865 results match your criteria Pediatrics Diabetic Ketoacidosis


Severe Hypercalcemia in an Adolescent with New-Onset Diabetes Mellitus and Diabetic Ketoacidosis.

Cureus 2020 Jun 4;12(6):e8435. Epub 2020 Jun 4.

Pediatric Endocrinology, Nemours Children's Hospital, Orlando, USA.

Severe hypercalcemia in diabetic ketoacidosis (DKA) among children is rare and can be life-threatening. Its exact etiology is not clear and several mechanisms related to dehydration and metabolic acidosis have been proposed. Rigorous hydration with the correct fluid choice usually corrects the hypercalcemia in those without other underlying causes of hypercalcemia such as hyperparathyroidism. Read More

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http://dx.doi.org/10.7759/cureus.8435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336636PMC

Health Care Utilization of Homeless Minors With Diabetes in New York State From 2009 to 2014.

Diabetes Care 2020 Jul 2. Epub 2020 Jul 2.

The Lundquist Institute for Biomedical Innovation, Torrance, CA.

Objective: This study aims to describe differences in health care utilization between homeless and nonhomeless minors with diabetes.

Research Design And Methods: Data from the Healthcare Cost and Utilization Project's Statewide Inpatient Database from New York for years 2009-2014 were examined to identify pediatric patients <18 years old with diabetes. Outcomes of interest included hospitalization rate, in-hospital mortality, admission through the emergency department (ED), diabetic ketoacidosis (DKA), hospitalization cost, and length of stay (LOS). Read More

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http://dx.doi.org/10.2337/dc19-2219DOI Listing

Microbiota, epidemiological and nutritional factors related to ketoacidosis at the onset of type 1 diabetes.

Acta Diabetol 2020 Jun 27. Epub 2020 Jun 27.

Department of Public Health and Pediatrics, University of Study of Torino, Piazza Polonia 94, 10126, Turin, Italy.

Aims: The incidence of type 1 diabetes has increased over the last decades. The pathological pathway is not yet clear, even if genetic and environmental risk factors are known. An early diagnosis can avoid ketoacidosis and its complications. Read More

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http://dx.doi.org/10.1007/s00592-020-01555-zDOI Listing

Development of a rubric for assessing delayed diagnosis of appendicitis, diabetic ketoacidosis and sepsis.

Diagnosis (Berl) 2020 Jun 25. Epub 2020 Jun 25.

Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.

Objectives Using case review to determine whether a patient experienced a delayed diagnosis is challenging. Measurement would be more accurate if case reviewers had access to multi-expert consensus on grading the likelihood of delayed diagnosis. Our objective was to use expert consensus to create a guide for objectively grading the likelihood of delayed diagnosis of appendicitis, new-onset diabetic ketoacidosis (DKA), and sepsis. Read More

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http://dx.doi.org/10.1515/dx-2020-0035DOI Listing

Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7).

Medicine (Baltimore) 2020 Jun;99(25):e20553

Clinical Pharmacology & Toxicology, University Hospital / Inselspital Bern, Bern, Switzerland.

There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM.The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Read More

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http://dx.doi.org/10.1097/MD.0000000000020553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310899PMC

Safety Audits in the Emergency Department: Applying the Threat and Error Model to the Management of Pediatric Diabetic Ketoacidosis.

Pediatr Emerg Care 2020 Jun 11. Epub 2020 Jun 11.

From the Department of Pediatrics, McMaster Children's Hospital.

Objectives: This study aims to better understand factors that impact management of patients with diabetic ketoacidosis (DKA) in the pediatric emergency department (ED) by novel application of the threat-and-error model, commonly used in the aviation industry.

Methods: This study was a retrospective chart review of all patients diagnosed with DKA and managed in our pediatric ED during a 1-year period. A "flight plan" was created for each patient's ED visit, from triage to final disposition. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002142DOI Listing

T1D progression is associated with loss of CD3CD56 regulatory T cells that control CD8 T cell effector functions.

Nat Metab 2020 Feb 17;2(2):142-152. Epub 2020 Feb 17.

Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples 80131, Italy.

An unresolved issue in autoimmunity is the lack of surrogate biomarkers of immunological self-tolerance for disease monitoring. Here, we show that peripheral frequency of a regulatory T cell population, characterized by the co-expression of CD3 and CD56 molecules (T), is reduced in subjects with new-onset type 1 diabetes (T1D). In three independent T1D cohorts, we find that low frequency of circulating T cells is associated with reduced β-cell function and with the presence of diabetic ketoacidosis. Read More

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http://dx.doi.org/10.1038/s42255-020-0173-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272221PMC
February 2020

Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes.

Acta Diabetol 2020 Jun 2. Epub 2020 Jun 2.

Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology (ZIBMT), Ulm University, Albert-Einstein-Allee 41, 89081, Ulm, Germany.

Aims: To compare diabetes patients with hyperglycaemic hyperosmolar state (HHS), diabetic ketoacidosis (DKA), and patients without decompensation (ND).

Methods: In total, 500,973 patients with type 1 or type 2 diabetes of all ages registered in the diabetes patient follow-up (DPV) were included. Analysis was stratified by age (≤ / > 20 years) and by manifestation/follow-up. Read More

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http://dx.doi.org/10.1007/s00592-020-01538-0DOI Listing

Etiologies, trends, and predictors of 30-day pediatric readmissions after hospitalizations for diabetic ketoacidosis in the United States.

Pediatr Diabetes 2020 May 29. Epub 2020 May 29.

Department of Medicine, Valley Children's Hospital, Madera, California.

Objective: To determine the causes, predictors, and trends of 30-day readmissions following hospitalizations for pediatric diabetic ketoacidosis (DKA) in the United States (US) from 2010 to 2014.

Research Design And Methods: We used International Classification of Diseases, ninth revision, Clinical Modification codes to identify children with DKA aged 2 to 18 years from the National Readmission Database in the US. Patients who had readmission within 30 days after an index admission for DKA were included in the study. Read More

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http://dx.doi.org/10.1111/pedi.13059DOI Listing
May 2020
2.569 Impact Factor

Macrohematuria during diabetic ketoacidosis at onset of type 1 diabetes: a case report of nephrolithiasis.

Acta Diabetol 2020 May 28. Epub 2020 May 28.

Department of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy.

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http://dx.doi.org/10.1007/s00592-020-01545-1DOI Listing
May 2020
2.399 Impact Factor

Children with onset-ketoacidosis are admitted to the nearest hospital available, regardless of center size.

J Pediatr Endocrinol Metab 2020 May 24;33(6):751-759. Epub 2020 May 24.

German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.

Background To investigate longitudinal trends of admissions with diabetic ketoacidosis (DKA) in new-onset type 1 diabetes (T1D) and subsequent duration of hospitalization in association with structural health care properties, such as size of treatment facility, population density and linear distance between home and treatment centers. Methods Data from 24,321 German and Austrian pediatric patients with newly-diagnosed T1D between 2008 and 2017 within the DPV registry were analyzed. Results Onset-DKA rates fluctuated at around 19% and slightly increased over the observation period (p<0. Read More

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http://dx.doi.org/10.1515/jpem-2020-0038DOI Listing

Incidence Trends of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes in British Columbia, Canada.

J Pediatr 2020 Jun;221:165-173.e2

Divisions of Diabetes and Endocrinology, British Columbia Children's Hospital and Department of Pediatrics, University of British Columbia, Vancouver, Canada. Electronic address:

Objectives: To estimate the 11-year incidence trend of diabetic ketoacidosis (DKA) at and after the diagnosis of type 1 diabetes.

Study Design: A retrospective cohort study using a population-based administrative cohort diagnosed with type 1 diabetes at <20 years of age from 2002 to 2012 in British Columbia, Canada. DKA at (1 episode per individual) and DKA after (multiple episodes per individual) the diagnosis of diabetes were defined as DKA occurring ≤14 days or >14 days, respectively, from diagnosis, identified using International Classification of Diseases,9th and 10theditions codes. Read More

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http://dx.doi.org/10.1016/j.jpeds.2020.02.069DOI Listing

Improving Disposition Decision-Making for Pediatric Diabetic Ketoacidosis: A Quality Improvement Study.

Pediatr Qual Saf 2020 Mar-Apr;5(2):e260. Epub 2020 Feb 15.

Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pa.

Introduction: In many centers, children with diabetic ketoacidosis (DKA) receive care either in an endocrinology ward or a pediatric intensive care unit (PICU). We conducted a quality improvement (QI) initiative to reduce potentially avoidable PICU admissions of children with DKA without increasing endocrinology ward-to-PICU transfers.

Methods: A survey of providers demonstrated opportunities to increase awareness of institutional criteria for PICU admissions of children with DKA. Read More

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http://dx.doi.org/10.1097/pq9.0000000000000260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190258PMC
February 2020

Concurrent diabetic ketoacidosis and pancreatitis in Paediatric acute lymphoblastic leukemia receiving L-asparaginase.

BMC Pediatr 2020 May 18;20(1):228. Epub 2020 May 18.

Department of Paediatrics, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, India.

Background: Although hyperglycemia and pancreatitis are known side effects of L-asparaginase, both contributing to the development of diabetic ketoacidosis (DKA) is unfamiliar in literature.

Case Presentation: We report a case of an adolescent girl, recently diagnosed with ALL, who presented with pain in abdomen and breathing difficulty following chemotherapy with L-asparaginase. On subsequent evaluation, she was found to have high anion gap metabolic acidosis, hyperglycemia and ketonuria. Read More

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http://dx.doi.org/10.1186/s12887-020-02136-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236281PMC

Health-related quality of life and metabolic control in immigrant and Italian children and adolescents with type 1 diabetes and in their parents.

Pediatr Diabetes 2020 May 16. Epub 2020 May 16.

Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatric Unit - University of Modena and Reggio Emilia, Modena, Italy.

Objective: To determine if the diabetes-specific health-related quality of life (D-HRQOL) of young people with type 1 diabetes (T1D) and their parents is influenced by migrant status.

Subjects And Methods: One hundred and twenty-five patients (12.4 ± 3. Read More

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http://dx.doi.org/10.1111/pedi.13042DOI Listing

Diabetic ketoacidosis.

Nat Rev Dis Primers 2020 May 14;6(1):40. Epub 2020 May 14.

Diabetes & Endocrinology, Emory University School of Medicine, Atlanta, GA, USA.

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present - 'D', either elevated blood glucose levels or a family history of diabetes mellitus; 'K', the presence of high urinary or blood ketoacids; and 'A', a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. Read More

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http://dx.doi.org/10.1038/s41572-020-0165-1DOI Listing

Hypertension During Diabetic Ketoacidosis in Children.

J Pediatr 2020 May 6. Epub 2020 May 6.

Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine. Electronic address:

Objectives: To characterize hemodynamic alterations occurring during diabetic ketoacidosis (DKA) in a large cohort of children and to identify clinical and biochemical factors associated with hypertension.

Study Design: This was a planned secondary analysis of data from the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Study, a randomized clinical trial of fluid resuscitation protocols for children in DKA. Hemodynamic data (heart rate, blood pressure) from children with DKA were assessed in comparison with normal values for age and sex. Read More

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http://dx.doi.org/10.1016/j.jpeds.2020.04.066DOI Listing

The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth.

Diabetes Technol Ther 2020 Jun 5;22(6):449-453. Epub 2020 May 5.

Professor of Medicine and Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado, USA.

The Stay at Home order in Colorado and The Stay Safe at Home order in California during COVID-19 pandemic have forced a majority of the endocrinologists/diabetologists to adapt to providing diabetes care remotely through telehealth. This may provide increased access to diabetes health care in certain settings. However, health care disparities continue to challenge availability of diabetes technologies for underprivileged communities. Read More

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http://dx.doi.org/10.1089/dia.2020.0187DOI Listing

Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents.

Diabetologia 2020 Aug 8;63(8):1530-1541. Epub 2020 May 8.

Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Aims/hypothesis: The aim of this work was to evaluate geographical variability and trends in the prevalence of diabetic ketoacidosis (DKA), between 2006 and 2016, at the diagnosis of childhood-onset type 1 diabetes in 13 countries over three continents.

Methods: An international retrospective study on DKA at diagnosis of diabetes was conducted. Data on age, sex, date of diabetes diagnosis, ethnic minority status and presence of DKA at diabetes onset were obtained from Australia, Austria, Czechia, Denmark, Germany, Italy, Luxembourg, New Zealand, Norway, Slovenia, Sweden, USA and the UK (Wales). Read More

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http://dx.doi.org/10.1007/s00125-020-05152-1DOI Listing

Acetazolamide aggravated diabetic ketoacidosis severity in a boy post-transplantation thalassaemia with intracranial hypertension.

J Paediatr Child Health 2020 May 4. Epub 2020 May 4.

Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

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http://dx.doi.org/10.1111/jpc.14907DOI Listing

Effects of Diabetic Ketoacidosis on Executive Function in Children With Type 1 Diabetes: Evidence From Wisconsin Card Sorting Test Performance.

Psychosom Med 2020 05;82(4):359-365

From the Medical Psychological Center, The Second Xiangya Hospital (J. He, J. Zhu, Du, Sh. Li, Si. Li, X. Zhu), Central South University, Changsha, China; Department of Psychology (J. He), The First Normal University, Changsha, China; Hunan Key Laboratory of Children's Psychological Development and Brain Cognitive Science (J. He), Changsha, China; Medical Psychological Institute of Central South University (J. Zhu, Du, Sh. Li, Si. Li, X. Zhu), Changsha, China; National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital (X. Zhu), Changsha, China; Department of Metabolism and Endocrinology, The Second Xiangya Hospital (Xie, X. Li, Zhou), Central South University, Changsha, China; National Clinical Research Center for Metabolic Disease, The Second Xiangya Hospital (Xie, X. Li, Zhou), Changsha, China; and Children's Healthcare Institution, Hu Nan Children's Hospital (W. He), The University of South China Academy of Pediatrics, Changsha, China.

Objective: Diabetic ketoacidosis (DKA) in patients with type 1 diabetes mellitus (T1DM) is known to affect memory function, but little is known about its impact on executive function. This study aimed to determine whether a history of DKA was associated with changes in executive function in children with T1DM.

Methods: The sample consisted of 99 patients with T1DM with histories of DKA, 82 patients with T1DM without DKA, and 100 healthy controls aged 7 to 18 years. Read More

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http://dx.doi.org/10.1097/PSY.0000000000000797DOI Listing

Effect of Potassium Infusions on Serum Levels in Children during Treatment of Diabetic Ketoacidosis.

J Pediatr Intensive Care 2020 Jun 8;9(2):113-118. Epub 2020 Jan 8.

Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, Illinois, United States.

A retrospective study was done to determine the effect of potassium (K ) infusions on serum levels in children admitted to the pediatric intensive care unit (PICU) with diabetic ketoacidosis (DKA). Eighty-two percent of 92 cases studied received 40 mEq/L K infusion over the treatment period of median 13.0 (interquartile range [IQR]: 7-18) hours. Read More

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http://dx.doi.org/10.1055/s-0039-1700981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186025PMC

Management of mitochondrial diabetes in the era of novel therapies.

J Diabetes Complications 2020 Apr 13:107584. Epub 2020 Apr 13.

Section on Endocrinology & Genetics (SEGEN), National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.

Mitochondrial disorders refer to the complex group of conditions affecting energy metabolism. A number of mitochondrial disorders can lead to the development of diabetes mellitus, and mitochondrial diabetes is thought to account for up to 3% of all diabetes mellitus cases. Depending on the degree of preservation of beta cell secretory capacity and peripheral muscle insulin sensitivity, the phenotype of mitochondrial diabetes may resemble that of type 1 or type 2 diabetes. Read More

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http://dx.doi.org/10.1016/j.jdiacomp.2020.107584DOI Listing

Diabetes management in Wolcott-Rallison syndrome: analysis from the German/Austrian DPV database.

Orphanet J Rare Dis 2020 Apr 22;15(1):100. Epub 2020 Apr 22.

Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.

Background: Wolcott-Rallison syndrome (WRS) is characterized by permanent early-onset diabetes, skeletal dysplasia and several additional features, e.g. recurrent liver failure. Read More

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http://dx.doi.org/10.1186/s13023-020-01359-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178620PMC

The complicated clinical course in a case of atypical lipodystrophy after development of neutralizing antibody to metreleptin: treatment with setmelanotide.

Endocrinol Diabetes Metab Case Rep 2020 Mar 25;2020. Epub 2020 Mar 25.

Brehm Center for Diabetes Research and Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, Michigan, USA.

Summary: A patient with atypical partial lipodystrophy who had a transient initial response to metreleptin experienced acute worsening of her metabolic state when neutralizing antibodies against metreleptin appeared. Because her metabolic status continued to deteriorate, a therapeutic trial with melanocortin-4 receptor agonist setmelanotide, that is believed to function downstream from leptin receptor in the leptin signaling system, was undertaken in an effort to improve her metabolic status for the first time in a patient with lipodystrophy. To achieve this, a compassionate use (investigational new drug application; IND) was initiated (NCT03262610). Read More

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http://dx.doi.org/10.1530/EDM-19-0139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159256PMC

Acute kidney injury and diabetic ketoacidosis in pediatric patients: risk factors.

Arch Argent Pediatr 2020 Apr;118(2):135-138

Hospital Niño de Saltillo. Saltillo, Coahuila, México.

Acute kidney injury is a cause of morbidity in children with diabetes in developing countries, especially in patients with diabetic ketoacidosis. The objective of this study was to identify the risk factors for acute kidney injury in patients with diabetic ketoacidosis. This was a retrospective cohort study. Read More

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http://dx.doi.org/10.5546/aap.2020.eng.135DOI Listing

Difference in the duration of pediatric diabetic ketoacidosis: Comparison of new-onset to known type 1 diabetes.

Pediatr Diabetes 2020 Aug 31;21(5):791-799. Epub 2020 Mar 31.

Department of Pediatrics, Fundación Universitaria de Ciencias de la Salud, Hospital Universitario Infantil de San José, Bogotá, Colombia.

Objective: To compare the duration (hours until  ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with previously diagnosed type 1 diabetes (PT1D).

Methods: A multicenter retrospective cohort study was designed. The duration of DKA was measured from the start of the treatment. Read More

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http://dx.doi.org/10.1111/pedi.13007DOI Listing

The factors relevant to partial remission in children with type 1 diabetes mellitus after measles vaccination: A retrospective study.

J Med Virol 2020 Feb 28. Epub 2020 Feb 28.

Department of Pediatric Endocrinology and Metabolism, Istanbul Medipol University, Istanbul, Turkey.

We aimed to identify the determinants of partial remission in patients with type 1 diabetes mellitus (DM), and whether there is an influence of vaccination against measles on partial remission. This was a retrospective study consisting of consecutive patients diagnosed with type 1 DM followed-up from 1 September 2010, through 30 November 2011. The study included children vaccinated within 3 months after diagnosis, and children unvaccinated during the first 12 months of the disease. Read More

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http://dx.doi.org/10.1002/jmv.25734DOI Listing
February 2020

Evaluation of Thiol/Disulfide Homeostasis in Pediatric Patients with Diabetic Ketoacidosis.

Comb Chem High Throughput Screen 2020 ;23(3):185-190

Department of Pediatrics, University of Hacettepe, Pediatric Intensive Care Unit, İhsan Doğramacı Children Hospital, Ankara, Turkey.

Aims And Objective: This study aimed to investigate the value of Thiol/Disulfide homeostasis in pediatric diabetic ketoacidosis patients suffering from type 1 diabetes mellitus.

Materials And Methods: This study featured children who were diagnosed with diabetic ketoacidosis and who were consecutively admitted to pediatric intensive care within one year of their diagnosis. Thiol/disulfide homeostasis was evaluated in 45 pediatric patients suffering from DKA, as well as 45 healthy controls of parallel gender and age. Read More

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http://dx.doi.org/10.2174/1386207323666200218114331DOI Listing
January 2020
1.222 Impact Factor

A Quality Improvement Initiative to Reduce Hospitalizations for Low-risk Diabetic Ketoacidosis.

Pediatrics 2020 03 13;145(3). Epub 2020 Feb 13.

Departments of Emergency Medicine.

Background And Objectives: Children with established type 1 diabetes (T1D) who present to the emergency department (ED) with mild diabetic ketoacidosis (DKA) are often hospitalized, although outpatient management may be appropriate. Our aim was to reduce hospitalization rates for children with established T1D presenting to our ED with mild DKA who were considered low risk for progression of illness.

Methods: We conducted a quality improvement initiative between January 1, 2012, and December 31, 2018 among children and young adults ≤21 years of age with established T1D presenting to our tertiary care ED with low-risk DKA. Read More

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http://dx.doi.org/10.1542/peds.2019-1104DOI Listing

THE GUIDED TRANSFER OF CARE IMPROVES ADULT CLINIC SHOW RATE.

Endocr Pract 2020 May 11;26(5):508-513. Epub 2020 Feb 11.

Every year, 500,000 youths in the U.S. with chronic disease turn 18 years of age and eventually require transfer to adult subspecialty care. Read More

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http://dx.doi.org/10.4158/EP-2019-0470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220827PMC

Plasma β-Hydroxybutyrate for the Diagnosis of Diabetic Ketoacidosis in the Emergency Department.

Pediatr Emerg Care 2020 Feb 1. Epub 2020 Feb 1.

From the Divisions of Endocrinology.

Objective: Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. Our objective was to characterize the relationship between BOHB and DKA. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002035DOI Listing
February 2020

Role of sodium-glucose cotransporter 2 inhibition to mitigate diabetic kidney disease risk in type 1 diabetes.

Nephrol Dial Transplant 2020 01;35(Suppl 1):i24-i32

Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.

Diabetic kidney disease (DKD) is a common complication of type 1 diabetes (T1D) and a major risk factor for premature death from cardiovascular disease (CVD). Current treatments, such as control of hyperglycaemia and hypertension, are beneficial, but only partially protect against DKD. Finding new, safe and effective therapies to halt nephropathy progression has proven to be challenging. Read More

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http://dx.doi.org/10.1093/ndt/gfz228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993198PMC
January 2020
3.577 Impact Factor

Yield of a Public Health Screening of Children for Islet Autoantibodies in Bavaria, Germany.

JAMA 2020 Jan;323(4):339-351

Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany.

Importance: Public health screening for type 1 diabetes in its presymptomatic stages may reduce disease severity and burden on a population level.

Objective: To determine the prevalence of presymptomatic type 1 diabetes in children participating in a public health screening program for islet autoantibodies and the risk for progression to clinical diabetes.

Design, Setting, And Participants: Screening for islet autoantibodies was offered to children aged 1. Read More

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http://dx.doi.org/10.1001/jama.2019.21565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990943PMC
January 2020

Diabetic ketoacidosis at diagnosis among youth with type 1 and type 2 diabetes: Results from SEARCH (United States) and YDR (India) registries.

Pediatr Diabetes 2020 Jan 14. Epub 2020 Jan 14.

Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.

Background: There is significant global variation in the prevalence of diabetic ketoacidosis (DKA) at diagnosis among youth with type 1 diabetes (T1D). However, data for youth with type 2 diabetes (T2D) are limited, even in developed countries. We compared the prevalence of DKA at diagnosis among individuals with T1D and T2D from the SEARCH for Diabetes in Youth (SEARCH) and the Registry of Youth Onset Diabetes in India (YDR) registries. Read More

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http://dx.doi.org/10.1111/pedi.12979DOI Listing
January 2020

Current understandings of the pathogenesis of type 1 diabetes: Genetics to environment.

World J Diabetes 2020 Jan;11(1):13-25

Department of Pathology, Johns Hopkins Medical Center, Baltimore, MD 21205, United States.

Type 1 diabetes (T1D) is an autoimmune disease that usually strikes early in life, but can affect individuals at almost any age. It is caused by autoreactive T cells that destroy insulin-producing beta cells in the pancreas. Epidemiological studies estimate a prevalence of 1 in 300 children in the United States with an increasing incidence of 2%-5% annually worldwide. Read More

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http://dx.doi.org/10.4239/wjd.v11.i1.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927819PMC
January 2020

Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? - case report and literature review.

J Pediatr Endocrinol Metab 2020 Feb;33(2):319-322

Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland.

Background Cerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient. Case presentation We present the case of a 11-year-old boy with severe DKA in the course of newly diagnosed type 1 diabetes (T1D). The delay in the diagnosis of DKA and some therapeutic problems contributed to the development of CE and direct life-threatening conditions. Read More

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http://dx.doi.org/10.1515/jpem-2019-0440DOI Listing
February 2020

Two cases of ketosis-prone diabetes mellitus in Korean adolescents.

Ann Pediatr Endocrinol Metab 2019 Dec 31;24(4):257-261. Epub 2019 Dec 31.

Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.

In recent years, reports of diabetes mellitus (DM) cases that do not fit the traditional classification system have increased in prevalence. While insulin deficiency appears as type 1 DM (T1DM), the new type also has the clinical features of type 2 DM (T2DM); as such, this new type of DM is called ketosis-prone diabetes (KPD) and is correlated with findings of severe hyperglycemia and ketoacidosis. To provide a clear, clinical classification of DM, new classification systems are being studied. Read More

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http://dx.doi.org/10.6065/apem.2019.24.4.257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944861PMC
December 2019

0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial.

Crit Care 2020 01 2;24(1). Epub 2020 Jan 2.

Division of Pediatric Allergy & Immunology, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India.

Background: Acute kidney injury (AKI) is an important complication encountered during the course of diabetic ketoacidosis (DKA). Plasma-Lyte with lower chloride concentration than saline has been shown to be associated with reduced incidence of AKI in adults with septic shock. No study has compared this in DKA. Read More

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http://dx.doi.org/10.1186/s13054-019-2683-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939333PMC
January 2020
6.960 Impact Factor

Pediatric diabetes in Saudi Arabia: Challenges and potential solutions. A review article.

Authors:
Aqeel A Alaqeel

Int J Pediatr Adolesc Med 2019 Dec 28;6(4):125-130. Epub 2019 May 28.

Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia.

Diabetes in children has increased globally, and the World Health Organization ranks Saudi Arabia 7th in prevalence and 5th in incidence of type 1 diabetes (T1D). Type 2 diabetes (T2D) in children and adolescents has been identified in Saudi Arabia but its prevalence is still unknown. Despite advances in diabetes management including new insulins, insulin delivery systems, glucose monitoring and easy access to media for disease awareness, diabetes in children continues to be challenging in many aspects. Read More

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http://dx.doi.org/10.1016/j.ijpam.2019.05.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6926216PMC
December 2019

Insulin Degludec in Adolescents with Type 1 Diabetes: Is Newer Better? - A Retrospective Self-Control Case Series in Adolescents with a History of Diabetic Ketoacidosis.

Horm Res Paediatr 2019 20;92(3):179-185. Epub 2019 Dec 20.

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Introduction: Insulin degludec (IDeg) is the longest-acting basal insulin available. Whether IDeg compared to shorter-acting basal insulins like insulin glargine U100 (IGlarU100) reduces the rate of diabetic ketoacidosis (DKA) in adolescents with type 1 diabetes is unknown.

Objective: We hypothesized that adolescents with type 1 diabetes would have lower DKA rates and mean hemoglobin A1c (HbA1c) when using IDeg as compared to IGlarU100. Read More

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http://dx.doi.org/10.1159/000504707DOI Listing

Fluid Therapy For Pediatric Patients With Diabetic Ketoacidosis: Current Perspectives.

Diabetes Metab Syndr Obes 2019 12;12:2355-2361. Epub 2019 Nov 12.

Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Diabetic ketoacidosis (DKA) is a preventable life-threatening complication of type 1 diabetes. Fluids form a crucial component of DKA therapy, goals being the restoration of intravascular, interstitial and intracellular compartments. Hydration reduces hyperglycemia by decreased counter-regulatory hormones, enhanced renal glucose clearance and augmented insulin sensitivity. Read More

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http://dx.doi.org/10.2147/DMSO.S194944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858801PMC
November 2019

Air occlusion in insulin pumps of children and adolescents with type 1 diabetes.

J Pediatr Endocrinol Metab 2020 Feb;33(2):179-184

Eastern Virginia Medical School/Children's Hospital of the King's Daughters, Department of Pediatrics, Division of Pediatric Endocrinology, Norfolk, VA, USA.

Background Insulin pumps are a frequently used technology among youth with type 1 diabetes. Air bubbles within insulin pump tubing are common, preventing insulin delivery and increasing the risk of large glycemic excursions and diabetic ketoacidosis (DKA). We sought to determine the prevalence of air bubbles in insulin pump tubing and identify factors associated with clinically significant air bubbles. Read More

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http://dx.doi.org/10.1515/jpem-2019-0358DOI Listing
February 2020

Assessment of Serum Concentrations of Adropin, Afamin, and Neudesin in Children with Type 1 Diabetes.

Biomed Res Int 2019 24;2019:6128410. Epub 2019 Oct 24.

Department of Pediatrics, Endocrinology, Diabetology with Subdivision of Cardiology, Medical University of Białystok, Białystok, Poland.

Introduction: The increasing knowledge of adropin, afamin, and neudesin and the regulation of glucose metabolism and insulin resistance allows for the assessment of the differences in their concentrations between the groups with varied duration of diabetes mellitus (DM).

Aim Of The Study: Assessment of serum levels of adropin, afamin, and neudesin in children with type 1 diabetes, with respect to the disease duration.

Materials And Methods: The study consisted of 138 patients aged 5-18 years (M 40. Read More

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http://dx.doi.org/10.1155/2019/6128410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855013PMC

Acute Normoglycemic Ketoacidosis.

Clin Chem 2019 12;65(12):1610-1612

Metabolic Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.

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http://dx.doi.org/10.1373/clinchem.2019.309062DOI Listing
December 2019

A retrospective multisite examination of depression screening practices, scores, and correlates in pediatric diabetes care.

Transl Behav Med 2019 Nov 25. Epub 2019 Nov 25.

Children's National Health System, Washington, DC, USA.

Psychosocial guidelines recommend routine screening of depressive symptoms in adolescents and young adults (AYA) with diabetes. Best practices for screening in routine care and patient characteristics associated with depressive symptoms require further investigation. The purpose of this study was to examine psychometric properties of the Patient Health Questionnaire (PHQ-2 and PHQ-9); document rates of depressive symptoms and related clinical actions; and evaluate associations with patient characteristics. Read More

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http://dx.doi.org/10.1093/tbm/ibz171DOI Listing
November 2019

How diabetes type 1 affects immune response to hepatitis B virus vaccine in pediatric population? Evaluation of a booster dose in unresponsive subjects with type 1 diabetes.

Minerva Pediatr 2019 Nov 11. Epub 2019 Nov 11.

Department of Pediatrics, Sapienza University of Rome, Rome, Italy.

Background: Hepatitis B virus (HBV) vaccine reduced the incidence of Hepatitis B worldwide. Genetic variability , by the presence of specific haplotypes of HLA system (HLA-DR3, HLA-DR4) , influences the response to the vaccination. Subjects affected by T1D, contrary to non-diabetics, have a high prevalence of Hepatitis B. Read More

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http://dx.doi.org/10.23736/S0026-4946.19.05678-0DOI Listing
November 2019

The Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosis

J Clin Res Pediatr Endocrinol 2020 06 14;12(2):189-196. Epub 2019 Nov 14.

Ege University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, İzmir, Turkey

Objective: Despite the guidelines, significant variations can be encountered in initial therapy for pediatric diabetic ketoacidosis (DKA) in the prehospital setting. These variations occur mostly in fluid administration, insulin dosing, route of administration, and other aspects of the initial resuscitation and stabilization. The aim was to identify the effect of transport care on outcomes in children with DKA admitted to the emergency department (ED). Read More

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http://dx.doi.org/10.4274/jcrpe.galenos.2019.2019.0121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291399PMC

Infantile Tremor Syndrome (ITS) Presenting as Diabetic Ketoacidosis (DKA): Correspondence.

Indian J Pediatr 2020 01 12;87(1):89-90. Epub 2019 Nov 12.

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1007/s12098-019-03104-1DOI Listing
January 2020
0.919 Impact Factor