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    681 results match your criteria Pediatrics Diabetic Ketoacidosis

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    Improving the Care of Youth With Type 1 Diabetes With a Novel Medical-Legal Community Intervention: The Diabetes Community Care Ambassador Program.
    Diabetes Educ 2018 Jan 1:145721717750346. Epub 2018 Jan 1.
    Division of Endocrinology & Diabetes, Department of Pediatrics, University of Washington, Seattle, Washington.
    Purpose The purpose of this study was to examine the feasibility and efficacy of the Diabetes Community Care Ambassador (DCCA) Program, a novel medical-legal community intervention designed to support high-risk youth with type 1 diabetes. Methods Study eligibility criteria: ages 3-19 years, A1C ≥8.5% (≥69 mmol/mol) and/or recent diabetic ketoacidosis hospitalization, type 1 diabetes duration ≥1 year, and English- or Spanish-speaking. Read More

    Fifteen-minute consultation: insulin pumps for type 1 diabetes in children and young people.
    Arch Dis Child Educ Pract Ed 2018 Jan 3. Epub 2018 Jan 3.
    Department of Paediatric Endocrinology, Royal Hospital for Sick Children, Edinburgh, UK.
    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. Read More

    Pediatric non-diabetic ketoacidosis: a case-series report.
    BMC Pediatr 2017 Dec 19;17(1):209. Epub 2017 Dec 19.
    Department of Endocrinology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Children Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Labortory of Pediatrics, Chongqing, 400014, People's Republic of China.
    Background: This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis.

    Methods: Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age ≤ 18 years; 2) urine ketone positive ++ or >8. Read More

    Elevated unmethylated and methylated insulin DNA are unique markers of A+β+ ketosis prone diabetes.
    J Diabetes Complications 2018 Feb 31;32(2):193-195. Epub 2017 Oct 31.
    Department of Medicine, Section of Diabetes and Endocrinology, Baylor College of Medicine, Houston, TX, USA. Electronic address:
    A+β+ ketosis prone diabetes (KPD) is associated with slowly progressive autoimmune beta cell destruction. Plasma unmethylated and methylated insulin DNA (biomarkers of ongoing beta cell damage and systemic inflammation, respectively) were elevated in A+β+ KPD compared to all other KPD subgroups. Read More

    Brugada phenocopy associated with diabetic ketoacidosis in two pediatric patients.
    J Electrocardiol 2017 Oct 28. Epub 2017 Oct 28.
    Division of Pediatric Cardiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 631, Rochester, NY, USA. Electronic address:
    Two patients without cardiac history demonstrated type 1 Brugada pattern during hospitalization for diabetic ketoacidosis (DKA). Both patients had normalization of their ECGs after treatment of marked electrolyte abnormalities and metabolic acidosis. In this report, we describe two cases of Brugada phenocopy associated with DKA in children. Read More

    Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis.
    Pediatr Endocrinol Diabetes Metab 2017 ;23(1):6-13
    Nassau University Medical Center, Department of Pediatrics, East Meadow, NY, USA.
    Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis.

    Aim Of The Study: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU). Read More

    A randomized controlled trial of one bag vs. two bag system of fluid delivery in children with diabetic ketoacidosis: Experience from a developing country.
    J Crit Care 2018 Feb 22;43:340-345. Epub 2017 Sep 22.
    Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
    Purpose: To compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA).

    Material And Methods: In an open labelled randomized controlled trial, thirty consecutive patients ≤12years with DKA were randomized to either one (n=15) or two bag (n=15) system of intravenous fluid delivery. Read More

    Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes.
    JAMA 2017 10;318(14):1358-1366
    Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
    Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear.

    Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes.

    Design, Setting, And Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg. Read More

    Effect of Metformin on Vascular Function in Children With Type 1 Diabetes: A 12-Month Randomized Controlled Trial.
    J Clin Endocrinol Metab 2017 Dec;102(12):4448-4456
    Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Australia.
    Context: Children with type 1 diabetes have vascular dysfunction preceding atherosclerosis. Early interventions are needed to reduce cardiovascular disease.

    Objective: To evaluate the effect of metformin on vascular function in children with type 1 diabetes. Read More

    Factors Associated with C-peptide Levels after Diagnosis in Children with Type 1 Diabetes Mellitus.
    Chonnam Med J 2017 Sep 25;53(3):216-222. Epub 2017 Sep 25.
    Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
    C-peptide is the best indicator of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide levels and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), as measured at 6-month intervals after diagnosis. We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. Read More

    Root Cause Analysis of Diabetic Ketoacidosis Admissions at a Tertiary Referral Pediatric Emergency Department in North India.
    Indian J Endocrinol Metab 2017 Sep-Oct;21(5):710-714
    Department of Pediatrics, Sri Ramachandra Medical College and Hospital, Chennai, Tamil Nadu, India.
    Objectives: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management.

    Materials And Methods: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011). Prehospital, health-care system, referral, follow-up, and continuum of care related details were obtained through direct interview of parents and physicians and/or field observations for all enrolled children. Read More

    In the setting of paediatric osteomyelitis do not be afraid to CAST an eye.
    BMJ Case Rep 2017 Oct 4;2017. Epub 2017 Oct 4.
    Paediatric Department, University Hospital Galway, Galway, Ireland.
    The case commences with an innocuous right ankle injury (lateral malleolus), for which the patient, a 9-year-old boy, was placed in a temporary cast at his local hospital. Three days following this incident, the patient was diagnosed with new-onset type 1 diabetes mellitus. He was admitted to his local hospital with severe diabetic ketoacidosis appropriately treated and subsequently discharged c. Read More

    A Collaborative In Situ Simulation-based Pediatric Readiness Improvement Program for Community Emergency Departments.
    Acad Emerg Med 2017 Oct 4. Epub 2017 Oct 4.
    Division of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT.
    Background: More than 30 million children are cared for across 5,000 U.S. emergency departments (EDs) each year. Read More

    Diabetic Ketoacidosis with Extreme Hypernatremia in a 4-Year-Old Girl.
    Indian J Crit Care Med 2017 Sep;21(9):610-612
    Department of Pediatrics, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.
    A 4-year-old girl admitted with altered mental status, new-onset diabetes mellitus, and diabetic ketoacidosis (DKA) had a rapid rise in serum sodium from 158 mEq/L (corrected sodium 165 mEq/L) at the admission to 204 mEq/L within 18 hours of admission despite standard fluid and insulin therapy recommended for the treatment of DKA. During her illness, she developed arterial and deep vein thrombosis (DVT), bloodstream infection with Candida species, and extensive skin blistering and denudation. The child needed mechanical ventilation, insulin infusion, careful fluid titration to bring down the sodium gradually, and low-molecular weight heparin for her DVT. Read More

    The Expression of Activating Receptor Gene of Natural Killer Cells (KLRC3) in Patients with 
Type 1 Diabetes Mellitus (T1DM).
    Oman Med J 2017 Jul;32(4):316-321
    Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
    Objectives: To identify the possible role of natural killer (NK) cells in the pathogenesis of type 1 diabetes mellitus (T1DM) through studying the expression of the KLRC3 gene, which encodes the NK cell activating receptor (NKG2E).

    Methods: This study was conducted at Alexandria University Children's Hospital from April to October 2015. The study was conducted with 30 newly diagnosed T1DM patients (15 males and 15 females), aged 7-13 years (10. Read More

    Screening for neonatal diabetes at day 5 of life using dried blood spot glucose measurement.
    Diabetologia 2017 Nov 5;60(11):2168-2173. Epub 2017 Aug 5.
    National Institute for Health Research (NIHR) Exeter Clinical Research Facility, University of Exeter, Exeter, UK.
    Aims/hypothesis: The majority of infants with neonatal diabetes mellitus present with severe ketoacidosis at a median of 6 weeks. The treatment is very challenging and can result in severe neurological sequelae or death. The genetic defects that cause neonatal diabetes are present from birth. Read More

    Nephrolithiasis: A complication of pediatric diabetic ketoacidosis.
    Pediatr Diabetes 2017 Jul 24. Epub 2017 Jul 24.
    The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
    Objective: To determine the frequency of nephrolithiasis as a complication of diabetic ketoacidosis (DKA) in pediatrics.

    Methods: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January 2009 and July 2016. We identified patients with nephrolithiasis during admission for DKA. Read More

    Clinical and Molecular Characterization of Children with Neonatal Diabetes Mellitus at a Tertiary Care Center in Northern India.
    Indian Pediatr 2017 Jun;54(6):467-471
    Division of Pediatric Endocrinology, Department of Pediatrics, AIIMS, New Delhi, and *Madras Diabetes Research Foundation, Chennai, India; and #Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK. Correspondence to: Prof. Vandana Jain, Division of Pediatric Endocrinology, Department of Pediatrics, AIIMS, Delhi-110 029, India.
    Objective: To study the genetic mutations and clinical profile in children with neonatal diabetes mellitus.

    Methods: Genetic evaluation, clinical management and follow-up of infants with neonatal diabetes.

    Results: Eleven infants were studied of which eight had permanent neonatal diabetes. Read More

    Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control.
    Diabetes Care 2017 Sep 30;40(9):1249-1255. Epub 2017 Jun 30.
    Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO
    Objective: This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors.

    Research Design And Methods: This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998-2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose >250 mg/dL, and venous pH <7. Read More

    Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital.
    Pediatr Diabetes 2017 Jun 30. Epub 2017 Jun 30.
    Department of Pediatrics, University of British Columbia, Vancouver, Canada.
    Objective: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion.

    Methods: A retrospective chart review was conducted of all DKA admissions to British Columbia Children's Hospital (BCCH) during September 2008 to December 2013. Data collection included diabetes history, estimation of dehydration, insulin and fluid infusion rates, and frequency of laboratory investigations. Read More

    Ketoacidosis in Neonatal Diabetes Mellitus, Part of Wolcott-Rallison Syndrome.
    Am J Case Rep 2017 Jun 27;18:719-722. Epub 2017 Jun 27.
    Department of Pediatrics, Gayathri Pediatric and Maternity Center, Vijayawada, Andhra Pradesh, India.
    BACKGROUND Neonatal diabetes mellitus is a rare condition and it is important to differentiate it from other causes, such as hyperglycemia in infancy, for better outcomes. We report a case of an infant who presented to our neonatal intensive care unit in ketoacidosis and a comatose state. CASE REPORT Our case was an infant who presented to the neonatal intensive care unit at 38 days of age in ketoacidosis. Read More

    Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator?
    J Pediatr Psychol 2017 Oct;42(9):933-940
    Department of Pediatrics, Baylor College of Medicine.
    Objective: This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D).

    Method: Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults (N = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes.

    Results: The relationships between the two stress types and glycemic control did not differ between African American and non-Hispanic Whites. Read More

    Markedly increased incidence of critical illness in adults with Type 1 diabetes.
    Diabet Med 2017 Oct 12;34(10):1414-1420. Epub 2017 Jul 12.
    Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
    Aims: To compare the incidence of and mortality after intensive care unit admission in adults with paediatric-onset Type 1 diabetes vs the general population.

    Methods: Using population-based administrative data from Manitoba, Canada, we identified 814 cases of paediatric-onset Type 1 diabetes, and 3579 general population controls matched on age, sex and region of residence. We estimated the incidence of intensive care unit admission in adulthood, and compared the findings between populations using incidence rate ratios and multivariable Cox proportional hazards regression, adjusting for age, sex, comorbidity and socio-economic status. Read More

    Racial and ethnic differences among children with new-onset autoimmune Type 1 diabetes.
    Diabet Med 2017 Oct 12;34(10):1435-1439. Epub 2017 Jul 12.
    Section of Diabetes and Endocrinology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
    Aim: To compare demographic and clinical characteristics among children from ethnic minorities and non-Hispanic white children with new-onset autoimmune Type 1 diabetes.

    Methods: We analysed a single-centre series of 712 children with new-onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9. Read More

    Long-Term Follow-up of a Case with Proprotein Convertase 1/3 Deficiency: Transient Diabetes Mellitus with Intervening Diabetic Ketoacidosis During Growth Hormone Therapy.
    J Clin Res Pediatr Endocrinol 2017 Sep 7;9(3):288-292. Epub 2017 Jun 7.
    University of Turin, Regina Margherita Children's Hospital, Department of Public Health and Pediatrics, Division of Pediatric Endocrinology, Turin, Italy.
    Proprotein convertase 1/3 (PC1/3) deficiency is a very rare disease characterized by severe intractable diarrhea in the first years of life, followed by obesity and several hormonal deficiencies later. Diabetes mellitus requiring insulin treatment and diabetic ketoacidosis have not been reported in this disorder. We herein present a girl with PC1/3 deficiency who has been followed from birth to 17 years of age. Read More

    Thyroid function test in diabetic ketoacidosis.
    Diabetes Metab Syndr 2017 Dec 15;11 Suppl 2:S623-S625. Epub 2017 Apr 15.
    Department of Pediatrics Endocrinology and Metabolism, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran,Iran.
    Background: Metabolism of thyroid hormones is influenced by acute systemic illnesses including diabetic ketoacidosis. In these cases T3 level is usually decreased and this condition is called "low T3 syndrome" which is usually reversed by treating the under lying Disease.

    Objectives: thyroid function test analysis before and after diabetic ketoacidosis treatment. Read More

    Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with newborn genetic screening and follow up of risk children.
    Pediatr Diabetes 2017 May 23. Epub 2017 May 23.
    Department of Pediatrics, MRC Oulu, PEDEGO Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland.
    We studied the frequency of diabetic ketoacidosis (DKA) in children at diagnosis of type 1 diabetes (T1D) in a region where newborn infants have since 1995 been recruited for genetic screening for human leukocyte antigen (HLA)-conferred disease susceptibility and prospective follow up. The aim was to study whether participation in newborn screening and follow up affected the frequency of DKA, and to follow the time trends in DKA frequency. We first included children born in Oulu University Hospital since 1995 when the prospective studies have been ongoing and diagnosed with T1D <15 years by 2015 (study cohort 1, n = 517). Read More

    Markers of immune-mediated inflammation in the brains of young adults and adolescents with type 1 diabetes and fatal diabetic ketoacidosis. Is there a difference?
    Exp Mol Pathol 2017 06 19;102(3):505-514. Epub 2017 May 19.
    Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, United States; Research Service, Veterans Administration Maryland Health Care System, MD 21201, United States. Electronic address:
    Due to the limited data on diabetic ketoacidosis and brain edema (DKA/BE) in children/adolescents and the lack of recent data on adults with type 1 diabetes (T1D), we addressed the question of whether neuroinflammation was present in the fatal DKA of adults. We performed immunohistochemistry (IHC) studies on the brains of two young adults with T1D and fatal DKA and compared them with two teenagers with poorly controlled diabetes and fatal DKA. C5b-9, the membrane attack complex (MAC) had significantly greater deposits in the grey and white matter of the teenagers than the young adults (p=0. Read More

    Hypothyroidism among pediatric patients with type 1 diabetes mellitus, from patients' characteristics to disease severity.
    Clin Pediatr Endocrinol 2017 22;26(2):73-80. Epub 2017 Apr 22.
    Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    We performed this study to evaluate the associations of hypothyroidism with clinical severity and the occurrence of diabetic ketoacidosis (DKA) at initial diagnosis among pediatric patients with type 1 diabetes mellitus (T1DM). 330 children with T1DM who referred to Diabetes Clinic were enrolled. The medical records were e valuated and a blood sample was drawn from patients for measuring thyroid function and antibodies, blood glucose, and glycated hemoglobin (HbA1C) levels. Read More

    Histological and cognitive alterations in adult diabetic rats following an episode of juvenile diabetic ketoacidosis: Evidence of permanent cerebral injury.
    Neurosci Lett 2017 May 21;650:161-167. Epub 2017 Apr 21.
    Department of Anesthesiology and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA.
    Evidence suggests that diabetic ketoacidosis (DKA) may cause subtle cognitive alterations in children but the mechanisms are poorly understood. Acute DKA is associated with reactive astrogliosis and microglial activation in a rat model. Whether these inflammatory changes permanently alter brain histology is unknown. Read More

    Continuous subcutaneous insulin infusion: Special needs for children.
    Pediatr Diabetes 2017 Jun 20;18(4):255-261. Epub 2017 Apr 20.
    Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Continuous subcutaneous insulin infusion (CSII) is a very common therapy for children with type 1 diabetes. Due to physiological differences they have other requirements for their insulin pump than adults. The main difference is the need for very low basal rates. Read More

    Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan.
    Saudi Med J 2017 Apr;38(4):366-371
    Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail.
    Objectives: To assess the benefit of using the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes mellitus (T1DM) during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA) was used. Read More

    Alcohol and cigarette use among adolescents with type 1 diabetes.
    Eur J Pediatr 2017 Jun 5;176(6):713-722. Epub 2017 Apr 5.
    Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, ul. Sporna 36/50, 91-738, Lodz, Poland.
    In this study, we compare the prevalence of alcohol and cigarette use among Polish adolescents with type 1 diabetes mellitus (T1DM) (n = 209), aged 15-18 years, with that of a large cohort of their healthy peers, using standardized questionnaire used in the European School Survey Project on Alcohol and Drugs (ESPAD). The lifetime, previous year, and past 30-day prevalence of alcohol consumption was high among adolescents with T1DM but lower than in the controls (82.8 vs 92. Read More

    Assessment of platelets morphological changes and serum butyrylcholinesterase activity in children with diabetic ketoacidosis: a case control study.
    BMC Endocr Disord 2017 Apr 4;17(1):23. Epub 2017 Apr 4.
    Department of Pediatrics, Faculty of Medicine, Minia University, El-Minya, Egypt.
    Background: Many studies indicated that mean platelet volume (MPV) and platelet distribution width (PDW) may be valuable in the diagnosis and management of clinical disorders; also, serum butyrylcholinesterase activity (BChE) was suggested to be linked to systemic inflammation and oxidative stress. Limited studies measured these readily available markers in children with diabetic ketoacidosis (DKA). Our objectives were to measure MPV, PDW and BChE in children with DKA; and to assess if any of these markers reflects the severity of DKA. Read More

    Comparing Practice Patterns Between Pediatric and General Emergency Medicine Physicians: A Scoping Review.
    Pediatr Emerg Care 2017 Apr;33(4):278-286
    From the *Department of Pediatrics, Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, NY; †Department of Pediatrics, Johns Hopkins University, Baltimore, MD; ‡Department of Pediatrics, Cohens Children's Hospital, Hofstra, Manhasset, NY; §Department of Pediatrics, University of Massachusetts School of Medicine, Worcester, MA; ∥Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI; and ¶Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
    Objective: Acutely ill infants and children presenting to the emergency department are treated by either physicians with pediatric emergency medicine (PEM) training or physicians without PEM training, a good proportion of which are general emergency medicine-trained physicians (GEDPs). This scoping review identified published literature comparing the care provided to infants and children (≤21 years of age) by PEM-trained physicians to that provided by GEDPs.

    Methods: The search was conducted in 2 main steps as follows: (1) initial literature search to identify available literature with evolving feedback from the group while simultaneously deciding search concepts as well as inclusion and exclusion criteria and (2) modification of search concepts and conduction of search using finalized concepts as well as review and selection of articles for final analysis using set inclusion criteria. Read More

    Adherence to pediatric diabetic ketoacidosis guidelines by community emergency departments' providers.
    Int J Emerg Med 2017 Dec 21;10(1):11. Epub 2017 Mar 21.
    Section of Pediatric Critical Care Medicine, Indianapolis, IN, USA.
    Background: Diabetic ketoacidosis (DKA) is a common presentation of type I diabetes mellitus to the emergency departments. Most children with DKA are initially managed in community emergency departments where providers may not have easy access to educational resources or pediatric-specific guidelines and protocols that are readily available at pediatric academic medical centers. The aim of this study is to evaluate adherence of community emergency departments in the state of Indiana to the pediatric DKA guidelines. Read More

    Acute Kidney Injury in Children With Type 1 Diabetes Hospitalized for Diabetic Ketoacidosis.
    JAMA Pediatr 2017 May 1;171(5):e170020. Epub 2017 May 1.
    Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada2Endocrinology & Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
    Importance: Acute kidney injury (AKI) in children is associated with poor short-term and long-term health outcomes; however, the frequency of AKI in children hospitalized for diabetic ketoacidosis (DKA) has not been previously examined.

    Objectives: To determine the proportion of children hospitalized for DKA who develop AKI and to identify the associated clinical and biochemical markers of AKI.

    Design, Setting, And Participants: This medical record review of all DKA admissions from September 1, 2008, through December 31, 2013, was conducted at British Columbia Children's Hospital, the tertiary pediatric hospital in British Columbia, Canada. Read More

    Pediatric Diabetes Outpatient Center at Rhode Island Hospital: The impact of changing initial diabetes education from inpatient to outpatient.
    R I Med J (2013) 2017 Feb 1;100(2):21-24. Epub 2017 Feb 1.
    Department of Pediatrics, Division of Pediatric Endocrinology at Rhode Island Hospital and Hasbro Children's Hospital/The Warren Alpert Medical School of Brown University, Providence, RI.
    Background: This study compared outcomes and costs for new-onset Type 1 diabetes mellitus (T1DM) patients educated at the outpatient versus inpatient settings.

    Methods/design: Retrospective study examining the following variables: 1) hemoglobin A1c (HbA1c), 2) severe hypoglycemia, 3) admissions for diabetic ketoacidosis (DKA) or ER visits, and 4) healthcare cost.

    Results: 152 patients with new-onset T1DM from September 2007-August 2009. Read More

    Self-reported regular alcohol consumption in adolescents and emerging adults with type 1 diabetes: A neglected risk factor for diabetic ketoacidosis? Multicenter analysis of 29 630 patients from the DPV registry.
    Pediatr Diabetes 2017 Dec 1;18(8):817-823. Epub 2017 Feb 1.
    Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
    Background: The risk of hypoglycemia increases after alcohol consumption in patients with type 1 diabetes. This study aimed to investigate the association between metabolic control and self-reported alcohol consumption in young patients with type 1 diabetes.

    Materials And Methods: N = 29 630 patients with type 1 diabetes aged 12 to <30 years (median age 17. Read More

    Pediatric Insulin Pump Therapy: Reflecting on the First 10 Years of a Universal Funding Program in Ontario.
    Healthc Q 2017 ;19(4):6-9
    Chief science officer at ICES, a staff pediatrician in the Division of Paediatric Medicine at The Hospital for Sick Children, and an associate professor in the Department of Paediatrics and the Institute of Health Policy, Management and Evaluation at the University of Toronto.
    We evaluated the universal funding program for pediatric insulin pumps in Ontario by examining the dynamics underlying patterns of pump use and adverse events using population-based health administrative data available at the Institute for Clinical Evaluative Sciences (ICES), supplemented by other data. We found that (1) pump use has increased steadily since 2006 with variation across centres and disparity in use by socioeconomic status; (2) pump discontinuation is uncommon; (3) physicians value pump therapy in numerous ways that provide important insights into patterns of uptake; and (4) the safety profile of pump therapy is, in general, very good; however, individuals of lower socioeconomic status are at an increased risk of acute diabetes complications, most frequently diabetic ketoacidosis. This comprehensive mixed-methods evaluation reveals the need to understand and intervene to reduce social disparities in the use and adverse outcomes of technologies used for diabetes management. Read More

    Residual beta-cell function in diabetes children followed and diagnosed in the TEDDY study compared to community controls.
    Pediatr Diabetes 2017 Dec 27;18(8):794-802. Epub 2017 Jan 27.
    Health Informatics Institute, University of South Florida, Tampa, Florida.
    Objective: To explore whether children diagnosed with type 1 diabetes during islet autoantibody surveillance through The Environmental Determinants of Diabetes in the Young (TEDDY) study retain greater islet function than children diagnosed through the community.

    Methods: TEDDY children identified at birth with high-risk human leukocyte antigen and followed every 3 months until diabetes diagnosis were compared to age-matched children diagnosed with diabetes in the community. Both participated in long-term follow up after diagnosis. Read More

    Predictive Hyperglycemia and Hypoglycemia Minimization: In-Home Evaluation of Safety, Feasibility, and Efficacy in Overnight Glucose Control in Type 1 Diabetes.
    Diabetes Care 2017 03 18;40(3):359-366. Epub 2017 Jan 18.
    Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, CA.
    Objective: The objective of this study was to determine the safety, feasibility, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system compared with predictive low-glucose insulin suspension (PLGS) alone in overnight glucose control.

    Research Design And Methods: A 42-night trial was conducted in 30 individuals with type 1 diabetes in the age range 15-45 years. Participants were randomly assigned each night to either PHHM or PLGS and were blinded to the assignment. Read More

    Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis.
    J Child Neurol 2017 04 5;32(5):475-481. Epub 2017 Jan 5.
    3 Department of Clinical Pathology, Assiut University Hospital, Assiut, Egypt.
    Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90 children (age 9. Read More

    Factors Associated with the Presence and Severity of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Korean Children and Adolescents.
    J Korean Med Sci 2017 Feb;32(2):303-309
    Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
    The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. Read More

    Higher-Than-Conventional Subcutaneous Regular Insulin Doses Following Diabetic Ketoacidosis in Children and Adolescents
    J Clin Res Pediatr Endocrinol 2017 06 30;9(2):132-137. Epub 2016 Dec 30.
    Dr. Behçet Uz Children's Hospital, Clinic of Pediatrics, İzmir, Turkey, Phone: +90 232 464 6167 E-mail:
    Objective: To evaluate the effect of initial insulin dosage on glycemic control in the first 48 hours of subcutaneous regular insulin therapy after resolution of diabetic ketoacidosis (DKA).

    Methods: Records of patients with DKA hospitalized in the past 3 years [n=76, median age=10.0 (6. Read More

    A Pediatric Diabetic Ketoacidosis Management Protocol Incorporating a Two-Bag Intravenous Fluid System Decreases Duration of Intravenous Insulin Therapy.
    J Pediatr Pharmacol Ther 2016 Nov-Dec;21(6):512-517
    Arnold Palmer Hospital for Children, Orlando, Florida.
    OBJECTIVES: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in children with type 1 diabetes. We implemented a standardized DKA management protocol by using a 2-bag intravenous (IV) fluid system. The purpose of the study was to examine if the protocol improved clinical outcomes and process efficiency. Read More

    Stroke in Pediatric Diabetic Ketoacidosis: Case Series.
    J Trop Pediatr 2017 Aug;63(4):324-327
    Department of Pediatrics, Government Medical College and Hospital, Chandigarh 160030, India.
    Diabetic ketoacidosis (DKA) can present with various neurological complications, but stroke is rare. Here, we present three children with recent-onset diabetes with DKA, two of them had deep coma not responding to standard DKA regimen and the third one had seventh nerve palsy noted after recovering from coma. Computed tomography scan of head showed hemorrhage in the area of midbrain in one patient and infarcts in two patients. Read More

    First 2 cases with thiamine-responsive megaloblastic anemia in the Czech Republic, a rare form of monogenic diabetes mellitus: a novel mutation in the thiamine transporter SLC19A2 gene-intron 1 mutation c.204+2T>G.
    Pediatr Diabetes 2017 Dec 22;18(8):844-847. Epub 2016 Dec 22.
    Department of Neonatology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic.
    Thiamine-responsive megaloblastic anemia (TRMA) is a rare autosomal recessive disorder caused by mutations in the SLC19A2 gene. To date at least 43 mutations have been reported for the gene encoding a plasma membrane thiamine transporter protein (THTR-1). TRMA has been reported in less than 80 cases worldwide. Read More

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