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Pediatr Diabetes 2022 Jun 25. Epub 2022 Jun 25.

Baylor College of Medicine, Department of Pediatrics/ Texas Children's Hospital, Houston, TX, USA.

Purpose: Among persons with type 1 diabetes (T1D), adolescents often experience the greatest challenge achieving optimal treatment engagement and glycemic targets. Risk-taking behaviors often increase during adolescence and may interfere with engagement in T1D care. We developed the Diabetes-Specific Risk-Taking Inventory (DSRI) to assess risky T1D self-management behaviors in adolescents with T1D. Read More

Nutr Clin Pract 2022 Jun 24. Epub 2022 Jun 24.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatric and Adolescent Medicine, Mayo Clinic Children's Center, Rochester, Minnesota, USA.

The proper use of intravenous fluids has likely been responsible for saving more lives than any other group of substances. Proper use includes prescribing an appropriate electrolyte and carbohydrate solution, at a calculated rate or volume, for the right child, at the right time. Forming intravenous fluid plans for hospitalized children requires an understanding of water and electrolyte physiology in healthy children and how different pathology deviates from the norm. Read More

Acta Endocrinol (Buchar) 2021 Oct-Dec;17(4):528-531

Post Graduate Institute of Medical Education and Research - Endocrinology and Diabetes Unit, Department of Pediatrics, Chandigarh, India.

Context: Mealtime insulin bolus is traditionally administered before meals in children with type 1 diabetes (T1D). Controlled studies on the use of pre-and postprandial insulin bolus have shown variable results. There are no real-world studies on postprandial bolusing of insulin in young children with T1D. Read More

Can J Diabetes 2022 Feb 11. Epub 2022 Feb 11.

Division of Endocrinology and Metabolism, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada. Electronic address:

Objectives: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity compared with TRANSITION-Q, a generic transition readiness questionnaire.

Methods: We systematically created 3 versions of On TRAck: adolescent, parent and health-care provider (HCP) versions (for case managers and physicians). Read More

Arch Dis Child 2022 Jun 23. Epub 2022 Jun 23.

Paediatric Emergency Department, Sidra Medicine, Doha, Qatar.

Importance: Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes mellitus, which may lead to significant morbidity and mortality.

Objectives: To compare the safety and efficacy of liberalised versus conservative intravenous fluid regimens in the management of DKA in children.

Data Source And Study Selection: Databases from inception to January 2022: MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials were included. Read More

Curr Diab Rep 2022 Jun 21. Epub 2022 Jun 21.

Department of Pediatrics, Division of Endocrinology and Diabetes, Children's Mercy Kansas City, 2401 Gilham Road, Kansas City, MO, 64108, USA.

Purpose Of Review: To synthesize findings from studies published within the last 5 to 10 years and recruiting families of children with new-onset type 1 diabetes (T1D).

Recent Findings: Children can establish glycated hemoglobin (HbA1c) trajectories in the new-onset period that may persist for up to a decade. Demographic factors, family conflict, and diabetic ketoacidosis at the time of diagnosis may be risk factors for sub-optimal child HbA1c, while new immune modulating therapies and a treatment approach that combines advanced technologies and remote patient monitoring may improve child HbA1c. Read More

Diabetes Care 2022 Jun 21. Epub 2022 Jun 21.

Zentralinstitut für Biomedizinische Technik (ZIBMT), Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.

Objective: To investigate whether socioeconomic deprivation and urbanization are associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of pediatric type 1 diabetes.

Research Design And Methods: Children and adolescents aged ≤18 years, living in Germany, with newly diagnosed type 1 diabetes documented between 2016 and 2019 in the Diabetes Prospective Follow-up Registry (DPV; Diabetes-Patienten-Verlaufsdokumentation), were assigned to a quintile of regional socioeconomic deprivation (German Index of Socioeconomic Deprivation) and to a degree of urbanization (Eurostat) by using their residence postal code. With multiple logistic regression models, we investigated whether the frequency of DKA at diagnosis was associated with socioeconomic deprivation or urbanization and whether associations differed by age-group, sex, or migration status. Read More

Arch Dis Child 2022 Jun 16. Epub 2022 Jun 16.

Children's Acute Transport Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

Objectives: To compare clinical management and key outcomes of critically ill children with diabetic ketoacidosis (DKA) in two cohorts (2015 cohort: managed according to the 2015 British Society of Paediatric Endocrinology and Diabetes (BSPED) guidelines; 2020 cohort: managed according to the 2020 BSPED guidelines).

Design: Retrospective cohort study using prospectively collected data.

Setting: A critical care advice and transport service based in London, and referring hospitals within the critical care network. Read More

Arch Dis Child Educ Pract Ed 2022 Jun 15. Epub 2022 Jun 15.

Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Pediatr Diabetes 2022 Jun 14. Epub 2022 Jun 14.

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

Background: There are several observations from various countries that the onset of Coronavirus 19 (COVID-19) pandemic was associated with an increase in the prevalence of DKA. However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions.

Objective: To compare the rate of diabetic ketoacidosis (DKA) in Polish children diagnosed with type 1 diabetes (T1D) between the first year of coronavirus 19 (COVID-19) pandemic (15. Read More

Pediatr Diabetes 2022 Jun 9. Epub 2022 Jun 9.

Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Objectives: Diabetic ketoacidosis (DKA) in type 1 diabetes (T1D) can occur during both insulin pump therapy (continuous subcutaneous insulin infusion, CSII) and insulin injection therapy (multiple daily injections, MDI). The primary aim of this study was to compare CSII and MDI regarding DKA frequency. A secondary aim was to compare metabolic derangement between CSII and MDI at hospital admission for DKA. Read More

Diabetes Care 2022 Jun 9. Epub 2022 Jun 9.

Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, NY.

Objective: Very young children with type 1 diabetes often struggle to achieve glycemic targets, putting them at risk for long-term complications and creating an immense management burden for caregivers. We conducted the first evaluation of the Omnipod 5 Automated Insulin Delivery System in this population.

Research Design And Methods: A total of 80 children aged 2. Read More

Global Health 2022 Jun 8;18(1):58. Epub 2022 Jun 8.

Shiraz Azad University, Dental Branch, Shiraz, Iran.

Background: Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people's access or intention to healthcare systems.

Objective: To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic.

Methods: Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. Read More

Clin Diabetes 2022 15;40(2):204-210. Epub 2022 Apr 15.

Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Houston, TX.

Identifying patients at high risk for diabetic ketoacidosis (DKA) is crucial for informing efforts at preventive intervention. This study sought to develop and validate an electronic medical record (EMR)-based tool for predicting DKA risk in pediatric patients with type 1 diabetes. Based on analysis of data from 1,864 patients with type 1 diabetes, three factors emerged as significant predictors of DKA: most recent A1C, type of health insurance (public vs. Read More

J Klin Endokrinol Stoffwechs 2022 May 31:1-3. Epub 2022 May 31.

Department of Pediatrics, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran.

Hyperosmolar hyperglycemic state (HHS) is a rare complication in children and a life-threatening emergency that presents with a significant increase in blood sugar and hyperosmolarity with or without low ketosis. This study reports the case of a 9-year-old boy with severe HHS due to type 1 diabetes. The patient's initial serum glucose level was 1600; however, he was discharged in a stable condition. Read More

J Korean Med Sci 2022 Jun 6;37(22):e176. Epub 2022 Jun 6.

Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.

Background: Hospital visitation has become challenging during the coronavirus disease 2019 pandemic because of quarantine measures and fear of infection. Consequently, newly diagnosed patients may present with more severe diseases during the pandemic. The present study analyzed the differences in the initial clinical presentations of newly diagnosed patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), comparing pre-pandemic and pandemic periods. Read More

Cureus 2022 Apr 25;14(4):e24456. Epub 2022 Apr 25.

Emergency Medicine, King Abdulaziz University, Jeddah, SAU.

Background: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) and a leading cause of morbidity and mortality in children. We aim to assess the frequency, clinical characteristics, biochemical findings, and outcomes of DKA at the onset of T1DM in young children and adolescents.

Design And Methods: This retrospective cohort study analyzed the medical records of patients ≤ 16 years old seen in the emergency department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between April 2015 and June 2019. Read More

J Chin Med Assoc 2022 Jun 2. Epub 2022 Jun 2.

Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROCA.

Background: Although type 1 diabetes mellitus (T1DM) is recognized as a catastrophic disease among the different types of diabetes, it is often confusedly diagnosed in clinical practice and difficult in care. The objective of this study is to reach a multidisciplinary consensus for the establishment of clinical recommendations on T1DM to optimize its undoubtedly diagnostic evaluation and transitional care.

Methods: Scientific evidence was reviewed by a committee of researchers, based on which recommendations related to T1DM diagnosis were formulated. Read More

Pediatr Diabetes 2022 May 29. Epub 2022 May 29.

Pediatrics Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

Background And Objectives: Acute kidney injury (AKI) is frequent among critically ill children. This study aimed to assess the incidence and factors associated with AKI among children with type 1 diabetes mellitus (T1DM) hospitalized with diabetic ketoacidosis (DKA).

Methods: This prospective observational study was conducted at Sohag University Hospital, Egypt over 1 year. Read More

Medicina (Kaunas) 2022 May 5;58(5). Epub 2022 May 5.

Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia.

: The incidence of severe and moderate forms of DKA as the initial presentation of type 1 diabetes mellitus (T1D) is increasing, especially during the COVID-19 pandemic. This poses a higher risk of developing cerebral edema as a complication of diabetic ketoacidosis (DKA), as well as morbidity and mortality rates. The aim of this study was to determine the trend and clinical features of children treated in the last 10 years in the Pediatric Intensive Care Unit (PICU) due to the development of DKA. Read More

R I Med J (2013) 2022 Jun 1;105(5):46-50. Epub 2022 Jun 1.

Division of Pediatric Endocrinology, Hasbro Children's Hospital, Department of Pediatrics, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Rhode Island Hospital.

Objective: To compare the frequency, severity of presentation and initial presentations of new onset diabetes mellitus (DM) in youth in Rhode Island during the early phase of the COVID-19 pandemic compared to the same time frame in 2018 and 2019.

Methods: A retrospective cohort study of youth treated for new onset DM at Hasbro Children's Hospital between March 1 and May 15, 2020, compared to those diagnosed in the same period in 2018 and 2019.

Results: Fewer youth were diagnosed with new onset DM in Spring 2020 and the percentage of youth with DKA at time of DM diagnosis was higher in Spring 2020 compared to prior years (p=0. Read More

J Pak Med Assoc 2022 Apr;72(4):790-792

National Institute of Child Health, Karachi Pakistan.

Mucormycosis is a cause of fulminant necrotising fungal infection in children with underlying immunocompromising conditions. Rhino-orbito-cerebral infection is its most common form in the paediatric group with uncontrolled diabetes mellitus or diabetic ketoacidosis. The initial presentation can mimic a bacterial infection; thus a high index of suspicion is needed for timely intervention to reduce morbidity and mortality. Read More

Front Pediatr 2022 6;10:869299. Epub 2022 May 6.

Division of Pediatrics, Department of Health Science, University of Piemonte Orientale, Novara, Italy.

Background: Type 1 Diabetes (T1D) is a well-known endocrinological disease in children and adolescents that is characterized by immune-mediated destruction of pancreatic β-cells, leading to partial or total insulin deficiency, with an onset that can be subtle (polydipsia, polyuria, weight loss) or abrupt (Diabetic Keto-Acidosis, hereafter DKA, or, although rarely, Hyperosmolar Hyperglycemic State, hereafter HHS). Severe DKA risk at the onset of T1D has recently significantly increased during the SARS-CoV-2 pandemic with life-threatening complications often due to its management. DKA is marked by low pH (<7. Read More

Pediatr Diabetes 2022 May 22. Epub 2022 May 22.

Southport and Ormskirk Hospital NHS Trust, Ormskirk, UK.

Objective: Before 2016, no child was known to survive type 1 diabetes (T1D) in Laos, a lower-middle income country (LMIC) in South-east Asia. In partnership with the Laos government, a non-government organization (NGO) called Action4Diabetes (A4D) has since been providing insulin, blood glucose monitoring kits, HbA1c testing, and emergency hospital expenses for Laotian children and young people (CYP) with T1D, and education for healthcare professionals. Here, we report the demographics and clinical outcomes of the CYP with T1D enrolled in A4D's Clinic Support Programme. Read More

SAGE Open Med Case Rep 2022 13;10:2050313X221097263. Epub 2022 May 13.

Pediatric Endocrinology, Pediatrics Department, Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia.

Diabetic ketoacidosis is a life-threatening complication associated with type 1 diabetes (T1D). Recent evidence suggests that SARS-CoV-2 could trigger diabetic ketoacidosis in type 1 diabetes susceptibility and previous insulitis; however, the data on SARS-CoV-2-infected patients with diabetic ketoacidosis as their type 1 diabetes are still limited. We report a 13-year-old Latinamerican male with symptoms and laboratory tests diagnostic of diabetic ketoacidosis and positive SARS-CoV-2 reverse transcription polymerase chain reaction, who required mild COVID-19 care management, fluid resuscitation, and insulin infusion at a regular dose, without further complications after the acute infection. Read More

Pediatr Nephrol 2022 May 18. Epub 2022 May 18.

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

Background: Acute kidney injury (AKI) is a common complication in patients with diabetic ketoacidosis (DKA) (incidence 35-77%). AKI evolution during DKA treatment/recovery is poorly understood. Our aim was to assess children with DKA for prevalence, short-term kidney outcomes, severity, and predictors of AKI development and resolution. Read More

BMJ Open Diabetes Res Care 2022 05;10(3)

Department of Physiology and Membrane Biology, UC Davis, Davis, California, USA.

Introduction: Diabetic ketoacidosis (DKA) causes acute and chronic neuroinflammation that may contribute to cognitive decline in patients with type 1 diabetes. We evaluated the effects of agents that reduce neuroinflammation (triarylmethane-34 (TRAM-34) and minocycline) during and after DKA in a rat model.

Research Design And Methods: Juvenile rats with DKA were treated with insulin and saline, either alone or in combination with TRAM-34 (40 mg/kg intraperitoneally twice daily for 3 days, then daily for 4 days) or minocycline (45 mg/kg intraperitoneally daily for 7 days). Read More

Dis Mon 2022 May 13:101418. Epub 2022 May 13.

Internal Medicine Residents Research Director, Department of Internal Medicine, Section of Endocrinology, University of Illinois at Chicago, Advocate Christ Medical Center. Electronic address:

Diabetic ketoacidosis (DKA) is a form of a hyperglycemic emergency mainly characterized by the triad of hyperglycemia, ketosis, and anion gap metabolic acidosis. DKA may be the initial presentation in approximately 25-40 % of patients with type 1 diabetes. It may also occur in at least 34% of patients with type 2 diabetes. Read More

Front Endocrinol (Lausanne) 2022 25;13:900278. Epub 2022 Apr 25.

Department of Pediatrics, University of Chieti, Chieti, Italy.

Diabetes Metab Syndr Obes 2022 2;15:1375-1387. Epub 2022 May 2.

Siriraj Diabetes Center of Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: This study aimed to investigate the clinical characteristics, glycemic control, and microvascular complications compared between young-onset type 1 (T1DM) and type 2 diabetes (T2DM) patients at Siriraj Hospital.

Patients And Methods: We collected demographic, clinical, glycemic control, and microvascular complication data of young-onset (onset <30 years of age) T1DM and T2DM patients at our center using February 2019-December 2020 data from the Thai Type 1 Diabetes and Diabetes diagnosed Age before 30 years Registry, Care and Network (T1DDAR CN).

Results: Of 396 patients, 76% had T1DM and 24% had T2DM. Read More