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Lancet Child Adolesc Health 2019 Apr 12. Epub 2019 Apr 12.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

The effect of type 1 diabetes on the developing brain is a topic of primary research interest. A variety of potential dysglycaemic insults to the brain can cause cellular and structural injury and lead to altered neuropsychological outcomes. These outcomes might be subtle in terms of cognition but appear to persist into adult life. Read More

Exp Mol Pathol 2019 Apr 13;108:97-104. Epub 2019 Apr 13.

Department of Neurology, University of Maryland, School of Medicine, Baltimore, MD, USA. Electronic address:

There is increasing awareness that in addition to the metabolic crisis of diabetic ketoacidosis (DKA) caused by severe insulin deficiency, the immune inflammatory response is likely an active multicomponent participant in both the acute and chronic insults of this medical crisis, with strong evidence of activation for both the cytokine and complement system. Recent studies report that the matrix metalloproteinase enzymes and their inhibitors are systemically activated in young Type 1 diabetes mellitus (T1D) patients during DKA and speculate on their involvement in blood-brain barrier (BBB) disruption. Based on our previous studies, we address the question if matrix metalloproteinase 9 (MMP9) is expressed in the brain in the fatal brain edema (BE) of DKA. Read More

Health Psychol 2019 Apr 11. Epub 2019 Apr 11.

Department of Pediatrics.

Objective: Diabetic ketoacidosis (DKA) and elevated hemoglobin A1c (HbA1c) in youth with Type 1 diabetes (T1D) can result in significant morbidity and mortality. Elucidating the risk factors for poor glycemic control and DKA hospitalizations is crucial for the refinement and development of prevention and treatment efforts.

Method: Based on a conceptual framework, this study used path analysis to evaluate individual and family characteristics, psychosocial responses, and individual and family responses that prospectively predict the number of DKA hospitalizations and HbA1c approximately 1 year after assessment, accounting for sociodemographics. Read More

Pediatr Emerg Care 2019 Apr 4. Epub 2019 Apr 4.

Division of Biostatistics ACHRI, Department of Pediatrics, Arkansas Children's Hospital Research Institute, College of Medicine, University of Arkansas, Little Rock, AR.

Background: Suspected cerebral edema diabetic ketoacidosis (SCEDKA) is more common than perceived with symptoms including altered mentation, headache with vomiting, depressed Glasgow coma scale (GCS), abnormal motor or verbal responses, combativeness, and neurological depression. Suspected cerebral edema diabetic ketoacidosis has been associated with initial diabetic ketoacidosis (DKA) presentation and at start of DKA therapy.Cerebral oximetry (bihemispheric regional cerebral oxygen saturation [rcSO2] and cerebral blood volume index [CBVI]) can detect increased intracranial pressure (ICP)-induced altered bihemispheric cerebral physiology (rcSO2) (Crit Care Med 2006;34:2217-2223, J Pediatr 2013;163: 1111-1116, Curr Med Chem 2009;16:94-112, Diabetologia 1985;28:739-742, Pediatr Crit Care Med 2013;14:694-700). Read More

Indian Pediatr 2019 Mar;56(3):244-246

Department of Pediatrics, Cloudnine Children's Hospital, Bengaluru, Karnataka, India.

Background: Posterior reversible encephalopathy syndrome (PRES) is a benign disorder of reversible subcortical vasogenic cerebral edema.

Case Characteristics: A 13-yr-old girl presented 4 days after complete recovery from diabetic ketoacidosis with symptoms of headache, altered sensorium, seizures, and visual loss. There was no hypertension or biochemical abnormalities identified. Read More

Cureus 2019 Jan 8;11(1):e3844. Epub 2019 Jan 8.

Pediatrics, University of Texas Health Science Center at Houston, Frisco, USA.

A 16-year-old female with new-onset diabetic ketoacidosis (DKA) developed acute pancreatitis and hypertriglyceridemia within 24 hours after admission. Her insulin regimen was continued after resolution of DKA, and her pancreatitis with hypertriglyceridemia showed resolution. We are presenting a case of pediatric DKA with hypertriglyceridemia and pancreatitis treated with extended insulin. Read More

J Emerg Med 2019 Mar 14. Epub 2019 Mar 14.

Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California.

Background: Diabetic ketoacidosis (DKA) is a common complication affecting patients with type 1 diabetes, and DKA is associated with dehydration and electrolyte abnormalities. Supraventricular tachycardia (SVT), although a common tachydysrhythmia in the pediatric population, remains a rare entity in patients presenting with DKA.

Case Report: We describe a case of first-time SVT in an adolescent patient with DKA and recent methamphetamine abuse, with both factors likely predisposing him to develop a tachydysrhythmia. Read More

Pediatr Emerg Care 2019 03 12. Epub 2019 Mar 12.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indiana University Health, Indianapolis, IN

Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs. Read More

Hosp Pediatr 2019 Apr 8;9(4):300-304. Epub 2019 Mar 8.

Regional Affiliations and Outreach,University of California, Davis Health, Sacramento, California.

Background: Our 121-bed children's hospital is a quaternary care referral center for a 33-county region. Referring hospitals asked for Pediatric Acute Care Education Sessions (PACES). To determine which topics to prioritize for these sessions, nominal group technique (NGT) methods were used to obtain stakeholder-prioritized consensus on education topics. Read More

Clin Case Rep 2019 Feb 18;7(2):264-267. Epub 2018 Dec 18.

Department of Pediatrics University of New Mexico Health Sciences Center Albuquerque New Mexico.

Subclinical cerebral edema in diabetic ketoacidosis tends to manifest with subtle neurological symptoms including headache, lethargy, or disorientation and a Glasgow Coma Scale of 14-15. Treatment of subclinical cerebral edema with hyperosmolar therapy for persistent symptoms is associated with good outcomes. Read More

Endocrinol Diabetes Metab Case Rep 2019 Mar 5;2019. Epub 2019 Mar 5.

Department of Pediatrics, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.

Hyperglycemic hyperosmolar state (HHS) and diabetic ketoacidosis (DKA) are the most severe acute complications of diabetes mellitus (DM). HHS is characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. A 14-year-old Japanese boy presented at the emergency room with lethargy, polyuria and polydipsia. Read More

Indian Pediatr 2019 Feb;56(2):126-129

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Objective: To find the strength of agreement between point-of-care and serum b-hydroxybutyrate.

Methods: 236 paired samples (capillary b-hydroxybutyrate by a point of care device and serum b-hydroxybutyrate by colorimetric enzymatic estimation) samples were collected from 26 children aged <13 years admitted with diabetic ketoacidosis. Inborn errors of metabolism and septic shock were excluded. Read More

Can J Diabetes 2018 Dec 26. Epub 2018 Dec 26.

Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Royal University Hospital, Saskatoon, Saskatchewan, Canada. Electronic address:

Objectives: Despite published clinical practice guidelines in pediatrics for the use of a standardized diabetic ketoacidosis (DKA) protocol, our centre lacked an accepted, evidence-informed protocol for pediatric DKA management. Our primary aim was to attain broad clinical uptake of a DKA order set. Secondary aims included improved standard-of-care DKA management principles regarding fluid, potassium and dextrose administration. Read More

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 02 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 2019 Apr 20;207:205-212.e5. 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 03 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 2019 Jan;32(1):11-17

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 02 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 Sep 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