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    637 results match your criteria Pediatrics Diabetic Ketoacidosis

    1 OF 13

    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 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

    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 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

    Predictive Hyperglycemia and Hypoglycemia Minimization: In-Home Evaluation of Safety, Feasibility, and Efficacy in Overnight Glucose Control in Type 1 Diabetes.
    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

    Serum Levels of Neuron-Specific Enolase in Children With Diabetic Ketoacidosis.
    J Child Neurol 2016 Jan 1:883073816686718. Epub 2016 Jan 1.
    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

    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 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

    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 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

    High frequency of diabetic ketoacidosis at diagnosis of type 1 diabetes in Italian children: a nationwide longitudinal study, 2004-2013.
    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

    Feasibility of Long-Term Closed-Loop Control: A Multicenter 6-Month Trial of 24/7 Automated Insulin Delivery.
    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

    Recognition and nursing management of diabetes in children.
    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

    Substantial reduction in hospital stay of children and adolescents with diabetic ketoacidosis after implementation of Clinical Practice Guidelines in a university hospital in Saudi Arabia.
    J Eval Clin Pract 2016 Nov 29. 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

    Interprofessional, multiple step simulation course improves pediatric resident and nursing staff management of pediatric patients with diabetic ketoacidosis.
    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

    Low vitamin D level in pediatric patients with new onset type 1 diabetes is common, especially if in ketoacidosis.
    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

    Clinical outcomes in youth beyond the first year of type 1 diabetes: Results of the Pediatric Diabetes Consortium (PDC) type 1 diabetes new onset (NeOn) study.
    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

    Regional Brain Water Content and Distribution During Diabetic Ketoacidosis.
    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

    A survey of youth with new onset type 1 diabetes: Opportunities to reduce diabetic ketoacidosis.
    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

    High incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes among Polish children aged 10-12 and under 5 years of age: A multicenter study.
    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

    COST-EFFECTIVENESS OF STRUCTURED EDUCATION IN CHILDREN WITH TYPE-1 DIABETES MELLITUS.
    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

    Small Fiber Neuropathy in Children: Two Case Reports Illustrating the Importance of Recognition.
    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

    Cognitive functions in children and adolescents with early-onset diabetes mellitus in Egypt.
    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

    Approach to the Treatment of Diabetic Ketoacidosis.
    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

    Insulin pump-associated adverse events are common, but not associated with glycemic control, socio-economic status, or pump/infusion set type.
    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

    Low socioeconomic status is associated with adverse events in children and teens on insulin pumps under a universal access program: a population-based cohort study.
    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

    Diabetic ketoacidosis in vanishing white matter.
    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

    Comorbidity of attention deficit hyperactivity disorder and type 1 diabetes in children and adolescents: Analysis based on the multicentre DPV registry.
    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

    Clinical characteristics of type 1 diabetes mellitus in Taiwanese children aged younger than 6 years: A single-center experience.
    J Formos Med Assoc 2016 Aug 9. 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

    Challenging the One-Dose-Fits-All Model for Insulin in the Acute Treatment of Pediatric Diabetic Ketoacidosis. A Critical Appraisal of "Low-Dose Versus Standard-Dose Insulin in Pediatric Diabetic Ketoacidosis: A Randomized Clinical Trial" by Nallasamy et al (JAMA Pediatrics 2014; 168:999-1005).
    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

    Timeliness of referral of children with new onset type 1 diabetes.
    Postgrad Med J 2016 Aug 3. 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

    Severity of clinical presentation in youth with type 1 diabetes is associated with differences in brain structure.
    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

    Serial optic nerve sheath diameter ultrasonography during pediatric diabetic ketoacidosis management: A pilot study.
    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

    Multiple daily injection of insulin regimen for a 10-month-old infant with type 1 diabetes mellitus and diabetic ketoacidosis.
    Ann Pediatr Endocrinol Metab 2016 Jun 30;21(2):96-8. Epub 2016 Jun 30.
    Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
    The incidence of type 1 diabetes is increasing worldwide, and the greatest increase has been observed in very young children under 4 years of age. A case of infantile diabetic ketoacidosis in a 10-month-old male infant was encountered by these authors. The infant's fasting glucose level was 490 mg/dL, his PH was 7. Read More

    A rare but important adverse effect of tacrolimus in a heart transplant recipient: diabetic ketoacidosis.
    Turk J Pediatr 2015 Sep-Oct;57(5):533-5
    Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
    Heart transplantation indications in pediatric population include congenital heart diseases, cardiomyopathies and retransplants. Cardiomyopathy is the primary indication for 11 to 17 years of age. The surveillance after transplantation is a very important issue because of both the rejection risk and the adverse effects due to medications after transplantation. Read More

    Thrombocytopenia-associated multiorgan failure occurring in an infant at the onset of type 1 diabetes successfully treated with fresh frozen plasma.
    Clin Case Rep 2016 Jul 2;4(7):671-4. Epub 2016 Jun 2.
    Department of Pediatric Diabetes and Endocrinology Starship Children's Hospital Auckland New Zealand.
    TAMOF is a devastating microangiopathy that can occur in association with the new onset of T1DM, and should be considered with the onset of thrombocytopenia, renal failure, and raised LDH. Treatment with fresh frozen plasma should be considered as a first-line option in such cases prior to plasma exchange. Read More

    Fatal Pulmonary Embolism Due to Inherited Thrombophilia Factors in a Child With Wolfram Syndrome.
    J Pediatr Hematol Oncol 2016 Oct;38(7):e254-6
    *Clinic of Pediatrics, Tekirdağ State Hospital, Tekirdağ Departments of †Pediatrics, Division of Pediatric, Endocrinology ‡Pediatrics, Division of Pediatric, Hematology ∥Pediatrics, Division of Pediatric, Cardiology ¶Cardiovascular Surgery #Medical Genetics **Nuclear Medicine ††Cardiology, Faculty of Medicine, Pamukkale University, Denizli §Iğdir State Hospital, Clinic of Pediatrics, Iğdir, Turkey.
    Wolfram syndrome-1 is a rare and severe autosomal recessive neurodegenerative disease characterized by diabetes mellitus (DM), optic atrophy, diabetes insipidus, and deafness. Poorly controlled type 1 DM increases the risk for thrombosis. However, coexistence of DM and hereditary thrombosis factors is rarely observed. Read More

    Metformin inhibits Branched Chain Amino Acid (BCAA) derived ketoacidosis and promotes metabolic homeostasis in MSUD.
    Sci Rep 2016 Jul 4;6:28775. Epub 2016 Jul 4.
    Buck Institute for Research on Aging, 8001 Redwood Blvd, Novato, CA 94945, USA.
    Maple Syrup Urine Disease (MSUD) is an inherited disorder caused by the dysfunction in the branched chain keto-acid dehydrogenase (BCKDH) enzyme. This leads to buildup of branched-chain keto-acids (BCKA) and branched-chain amino acids (BCAA) in body fluids (e.g. Read More

    Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait.
    Sci Rep 2016 Jun 22;6:27519. Epub 2016 Jun 22.
    Amiri Hospital, Department of Pediatrics, Capital 13041 Kuwait.
    We examined the frequency and severity of diabetic ketoacidosis (DKA) in 679 children and adolescents (0-14 years) at diagnosis of Type 1 Diabetes Mellitus (T1DM) in Kuwait. Between 1(st) January 2011 and 31(st) December 2013, all newly diagnosed children with diabetes were registered prospectively in a population-based electronic register. DKA was diagnosed using standard criteria based on the levels of venous pH and serum bicarbonate. Read More

    Outpatient Care Preceding Hospitalization for Diabetic Ketoacidosis.
    Pediatrics 2016 Jun;137(6)
    Center for Primary Care and Outcomes Research, and General Pediatrics, Stanford University School of Medicine, Stanford, California.
    Objective: To identify patterns of outpatient care associated with diabetic ketoacidosis (DKA) among pediatric patients with type 1 diabetes (T1D).

    Methods: Retrospective cohort study using Medicaid claims data from 2009 to 2012 for children with T1D enrolled ≥365 consecutive days in California Children's Services, a Title V program for low-income children with chronic disease. Outcome was DKA hospitalization >30 days after enrollment. Read More

    Treatment with the KCa3.1 inhibitor TRAM-34 during diabetic ketoacidosis reduces inflammatory changes in the brain.
    Pediatr Diabetes 2016 May 13. Epub 2016 May 13.
    Department of Physiology and Membrane Biology, University of California, Davis School of Medicine, Sacramento, CA 95817, USA.
    Background: Diabetic ketoacidosis (DKA) causes brain injuries in children ranging from subtle to life-threatening. Previous studies suggest that DKA-related brain injury may involve both stimulation of Na-K-Cl cotransport and microglial activation. Other studies implicate the Na-K-Cl cotransporter and the Ca-activated K channel KCa3. Read More

    Testicular failure following severe diabetic ketoacidosis complicated by hypotensive shock.
    Clin Case Rep 2016 Apr 4;4(4):396-8. Epub 2016 Mar 4.
    Department of Pediatrics University at Buffalo Women and Children's Hospital of Buffalo 219 Bryant Street Buffalo New York 14222.
    The stalling or regression of pubertal development may be the first sign of hypergonadotropic hypogonadism in adolescent males. We report here a case of pediatric hypergonadotropic hypogonadism that likely developed secondary to ischemic injury during severe diabetic ketoacidosis (DKA). This case highlights the importance of performing genital exams during all evaluations of pediatric patients. Read More

    Elevated Leukocyte Azurophilic Enzymes in Human Diabetic Ketoacidosis Plasma Degrade Cerebrovascular Endothelial Junctional Proteins.
    Crit Care Med 2016 Sep;44(9):e846-53
    1Children's Health Research Institute, London, ON, Canada.2Department of Physiology and Pharmacology, Western University, London, ON, Canada.3Centre for Critical Illness Research, Lawson Health Research Institute, London, ON, Canada.4Department of Translational Bioscience, National Research Council Canada, Ottawa, ON, Canada.5Department of Medicine, Western University, London, ON, Canada.6Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.7Department of Paediatrics, Western University, London, ON, Canada.8Department of Clinical Neurological Sciences, Western University, London, ON, Canada.
    Objective: Diabetic ketoacidosis in children is associated with vasogenic cerebral edema, possibly due to the release of destructive polymorphonuclear neutrophil azurophilic enzymes. Our objectives were to measure plasma azurophilic enzyme levels in children with diabetic ketoacidosis, to correlate plasma azurophilic enzyme levels with diabetic ketoacidosis severity, and to determine whether azurophilic enzymes disrupt the blood-brain barrier in vitro.

    Design: Prospective clinical and laboratory study. Read More

    Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes.
    Free Radic Biol Med 2016 Jun 29;95:268-77. Epub 2016 Mar 29.
    Department of Pediatrics, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA. Electronic address:
    Diets that boost ketone production are increasingly used for treating several neurological disorders. Elevation in ketones in most cases is considered favorable, as they provide energy and are efficient in fueling the body's energy needs. Despite all the benefits from ketones, the above normal elevation in the concentration of ketones in the circulation tend to illicit various pathological complications by activating injurious pathways leading to cellular damage. Read More

    Acute Erosive Esophagitis As a Rare Complication of Severe Pediatric Diabetes Ketoacidosis.
    J Pediatr Gastroenterol Nutr 2016 Apr;62(4):e38-9
    *Division of Pediatric Endocrinology†Division of Pediatric Gastroenterology‡Division of Pediatric Critical Care, Department of Pediatrics, Rhode Island Hospital/Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence.

    Subcutaneous regular insulin for the treatment of diabetic ketoacidosis in children.
    Pediatr Diabetes 2016 Mar 23. Epub 2016 Mar 23.
    Pediatric Diabetes unit and Pediatrics A Division, Ruth Rappaport Children's Hospital of Haifa, Rambam Healthcare Campus, Haifa, Israel.
    Background: Diabetic ketoacidosis (DKA) treatment protocols vary, however low-dose intravenous administration of regular insulin is the standard care for replacing insulin in most centers. Few studies, the majority in adults, demonstrated subcutaneous injection of rapid-acting insulin every 1-2 hours to be a valid alternative.

    Objective: To evaluate the efficacy and safety of subcutaneous regular insulin administered every 4 hours in pediatric DKA in a clinical setting. Read More

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