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Paediatr Int Child Health 2019 Feb 11:1-3. Epub 2019 Feb 11.

a 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences , Aristotle University of Thessaloniki, Papageorgiou General Hospital , Thessaloniki , Greece.

Neuropathy, a complication of type 1 diabetes (T1D), is a heterogeneous group, and chronic polyneuropathy is the most common form in adults. Αn 8-year-old girl admitted with severe diabetic ketoacidosis was diagnosed with T1D. She was managed with intravenous fluids and insulin and was subsequently commenced on multiple daily subcutaneous injections of insulin. Read More

Diabetes Care 2019 Feb 6. Epub 2019 Feb 6.

Diabetes Centre for Children and Adolescents, AUF DER BULT, Kinder- und Jugendkrankenhaus, Hannover, Germany.

Sodium glucose cotransporter (SGLT) inhibitors are new oral antidiabetic medications shown to effectively reduce glycated hemoglobin (A1C) and glycemic variability, blood pressure and body weight without intrinsic properties to cause hypoglycemia in people with type 1 diabetes. However, recent studies, particularly in individuals with type 1 diabetes, have demonstrated increases in the absolute risk of diabetic ketoacidosis (DKA). Some cases presented with near-normal blood glucose levels or mild hyperglycemia, complicating the recognition/diagnosis of DKA and potentially delaying treatment. Read More

Clin Med Insights Endocrinol Diabetes 2019 24;12:1179551418825159. Epub 2019 Jan 24.

Endocrine Division, Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia.

Objective: To determine the glycemic control and cardio-metabolic complications of children and adolescents with type 1 diabetes mellitus (T1DM) attending a tertiary care diabetes clinic in Saudi Arabia.

Methods: We conducted a retrospective cross-sectional study of children and adolescents with T1DM attending King Abdulaziz Medical City-Jeddah from 2010 to 2013. We assessed their glycemic control and diabetes management. Read More

J Pediatr Endocrinol Metab 2019 Feb;32(2):115-119

Saudi Board Family Medicine, Ministry of Health, Qassim, Saudi Arabia.

Background As per the International Society for Pediatrics and Adolescent Diabetes (ISPAD) census, diabetic ketoacidosis (DKA) is the most frequent cause of diabetes-related death. In developing countries, DKA-related mortality rate ranges from 6% to 24% (Onyiriuka AN, Ifebi E. Ketoacidosis at diagnosis of type 1 diabetes in children and adolescents: frequency and clinical characteristics. Read More

Cureus 2018 Nov 19;10(11):e3608. Epub 2018 Nov 19.

Internal Medicine, Louis Stokes Cleveland VA Medical Center/Case Western Reserve University School of Medicine, Cleveland, USA.

Epidermolysis bullosa acquisita is a rare autoimmune bullous disease involving the skin and mucosa, most commonly treated with systemic corticosteroids. This case illustrates the importance of counseling patients on medication side effects and ensuring close physician follow-up during an extended course of steroids. A 46-year-old man presented to the emergency department with weakness, fatigue, dizziness and polyuria in the setting of eight weeks of prednisone therapy for a flare-up of his bullous disease. Read More

Diabetes Technol Ther 2019 Feb 18;21(2):66-72. Epub 2019 Jan 18.

8 Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado.

Objective: To provide a snapshot of the profile of adults and youth with type 1 diabetes (T1D) in the United States and assessment of longitudinal changes in T1D management and clinical outcomes in the T1D Exchange registry.

Research Design And Methods: Data on diabetes management and outcomes from 22,697 registry participants (age 1-93 years) were collected between 2016 and 2018 and compared with data collected in 2010-2012 for 25,529 registry participants.

Results: Mean HbA1c in 2016-2018 increased from 65 mmol/mol at the age of 5 years to 78 mmol/mol between ages 15 and 18, with a decrease to 64 mmol/mol by age 28 and 58-63 mmol/mol beyond age 30. Read More

Arch Pediatr 2019 Feb 12;26(2):95-101. Epub 2019 Jan 12.

Unité endocrinologie et diabétologie pédiatrique, université Bordeaux, CHU Bordeaux, 33000 Bordeaux, France. Electronic address:

Background: The impact of 7-day real-time continuous glucose monitoring (RT-CGM) on type 1 diabetes (T1D) management remains unknown in youths with suboptimal control by multiple daily injections (MDI). The DIACCOR Study aimed to describe treatment decisions and glucose outcomes after a short-term RT-CGM sequence in real-life conditions.

Methods: This French multicenter longitudinal observational study included T1D youths with HbA1c>7. Read More

J Pediatr 2018 Dec 20. Epub 2018 Dec 20.

Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology (ZIBMT), University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.

Objective: To assess indications of eating disorders in girls with type 1 diabetes mellitus (T1DM).

Study Design: In total 31 556 girls aged >6 months and <23 years of age with T1DM from the Diabetes Patienten Verlaufsdokumentation (DPV) cohort were analyzed including 155 (0.49%) girls with anorexia nervosa, 85 (0. Read More

Rev Assoc Med Bras (1992) 2018 Nov;64(11):1038-1044

Universidade Federal do Paraná, Pediatric Endocrinology Unit, Department of Pediatrics, Hospital de Clínicas, Curitiba, PR, Brasil.

Objective: Health-related quality of life (HRQOL) in type 1 diabetes mellitus (T1DM) has been widely studied. The objectives of this study were to evaluate and identify the factors influencing the HRQOL of children and adolescents with T1DM.

Material And Methods: In total, 59 patients (9-16 years, T1DM for ≥1 year) responded to a version of the Diabetes Quality of Life Instrument for Youth (DQOLY) adapted to adapted to Brazilian patients, the Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD). Read More

Pediatr Diabetes 2019 Mar 27;20(2):172-179. Epub 2018 Dec 27.

Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Background: The diagnosis of type 1 diabetes (T1D) in youth is often associated with diabetic ketoacidosis (DKA). We aimed to evaluate if the presence of DKA at diagnosis of T1D is associated with less favorable hemoglobin A1c (HbA1c) trajectories over time.

Methods: The SEARCH for Diabetes in Youth study of 1396 youth aged <20 years with newly diagnosed T1D were followed for up to 13 (median 8 [interquartile range or IQR 6-9]) years after diagnosis. Read More

J Pediatr Endocrinol Metab 2018 Dec 7. Epub 2018 Dec 7.

Division of Critical Care Medicine, Children's National Health System, Washington, DC, USA.

Background Standard therapy of diabetic ketoacidosis (DKA) in pediatrics involves intravenous (IV) infusion of regular insulin until correction of acidosis, followed by transition to subcutaneous (SC) insulin. It is unclear what laboratory marker best indicates correction of acidosis. We hypothesized that an institutional protocol change to determine correction of acidosis based on serum bicarbonate level instead of venous pH would shorten the duration of insulin infusion and decrease the number of pediatric intensive care unit (PICU) therapies without an increase in adverse events. Read More

Turk J Pediatr 2018 ;60(3):348-351

Department of Pediatric Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey.

Argun M, Baykan A, Hatipoğlu N, Akın L, Şahin Y, Narin N, Kurtoğlu S. Arrhythmia in thiamine responsive megaloblastic anemia syndrome. Turk J Pediatr 2018; 60: 348-351. Read More

Biochim Biophys Acta Mol Basis Dis 2019 Feb 20;1865(2):428-433. Epub 2018 Nov 20.

Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan; Department of Pediatric Endocrinology, Mackay Children's Hospital, Taipei City 10449, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Tamsui Branch, New Taipei City 25160, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan. Electronic address:

Monogenic diabetes is caused by mutations that reduce β-cell function. While Sanger sequencing is the standard method used to detect mutated genes. Next-generation sequencing techniques, such as whole exome sequencing (WES), can be used to find multiple gene mutations in one assay. Read More

Pediatr Diabetes 2019 Feb 4;20(1):10-14. Epub 2018 Dec 4.

Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, California.

The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). Read More

Intensive Care Med 2018 Dec 31;44(12):2183-2191. Epub 2018 Oct 31.

Sections of Cardiology, Department of Paediatrics, University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.

Purpose: To determine if there is an association between mortality and admission chloride levels and/or increases in the chloride level in critically ill children.

Methods: We performed a retrospective cohort study of all patients admitted to the paediatric intensive care unit (PICU) from January 2014 to December 2015. Patients were excluded for the following reasons: (1) age < 90 days or > 18 years, (2) admission to the cardiac intensive care unit, (3) no laboratory values upon admission to the PICU, (4) history of end-stage renal disease, (5) a disorder of chloride transport, and (6) admission for diabetic ketoacidosis. Read More

Ir Med J 2018 03 14;111(3):714. Epub 2018 Mar 14.

Discipline of Paediatrics, Trinity Centre for Health Sciences Building, AMNCH, Tallaght, Dublin 24.

Type 1 diabetes (T1D) symptoms are subtle and easily overlooked. Delayed diagnosis can result in Diabetic ketoacidosis (DKA), a life threatening complication with lasting consequences. We sought to define the presenting features of T1D and DKA frequency, in children <15 years diagnosed in a single national tertiary centre, and identify predictive factors for DKA. Read More

J Paediatr Child Health 2018 Oct 30. Epub 2018 Oct 30.

Department of Paediatrics, Townsville Hospital and Health Service, Townsville, Queensland, Australia.

Aim: Peer review is one component of the improvement of diabetes care delivered by the National Health Service (NHS) in England and Wales. Queensland has a decentralised model of service provision with an established state diabetes network.

Methods: The NHS scheme was adapted for use in Australia, and seven trained reviewers were recruited to visit 14 'hub' centres, which in turn covered 29 'spoke' units delivering care to over 95% of all public patients <16 years old in the state. Read More

Diabet Med 2019 Mar 19;36(3):326-334. Epub 2018 Nov 19.

Department of Paediatric Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, NSW.

Dietary management has been a mainstay of care in Type 1 diabetes since before the discovery of insulin when severe carbohydrate restriction was advocated. The use of insulin facilitated re-introduction of carbohydrate into the diet. Current management guidelines focus on a healthy and varied diet with consideration of glycaemic load, protein and fat. Read More

Acta Diabetol 2018 Dec 16;55(12):1295-1301. Epub 2018 Oct 16.

Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna Str. 36/50, 91-738, Lodz, Poland.

Aims: Some patients with diabetic ketoacidosis develop cerebral edema (CE) in the course of type 1 diabetes mellitus (T1D), which may result in central nervous system disorders and high mortality. The imperfection of existing neuroimaging techniques for early recognition of CE forces us to search for the new and non-invasive methods. The aim of the study was to assess the usefulness of new methods (pachymetry, transorbital ultrasonography-USG, optical coherence tomography-OCT study) in the assessment of the risk of CE occurrence in children with newly diagnosed T1D. Read More

Turk J Pediatr 2018 ;60(2):201-205

Pediatric Endocrinology Clinic, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey.

Keskin M, Savaş-Erdeve Ş, Çetinkaya S, Aycan Z. Low hemoglobin A1c levels in a patient with diabetic ketoacidosis: Fulminant type 1 diabetes mellitus. Turk J Pediatr 2018; 60: 201-205. Read More

Pediatr Endocrinol Diabetes Metab 2018 ;24(2):56-64

Division of Pediatric Intensive Care, Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Children's Hospital, New Delhi - 110001, India.

Introduction: The optimal fluid therapy in children with DKA is a matter of debate, especially if we take into account its association with cerebral edema, the most important complication. Hypertonic Saline Solution is used in the treatment of cerebral edema, and also has been used for volume resuscitation in children with shock.

Aim Of Study: To compare the effects of 3% saline and 0. Read More

Lancet 2018 10 3;392(10155):1321-1329. Epub 2018 Oct 3.

Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK. Electronic address:

Background: The achievement of glycaemic control remains challenging for patients with type 1 diabetes. We assessed the effectiveness of day-and-night hybrid closed-loop insulin delivery compared with sensor-augmented pump therapy in people with suboptimally controlled type 1 diabetes aged 6 years and older.

Methods: In this open-label, multicentre, multinational, single-period, parallel randomised controlled trial, participants were recruited from diabetes outpatient clinics at four hospitals in the UK and two centres in the USA. Read More

Ann Pediatr Endocrinol Metab 2018 Sep 28;23(3):154-157. Epub 2018 Sep 28.

Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.

Permanent neonatal diabetes mellitus is most commonly caused by mutations in the ATP-sensitive potassium channel (KATP) subunits. Prompt initiation of sulfonylurea treatment can improve glycemic control in children with KCNJ11 mutation. In this report, we present a case of permanent neonatal diabetes caused by a mutation in the KCNJ11 gene that was successfully treated via early switching of insulin to sulfonylurea treatment. Read More

Diabetes Care 2018 11 29;41(11):2289-2296. Epub 2018 Sep 29.

Department of Pediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark

Objective: Type 1 diabetes is associated with an increased risk of psychiatric morbidities. We investigated predictors and diabetes outcomes in a pediatric population with and without psychiatric comorbidities.

Research Design And Methods: Data from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) and National Patient Register were collected (1996-2015) for this population-based study. Read More

Diabetes Res Clin Pract 2018 Oct 13;144:252-259. Epub 2018 Sep 13.

International Diabetes Federation Life for a Child Program, Glebe, NSW 2037, Australia; Diabetes NSW, Glebe 2037, NSW, Australia. Electronic address:

Aims: Determine the incidence and typology of diabetes in children in Azerbaijan.

Methods: Clinical features, C-peptide, autoantibodies (glutamic acid decarboxylase 65 (GAD65) and islet antigen 2 (IA-2)), and HLA-DRB1 status were studied in 106 subjects <18 years of age who were recently diagnosed. 104 cases were consecutive. Read More

Pediatr Diabetes 2018 12 28;19(8):1487-1491. Epub 2018 Sep 28.

Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland.

Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new onset type 1 diabetes mellitus (T1DM). Children have a higher rate of neurological complications from DKA when compared to adults. The differential for sudden focal neurological deterioration in the setting of DKA is cerebral oedema followed by ischaemic and haemorrhagic stroke. Read More

J Pediatr Endocrinol Metab 2018 Sep;31(9):1043-1045

University of Health Sciences, Van Training and Research Hospital, Pediatric Endocrinology, Van, Turkey.

Diabetes Technol Ther 2018 09 21;20(9):571-575. Epub 2018 Aug 21.

5 Children's and Youth Hospital Auf der Bult , Hannover Medical School, Hannover, Germany .

Lancet Child Adolesc Health 2018 Sep 30;2(9):635-646. Epub 2018 Jul 30.

Departments of Nutrition and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Adolescents with type 1 diabetes commonly have poor glycaemic control. We aimed to test the efficacy of a newly developed adaptive behavioral intervention (Flexible Lifestyles Empowering Change; FLEX) on metabolic and psychosocial outcomes in adolescents with type 1 diabetes.

Methods: Young people (13-16 years, type 1 diabetes duration >1 year, HbA of 64-119 mmol/mol [8·0-13·0%], and without other serious medical conditions or pregnancy) from two clinical sites (Colorado and Ohio, USA) were eligible for enrolment. Read More

Endocr Pract 2018 08 7;24(8):726-732. Epub 2018 Aug 7.

Objective: Studies of hyperglycemic emergencies with hyperosmolality, including hyperglycemic hyperosmolar state (HHS) and "mixed presentation" with features of diabetic ketoacidosis (DKA) and HHS, are lacking in children. Objectives were to determine the incidence of DKA, HHS, and mixed presentation in a pediatric population, to characterize complications, and to assess accuracy of associated diagnosis codes.

Methods: Retrospective cohort study of 411 hyperglycemic emergencies in pediatric patients hospitalized between 2009 and 2014. Read More

Endocr Pract 2018 09 7;24(9):789-795. Epub 2018 Aug 7.

Objective: Severe hypertriglyceridemia (HTG) (i.e., plasma triglycerides [TGs] >1,000 mg/dL) in children is a rare but pernicious and understudied condition. Read More

Acta Biomed 2018 May 23;89(S5):27-31. Epub 2018 May 23.

Department of Pediatrics, Hamad Medical Center, Doha, Qatar.

Introduction: Familial type 1 diabetes mellitus (FT1DM) comprises parent-offspring and sib-pair subgroups. The clinical and genetic characteristics of FT1DM cases with and without affected family members have been previously studied with varying results. Some investigators found similarity of presenting features whereas others reported significant differences between the two groups. Read More

Pediatr Emerg Care 2018 Jul 24. Epub 2018 Jul 24.

From the Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria.

Background: The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience.

Patients And Methods: An online questionnaire was sent to members of the working groups of the Austrian Society of Pediatric and Adolescent Medicine.

Results: Of 106 questionnaires, 56 were included in the analysis. Read More

Diabet Med 2018 11 3;35(11):1515-1522. Epub 2018 Aug 3.

Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Aims: To describe patterns of primary and diabetes care during transition age (17 to < 19 years) into early adulthood (age 19 to 26 years), and to evaluate the association of primary and diabetes care patterns during transition age with the risk of adverse events in early adulthood.

Methods: We conducted a population-based cohort study of individuals in Ontario, Canada who were diagnosed with diabetes aged < 15 years and who turned 17 between November 2006 and March 2011, followed until March 2015 (n = 2525). Using linked administrative databases, we examined healthcare use during: 'pre-transition-age' (15 to < 17 years), 'transition-age' (17 to < 19 years), and 'early adulthood' (19 to 26 years). Read More

Ann Pediatr Endocrinol Metab 2018 Jun 20;23(2):103-106. Epub 2018 Jun 20.

Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Phosphate is essential in regulating human metabolic processes, and severe hypophosphatemia can induce neurologic and hematological complications and result in respiratory failure and cardiac dysfunction. Therefore, correction of severe hypophosphatemia can be pivotal in the management of diabetic ketoacidosis (DKA). We report the case of a 14-year-old female who was diagnosed with type 1 diabetes and referred to our institute for treatment of DKA. Read More

Diabetes Educ 2018 Aug 27;44(4):340-347. Epub 2018 Jun 27.

Children's Healthcare of Atlanta, Atlanta, Georgia.

Purpose The purpose of this study is to examine the characteristics and health outcomes of college students with type 1 diabetes mellitus (T1DM) as it relates to membership in a local university-based diabetes student organization. Methods This descriptive, correlational research design is a secondary analysis of data. The sample consisted of nationally representative young adults in college (n = 317) between 18 and 30 years of age who were diagnosed with T1DM. Read More

Diabetes Care 2018 09 24;41(9):1981-1990. Epub 2018 Jun 24.

Lexicon Pharmaceuticals, Inc., The Woodlands, TX.

Objective: The objective of this study was to evaluate the efficacy and safety of the dual sodium-glucose cotransporter 1 and 2 inhibitor sotagliflozin compared with placebo when combined with optimized insulin in adults with type 1 diabetes (T1D).

Research Design And Methods: In a double-blind, 52-week, international phase 3 trial, adults with T1D were randomized to placebo ( = 258) or once-daily oral sotagliflozin 200 mg ( = 261) or 400 mg ( = 263) after 6 weeks of insulin optimization. The primary outcome was change in HbA from baseline to 24 weeks. Read More

Diabetes Care 2018 09 24;41(9):1970-1980. Epub 2018 Jun 24.

Lexicon Pharmaceuticals, Inc., The Woodlands, TX.

Objective: Evaluate the efficacy and safety of the dual sodium-glucose cotransporter 1 (SGLT1) and SGLT2 inhibitor sotagliflozin in combination with optimized insulin in type 1 diabetes (T1D).

Research Design And Methods: The inTandem1 trial, a double-blind, 52-week phase 3 trial, randomized North American adults with T1D to placebo ( = 268), sotagliflozin 200 mg ( = 263), or sotagliflozin 400 mg ( = 262) after 6 weeks of insulin optimization. The primary end point was HbA change from baseline at 24 weeks. Read More

Eur Endocrinol 2018 Apr 18;14(1):59-61. Epub 2018 Apr 18.

University Malaya Pediatric and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia.

Cerebral oedema is the most common neurological complication of diabetic ketoacidosis (DKA). However, ischaemic and haemorrhagic brain injury has been reported infrequently. A 10-year old girl who was previously well presented with severe DKA. Read More

Pediatr Diabetes 2018 Oct;19 Suppl 27:155-177

Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.

N Engl J Med 2018 06;378(24):2336-2338

From the Department of Pediatrics, Division of Endocrinology and Diabetes, Icahn School of Medicine at Mt. Sinai, New York.

N Engl J Med 2018 Jun;378(24):2275-2287

From the Departments of Emergency Medicine (N.K., L.T.), Pediatrics (N.K., N.S.G.), and Psychology (S.G., C.S.P.), University of California Davis Health, University of California, Davis, School of Medicine, Sacramento; the Department of Pediatrics, University of Utah School of Medicine, Salt Lake City (J.E.S., C.S.O., T.C.C., J.M.D.); the Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.J.S.); the Division of Emergency Medicine, Department of Pediatrics, Colorado Children's Hospital, University of Colorado-Denver School of Medicine, Aurora (A.R.); the Division of Emergency Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston (J.K.M.); the Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania (S.R.M.), and the Division of Emergency Medicine, Nemours/A.I. duPont Hospital for Children, Sidney Kimmel Medical College at Thomas Jefferson University (J.E.B., A.D.D.) - both in Philadelphia; the Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston (L.E.N.); the Departments of Emergency Medicine and Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence (A.G.); the Division of Emergency Medicine, Department of Pediatrics, Children's National Medical Center, George Washington School of Medicine and Health Sciences, Washington, DC (K.M.B.); the Division of Emergency Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis (K.S.Q.); the Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (J.L.T.); and the Division of Emergency Medicine, Department of Pediatrics, New York Presbyterian Morgan Stanley Children's Hospital, Columbia University College of Physicians and Surgeons, New York (M.Y.K.); and the Department of Psychology, Tufts University, Medford, MA (C.S.P.).

Background: Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute to these injuries has been debated for decades.

Methods: We conducted a 13-center, randomized, controlled trial that examined the effects of the rate of administration and the sodium chloride content of intravenous fluids on neurologic outcomes in children with diabetic ketoacidosis. Read More

Diabetes Technol Ther 2018 06 6;20(S2):S21-S24. Epub 2018 Jun 6.

1 Department of Medicine and Pediatrics, University of Colorado Denver , Aurora, Colorado.

Endocrine 2018 08 24;61(2):267-274. Epub 2018 May 24.

Associate Professor of Biostatistics, Hamedan University of Medical Sciences, Hamedan, Iran.

Purpose: To compare the safety/efficacy of intermittent subcutaneous rapid-acting insulin aspart with the standard low-dose intravenous infusion protocol of regular insulin for treatment of pediatric diabetic-ketoacidosis.

Methods: For a prospective randomized-controlled clinical trial on 50 children/adolescents with mild/moderate diabetic-ketoacidosis, the diagnostic criteria for ketoacidosis included: blood glucose level >250 mg/dl, ketonuria>++, venous pH <7.3 and/or bicarbonate <15 mEq/l. Read More

Pak J Med Sci 2018 Jan-Feb;34(1):106-109

Dr. Khadija Nuzhat Humayun, FCPS. Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.

Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA.

Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Read More

Acta Biomed 2018 Jan 8;89(1):67-71. Epub 2018 Jan 8.

Center on health systems organization, quality and sustainability. Children Hospital and University of Parma, Parma, Italy.

Aim: To analyze clinical characteristics associated with the occurrence of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes (T1D) in children aged <5 years in order to identify early signs or symptoms useful to prevent DKA appearance.

Methods: Data of patients  with newly diagnosed TID aged <5 years (Group 1) and 6-10 years old  (Group 2) coming from the province of Parma were collected in the period 2012-2016.

Results: Mild/moderate ketoacidosis at diabetes diagnosis occurred more frequently in Group 1 than in Group 2 patients (p<0. Read More

CMAJ 2018 Apr;190(14):E416-E421

Department of Pediatrics (Nakhla, Legault, Li), The Montreal Children's Hospital, McGill University; Research Institute of the McGill University Health Centre (Nakhla, Rahme, Legault, Li), Montréal, Que.; Institut national de santé publique du Québec (Simard, Larocque), Québec, Que.

Background: Diabetic ketoacidosis is the leading cause of death among children with type 1 diabetes mellitus, and is an avoidable complication at first-time diagnosis of diabetes. Because having a usual provider of primary care is important in improving health outcomes for children, we tested the association between having a usual provider of care and risk of diabetic ketoacidosis at onset of diabetes.

Methods: Using linked health administrative data for the province of Quebec, we conducted a population-based retrospective cohort study of children aged 1-17 years in whom diabetes was diagnosed from 2006 to 2015. Read More

J Eval Clin Pract 2018 Apr 3. Epub 2018 Apr 3.

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

Rationale, Aims, And Objectives: To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG).

Methods: A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department.

Results: The response rate was 95. Read More

Diabet Med 2018 07 19;35(7):920-928. Epub 2018 Apr 19.

Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.

Aim: To determine the association of mental health visits and socio-economic status in late adolescence with the risk of mortality and acute and chronic diabetes complications in early adulthood.

Methods: We conducted a population-based cohort study of individuals in Ontario, Canada, who had their 20th birthday between January 1999 and March 2015 and a diagnosis of diabetes prior to their 15 birthday, using linked administrative databases (n=8491). The main outcome was death; other outcomes were hypoglycaemia or hyperglycaemia-related hospitalizations and emergency department visits and chronic diabetes complications (dialysis, ophthalmological and macrovascular complications). Read More

Pediatr Diabetes 2018 08 14;19(5):930-936. Epub 2018 Apr 14.

University of Ulm, Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, Ulm, Germany.

Background: A paucity of reports in the literature exists concerning the co-existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D).

Objective: To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD).

Methods: Using the German/Austrian diabetes patient follow-up registry, this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January, 2005 and March, 2017. Read More