Diabet Med 2017 Jun 19. Epub 2017 Jun 19.

University of Manitoba, Internal Medicine.

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

Diabet Med 2017 Jun 19. Epub 2017 Jun 19.

Section of Diabetes and Endocrinology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine.

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

Diabetes Metab Syndr 2017 Apr 15. 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

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

Exp Mol Pathol 2017 Jun 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

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

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

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

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

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

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

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

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

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

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

Pediatr Diabetes 2017 Feb 1. 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

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

Pediatr Diabetes 2017 Jan 27. 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

Diabetes Care 2017 Mar 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

J Child Neurol 2017 Apr 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

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

J Clin Res Pediatr Endocrinol 2017 Jun 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

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

J Trop Pediatr 2016 Dec 24. Epub 2016 Dec 24.

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

Pediatr Diabetes 2016 Dec 22. 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

Sci Rep 2016 Dec 19;6:38844. Epub 2016 Dec 19.

Centre of Epidemiology and Biostatistics, Polytechnic University of Marche, Ancona, Italy.

This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004-2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7. Read More

Diabetes Technol Ther 2017 Jan 16;19(1):18-24. Epub 2016 Dec 16.

2 Jaeb Center for Health Research , Tampa, Florida.

Background: In the past few years, the artificial pancreas-the commonly accepted term for closed-loop control (CLC) of blood glucose in diabetes-has become a hot topic in research and technology development. In the summer of 2014, we initiated a 6-month trial evaluating the safety of 24/7 CLC during free-living conditions.

Research Design And Methods: Following an initial 1-month Phase 1, 14 individuals (10 males/4 females) with type 1 diabetes at three clinical centers in the United States and one in Italy continued with a 5-month Phase 2, which included 24/7 CLC using the wireless portable Diabetes Assistant (DiAs) developed at the University of Virginia Center for Diabetes Technology. Read More

Emerg Nurse 2016 Dec;24(8):26-32

Torbay Hospital, Paediatrics, Torquay, Devon.

Diabetes mellitus is a common condition in children, characterised by chronic hyperglycaemia resulting from an absolute insulin deficiency. It can present in various ways, and hospital admission may result from complications related to previously diagnosed diabetes, or from a new diagnosis. To raise awareness of the condition, Diabetes UK has launched the 4Ts campaign, which highlights the four most common symptoms of diabetes. Read More

J Eval Clin Pract 2017 Feb 29;23(1):173-177. Epub 2016 Nov 29.

Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Rationale, Aims And Objectives: We aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA).

Methods: This was a 6-year (2008-2014) case-control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation.

Results: There were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG. Read More

World J Crit Care Med 2016 Nov 4;5(4):212-218. Epub 2016 Nov 4.

Linnea M Larson-Williams, Department of Pediatric Endocrinology, Georgia Regents University, Augusta, GA 30912, United States.

Aim: To investigate the use of a multidisciplinary, longitudinal simulation to educate pediatric residents and nurses on management of pediatric diabetic ketoacidosis.

Methods: A multidisciplinary, multiple step simulation course was developed by faculty and staff using a modified Delphi method from the Pediatric Simulation Center and pediatric endocrinology department. Effectiveness of the simulation for the residents was measured with a pre- and post-test and a reference group not exposed to simulation. Read More

Pediatr Diabetes 2016 Dec 23;17(8):592-598. Epub 2015 Dec 23.

University of California San Diego, Pediatrics San Diego, CA, USA.

Background: Vitamin D deficiency (VDD) adversely affects bone health. US data on prevalence of VDD or vitamin D insufficiency (VDI) at diagnosis of type 1 diabetes (T1D) is lacking. Low serum 25-hydroxyvitamin D (25OHD) is speculated to increase the risk of developing T1D. Read More

Pediatr Diabetes 2016 Oct 19. Epub 2016 Oct 19.

Jaeb Center for Health Research, Tampa, Florida.

Objective: Current data are limited on the course of type 1 diabetes (T1D) in children and adolescents through the first few years of diabetes. The Pediatric Diabetes Consortium T1D new onset (NeOn) Study was undertaken to prospectively assess natural history and clinical outcomes in children treated at 7 US diabetes centers from the time of diagnosis. This paper describes clinical outcomes in the T1D NeOn cohort during the first 3 years postdiagnosis. Read More

J Pediatr 2017 Jan 13;180:170-176. Epub 2016 Oct 13.

Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, CA; Department of Emergency Medicine, School of Medicine, University of California Davis, Sacramento, CA.

Objective: To characterize regional differences in brain water distribution and content during diabetic ketoacidosis (DKA) in children and determine whether these differences correlate with regional vascular supply.

Study Design: We compared changes in brain water distribution and water content in different brain regions during DKA by analyzing magnetic resonance diffusion weighted imaging data collected during DKA and after recovery in 45 children (<18 years of age). We measured the apparent diffusion coefficient (ADC) of water in the frontal and occipital cortex, basal ganglia, thalamus, hippocampus, and medulla. Read More

Pediatr Diabetes 2016 Oct 11. Epub 2016 Oct 11.

Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

Objective: Pediatric patients in Colorado with new onset type 1 diabetes (T1D) presenting with diabetic ketoacidosis (DKA) increased from 29.9% to 46.2% from 1998 to 2012. Read More

Pediatr Diabetes 2016 Oct 11. Epub 2016 Oct 11.

Department of Endocrinology and Diabetology, Children's Memorial Health Institute, Warsaw, Poland.

Aim: Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17.

Methods: The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. Read More

Int J Technol Assess Health Care 2016 Jan 10;32(4):203-211. Epub 2016 Oct 10.

Sheffield Children's NHS Foundation Trust.

Objectives: Kids in Control OF Food (KICk-OFF) is a 5-day structured education program for 11- to 16-year-olds with type 1 diabetes mellitus (T1DM) who are using multiple daily insulin injections. This study evaluates the cost-effectiveness of the KICk-OFF education program compared with the usual care using data from the KICk-OFF trial.

Methods: The short-term within-trial analysis covers the 2-year postintervention period. Read More

Pediatrics 2016 Oct;138(4)

Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.

Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. Read More

West J Emerg Med 2016 Sep 25;17(5):531-41. Epub 2016 Jul 25.

Children's Hospitals and Clinics of Minnesota, Department of Pediatric Emergency Medicine, Minneapolis, Minnesota.

Appl Neuropsychol Child 2016 Sep 8:1-10. Epub 2016 Sep 8.

c Psychiatry Department, College of Medicine , United Arab Emirates University , Al-Ain , United Arab Emirates.

The objective of this study was to investigate performance on memory, intelligence, and executive functions in children and adolescents with type 1 diabetes mellitus (T1DM) and to investigate the role of glycemic control, hypoglycemic attacks and diabetic ketoacidosis. We compared 50 subjects with T1DM with 30 healthy controls (ages between 7 and 16 years) using Benton Visual Retention Test (BVRT), the Arabic version of the Wechsler Intelligence Scale for Children (WISC), and Wisconsin Card Sorting Test (WCST). We also compared good versus poor glycemic control in T1DM subjects. Read More

Am J Kidney Dis 2016 Dec 3;68(6):967-972. Epub 2016 Sep 3.

Renal Division, St Michael's Hospital and University of Toronto, Ontario, Canada; Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.

Diabetic ketoacidosis (DKA), a common cause of severe metabolic acidosis, remains a life-threatening condition due to complications of both the disease and its treatment. This Acid-Base and Electrolyte Teaching Case discusses DKA management, emphasizing complications of treatment. Because cerebral edema is the most common cause of mortality and morbidity, especially in children with DKA, we emphasize its pathophysiology and implications for therapy. Read More

Acta Diabetol 2016 Dec 1;53(6):991-998. Epub 2016 Sep 1.

Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, 9054, New Zealand.

Aims: While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM. Read More

BMJ Open Diabetes Res Care 2016 22;4(1):e000239. Epub 2016 Jun 22.

Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Sickkids Research Institute; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.

Objective: To describe adverse events in pediatric insulin pump users since universal funding in Ontario and to explore the role of socioeconomic status and 24-hour support.

Research Design And Methods: Population-based cohort study of youth (<19 years) with type 1 diabetes (n=3193) under a universal access program in Ontario, Canada, from 2006 to 2013. We linked 2012 survey data from 33 pediatric diabetes centers to health administrative databases. Read More

Clin Case Rep 2016 Aug 17;4(8):717-20. Epub 2016 Jun 17.

Department of Pathology and Laboratory MedicineKing Abdulaziz Medical CityRiyadhSaudi Arabia; Department of PediatricsCollege of MedicineQassim UniversityAlmulydaSaudi Arabia.

Clinicians should consider the EIF2B1 gene defect in any patient with diffuse white matter disease on an MRI of the brain and DKA. Read More

Pediatr Diabetes 2016 Aug 15. Epub 2016 Aug 15.

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

Background: The interaction between type 1 diabetes mellitus (T1DM) and attention deficit hyperactivity disorder (ADHD) in children and adolescents has been studied rarely. We aimed to analyse metabolic control in children and adolescents with both T1DM and ADHD compared to T1DM patients without ADHD.

Patients And Methods: Auxological and treatment data from 56. Read More

J Formos Med Assoc 2017 May 9;116(5):340-344. Epub 2016 Aug 9.

Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address:

Background/purpose: Cases of type 1 diabetes mellitus in children aged younger than 6 years in Taiwan has increased in the past 10 years. This retrospective study aimed to review the management experience of such patients in a single center.

Methods: From January 2004 to June 2015, 52 newly diagnosed diabetic children younger than 6 years who had regular follow-up for > 1 year were enrolled, as well as 94 older diabetic children for comparison. Read More

Pediatr Crit Care Med 2016 Oct;17(10):e477-e480

Division of Pediatric Critical Care, Department of Pediatrics, University of California San Francisco Benioff Children's Hospitals, San Francisco and Oakland, CA.

Objective: To review the findings and discuss the implications of the use of low-dose insulin infusions in pediatric diabetic ketoacidosis compared with standard-dose insulin.

Data Sources: A search of the electronic PubMed database was used to perform the clinical query as well as to search for additional relevant literature.

Study Selection And Data Extraction: The article by Nallasamy K et al "Low-Dose vs Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis: A Randomized Clinical Trial. Read More

Postgrad Med J 2017 May 3;93(1099):242-244. Epub 2016 Aug 3.

Department of Paediatrics, Sundwell and West Birmingham NHS Trust, West Bromwich, UK.

Introduction: Type 1 diabetes (T1D) is characterised by autoimmune destruction of pancreatic β cells leading to insulin deficiency. Prompt referral to a specialist paediatric diabetes team (PDT) for insulin initiation and further management is important to prevent diabetic ketoacidosis (DKA), which remains the most common cause of death in this condition.

Objective: The aim was to study the timeliness of referrals from general practitioners (GPs) to PDT, of children suspected of having TID. Read More

Pediatr Diabetes 2016 Aug 2. Epub 2016 Aug 2.

Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.

Objective: Differences in cognition and brain structure have been found in youth with type 1 diabetes compared with controls, even after relatively short disease duration. To determine whether severity of clinical presentation contributes to these differences, we obtained structural magnetic resonance imaging (MRI) scans in youth ages 7-17 who were either newly diagnosed with type 1 diabetes (<3.5 months from diagnosis, n  = 46) or a sibling without diabetes (n = 28). Read More

J Diabetes Complications 2016 Nov - Dec;30(8):1600-1602. Epub 2016 Jul 21.

Section of Pediatric Endocrinology, Department of Pediatrics and Child Health, University of Manitoba, Children's Hospital, Winnipeg, Manitoba, Canada.

Objective: Intracranial hypertension is an infrequent but serious acute complication of pediatric diabetic ketoacidosis (DKA). Subclinical elevations of intracranial pressures however, may be more common, and can be indirectly evaluated with ultrasonography of the optic nerve sheath diameter (ONSD). In this pilot study, we report serial data on ONSD trajectories from five pediatric patients with DKA to generate hypotheses for future studies. Read More