider data were collected...
January 27, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Karolina Stożek, Artur Bossowski, Katarzyna Ziora, Anna Bossowska, Małgorzata Mrugacz, Anna Noczyńska, Mieczysław Walczak, Elżbieta Petriczko, Beata Pyrżak, Anna Kucharska, Mieczysław Szalecki, Tanja Diana, George J Kahaly
INTRODUCTION: The diagnostic value of the level of TSH receptor antibodies (TSHR-Ab) in the population of children with autoimmune thyroid diseases (AITDs) is still unknown. The aim of this cross-sectional study was to investigate the prevalence of TSHR-Ab in a paediatric cohort with AITD and healthy controls. MATERIALS AND METHODS: A total of 240 serum samples were obtained from 205 patients with AITD, type 1 diabetes (T1D), juvenile arthritis (JA), and healthy controls (C)...
January 26, 2018: Autoimmunity
Philippa Prentice, Daniela Elleri
There is increasing worldwide use of continuous subcutaneous insulin infusions in paediatric type 1 diabetes (T1D), reflecting recent research outcomes and guidance, as well as families' wishes. Children/young people may present acutely with medical or surgical problems, in addition to issues related to T1D. This review provides general paediatricians with an introduction to pump therapy, highlighting common problems, management issues and when to seek specialist advice.
January 3, 2018: Archives of Disease in Childhood. Education and Practice Edition
Amal R Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell M Viner, Justin Warner, Evelien F Gevers, Terence Stephenson
It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type...
December 25, 2017: International Journal of Environmental Research and Public Health
Samaneh Khanpour Ardestani, Mohammad Karkhaneh, Hai Chuan Yu, Muhammad Zafar Iqbal Hydrie, Sunita Vohra
OBJECTIVE: Our objective was to systematically review randomised clinical trials (RCTs) of paediatric type 1 diabetes mellitus (T1DM) to assess reporting of (1) primary outcome, (2) outcome measurement properties and (3) presence or absence of adverse events. METHODS: Electronic searches in MEDLINE, EMBASE, CINAHL, Cochrane SR and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were undertaken. The search period was between 2001 and 2017. English-language RCTs on children younger than 21 years with T1DM were selected...
December 19, 2017: BMJ Open
Johanna Metsälä, Annamari Lundqvist, Lauri J Virta, Minna Kaila, Mika Gissler, Suvi M Virtanen, Jaakko Nevalainen
Background: The association between asthma and type 1 diabetes, two chronic, immune-mediated diseases, has been of longstanding interest, but the evidence is still conflicting. We examined this association in a large, nationwide case-cohort study among Finnish children, using a novel statistical approach. Methods: Among the initial cohort of all children born between 1 January 1981 and 31 December 2008, those who were diagnosed with asthma (n = 81 473) or type 1 diabetes (n = 9541) up to age 16 years by the end of 2009 were identified from the Central Drug Register maintained by the Social Insurance Institution of Finland...
December 2, 2017: International Journal of Epidemiology
Juan Pedro López Siguero, Olga Pérez González, Ana Lucía Gómez Gila, Isabel Leiva Gea
INTRODUCTION: The representation of Spain in European epidemiological studies on diabetes is limited, with only one centre in the Hvidoere study and another in the SWEET study. No Spanish studies have been published that combine epidemiological data and care resources. The aim of this study was to determine the epidemiological data, care resources, and use of new technologies in all Andalusian hospitals that care for children with Diabetes Mellitus type 1 (DM1) under 14 years. MATERIAL AND METHODS: An electronic questionnaire of 18 questions was sent to all paediatric endocrinologists who treated children with diabetes in Andalusian hospitals...
November 14, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Maria Carolina Ibanez-Bruron, Ameenat L Solebo, Phillippa M Cumberland, Jugnoo S Rahi
INTRODUCTION: The frequency of diabetes mellitus in childhood is increasing. Thus, more children and young people are at risk of developing diabetic retinopathy and diabetes related visual impairment. However, there is no consensus on optimal screening strategies for the paediatric population reflecting the lack of clarity about the current burden of disease in this group. We aim to estimate the prevalence of diabetic retinopathy in children and young people living with types 1 or 2 diabetes, and to investigate potential sources of heterogeneity in this figure so as to inform screening strategies for this population...
November 15, 2017: BMJ Open
Mieczysław Szalecki, Marta Wysocka-Mincewicz, Anna Ramotowska, Artur Mazur, Lucyna Lisowicz, Iwona Ben-Skowronek, Joanna Sieniawska, Bożena Klonowska, Dorota Charemska, Jolanta Nawrotek, Irena Jałowiec, Artur Bossowski, Milena Jamiołkowska, Beata Pyrżak, Grażyna Miszkurka, Agnieszka Szypowska
BACKGROUND: The incidence of childhood Type-1 diabetes (T1D) varies greatly between populations and the estimates and/or predictions of the rates would aid in adequate planning of health care resources. The study's aim was to assess the incidence of T1D in the paediatric population of eastern and central Poland. METHODS: In this cohort study covering the period from January 2010 to December 2014 data were collected for children and adolescents below 18 years of age with newly diagnosed T1D, living in eastern and central Poland...
November 16, 2017: Diabetes/metabolism Research and Reviews
Małgorzata Michalska, Maria Bartoszewicz, Piotr Wąż, Sylwia Kozaczuk, Iwona Beń-Skowronek, Katarzyna Zorena
INTRODUCTION: The aim of our study was to evaluate the relation between the concentration of particulate matter of less than 10 μm in diameter (PM10) in air and the effect of psychrophilic bacteria, mesophilic bacteria and mould fungi on the number of new cases of type 1 diabetes mellitus in children and adolescents in the Lubelskie Voivodeship in the years 2015-2016. PATIENTS AND METHODS: Epidemiological data on the number of new cases of T1DM was obtained from the Department of Paediatric Endocrinology and Diabetology of the Medical University in Lublin...
2017: Pediatric Endocrinology, Diabetes, and Metabolism
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