3,863 results match your criteria Pediatrics Hypoglycemia

Adherence to pre-operative fasting guidelines and associated factors among pediatric surgical patients in selected public referral hospitals, Addis Ababa, Ethiopia: Cross sectional study.

Ann Med Surg (Lond) 2022 Jun 21;78:103813. Epub 2022 May 21.

School of Medicine, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.

Background: Fasting before anesthesia is mandatory in children to reduce the complications of regurgitation, vomiting, and aspiration during anesthesia and surgery. Prolonged fasting times have several negative implications in children, because high fluid turnover quickly leads to dehydration, hypotension, metabolic disturbances, and hypoglycemia, resulting in poor anesthetic outcomes.

Aims: This study aimed to assess adherence to preoperative fasting guidelines and associated factors among pediatric patients undergoing elective surgery in Addis Ababa public hospitals in Ethiopia in 2020. Read More

View Article and Full-Text PDF

More hypoglycemia not associated with increasing estimated adiposity in youth with type 1 diabetes.

Pediatr Res 2022 Jun 22. Epub 2022 Jun 22.

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: Despite the widespread clinical perception that hypoglycemia may drive weight gain in youth with type 1 diabetes (T1D), there is an absence of published evidence supporting this hypothesis.

Methods: We estimated the body fat percentage (eBFP) of 211 youth (HbA1c 8.0-13. Read More

View Article and Full-Text PDF

Glycogen storage diseases with liver involvement: a literature review of GSD type 0, IV, VI, IX and XI.

Orphanet J Rare Dis 2022 06 20;17(1):241. Epub 2022 Jun 20.

Division of Metabolism, Department of Pediatric Subspecialties, Ospedale Pediatrico Bambino Gesù, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.

Background: Glycogen storage diseases (GSDs) with liver involvement are classified into types 0, I, III, IV, VI, IX and XI, depending on the affected enzyme. Hypoglycemia and hepatomegaly are hallmarks of disease, but muscular and renal tubular involvement, dyslipidemia and osteopenia can develop. Considering the paucity of literature available, herein we provide a narrative review of these latter forms of GSDs. Read More

View Article and Full-Text PDF

Effect and Safety of Adding Metformin to Insulin Therapy in Treating Adolescents With Type 1 Diabetes Mellitus: An Updated Meta-Analysis of 10 Randomized Controlled Trials.

Front Endocrinol (Lausanne) 2022 30;13:878585. Epub 2022 May 30.

Center of Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.

Background: The role of metformin in the treatment of adolescents with type 1 diabetes mellitus (T1DM) remains controversial. We conducted this updated meta-analysis to generate a comprehensive assessment regarding the effect and safety of metformin in treating adolescents with T1DM.

Methods: We systematically searched PubMed, Embase, and the Cochrane Central Registry of Controlled Trials (CENTRAL) from their inception to November 2021 to identify randomized controlled trials evaluating the efficacy of metformin in the treatment of adolescents with T1DM. Read More

View Article and Full-Text PDF

Referral challenges and outcomes of neonates received at Muhimbili National Hospital, Dar es Salaam, Tanzania.

PLoS One 2022 15;17(6):e0269479. Epub 2022 Jun 15.

Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Background: Functional referral system including pre referral care, access to emergency transport and ensuring continuity of care between facilities is critical for improved newborn health outcome. The neonatal transport system is quite undervalued in many sub Saharan countries, Tanzania included. This study assessed the pre referral care, transport process, ambulance characteristics, admission clinical status and outcomes of referred neonates at Muhimbili National Hospital Upanga, a tertiary facility in Dar es Salaam, Tanzania. Read More

View Article and Full-Text PDF

Pediatric Acute Liver Failure in Sickle Cell Disease.

GE Port J Gastroenterol 2022 May 28;29(3):192-196. Epub 2021 Apr 28.

Gastroenterology Unit, Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Introduction: Sickle cell intrahepatic cholestasis (SCIC) is one of the rarest and the most severe acute hepatic manifestations of sickle cell disease (SCD) and it can rapidly progress to acute liver failure. It is associated with a high mortality rate, demanding prompt recognition and management.

Case Presentation: We report a case of a 7-year-old boy with a history of homozygous HbS SCD who presented to the emergency department with fever, increasing abdominal pain, and jaundice. Read More

View Article and Full-Text PDF

Drug Induced Diabetes Mellitus (DIDM) in Pediatric Acute Lymphoblastic Leukemia: Approach to diagnosis and management.

J Pediatr Hematol Oncol 2022 Jun 7. Epub 2022 Jun 7.

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh.

Corticosteroids and l-asparaginase used in the treatment of pediatric acute lymphoblastic leukemia (ALL) can cause drug-induced diabetes mellitus (DIDM). DIDM can lead to dyselectrolytemia, a higher risk of infections including cellulitis, bacteremia, fungemia, and a higher incidence of febrile neutropenia and may have an impact on the outcome of ALL. Literature on the management of DIDM among children with ALL is sparse and the diagnostic criteria for pediatric diabetes should be carefully applied considering the acute and transient nature of DIDM during ALL therapy. Read More

View Article and Full-Text PDF

Hospital Readmission Among Late Preterm Infants: New Insights and Remaining Questions.

Hosp Pediatr 2022 Jun 13. Epub 2022 Jun 13.

Nemours Children's Health, Wilmington, Delaware; and.

Late preterm infants (LPIs), those born at 34 to 36 6/7 weeks' gestation, account for the majority of preterm births (73%).1 Given their physiologic immaturity, LPIs are at increased risk of respiratory distress, hyperbilirubinemia, hypoglycemia, and other complications in the neonatal period, and are at increased risk of hospital readmission in the first month of life.2 As Amsalu and colleagues describe in this month's issue of Hospital Pediatrics,3 identification of a predictive model to differentiate LPI at higher risk of complications would help inform tailored discharge plans and prevent readmissions. Read More

View Article and Full-Text PDF

Maternal Obesity-Associated Neonatal Morbidities in Early Newborn Period.

Front Pediatr 2022 25;10:867171. Epub 2022 May 25.

Department of Pediatrics, Albany Medical College, Albany, NY, United States.

Maternal obesity has been associated with pregnancy-related complications and neonatal morbidities. The primary aim of this study was to evaluate early neonatal morbidities associated with maternal obesity from the infant-mother dyad data set at a single, large Regional Perinatal Center (RPC) in NY. A retrospective chart review of all mother-infant dyads born from January 2009 to December 2019 was done. Read More

View Article and Full-Text PDF

Severe Hypoglycemia Caused by a Giant Borderline Phyllodes Tumor of the Breast: A Case Report and Literature Review.

Front Endocrinol (Lausanne) 2022 26;13:871998. Epub 2022 May 26.

Department of Geriatrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

A case of hypoglycemic coma caused by a giant borderline phyllodes tumor of the breast has been described. The patient, a 63-year-old woman, was admitted with recurrent unconsciousness. She had a giant breast tumor with decreased blood glucose, insulin, and C-peptide. Read More

View Article and Full-Text PDF

Safety and Glycemic Outcomes With a Tubeless Automated Insulin Delivery System in Very Young Children With Type 1 Diabetes: A Single-Arm Multicenter Clinical Trial.

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

View Article and Full-Text PDF

Outcomes and genotype correlations in patients with mitochondrial trifunctional protein or isolated long chain 3-hydroxyacyl-CoA dehydrogenase deficiency enrolled in the IBEM-IS database.

Mol Genet Metab Rep 2022 Sep 3;32:100884. Epub 2022 Jun 3.

University of Pittsburgh School of Medicine, USA.

Purpose: Mitochondrial trifunctional protein deficiency (TFPD) and isolated long chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD) are two related defects of fatty acid β -oxidation. While NBS has decreased mortality, morbidity remains significant. Additionally, the relationship of genotype to clinical outcome remains unclear. Read More

View Article and Full-Text PDF
September 2022

Localized Islet Nuclear Enlargement Hyperinsulinism (LINE-HI) due to ABCC8 and GCK Mosaic Mutations.

Eur J Endocrinol 2022 Jun 1. Epub 2022 Jun 1.

D De Leon, Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, United States.

Objective: Congenital hyperinsulinism (HI) is the most common cause of persistent hypoglycemia in children. In addition to typical focal or diffuse HI, some cases with diazoxide-unresponsive congenital hyperinsulinism (HI) have atypical pancreatic histology termed Localized Islet Nuclear Enlargement (LINE) or mosaic HI, characterized by histologic features similar to diffuse HI, but confined to only a region of pancreas. Our objective was to characterize the phenotype and genotype of children with LINE-HI. Read More

View Article and Full-Text PDF

Case Report: Jejunoileal Atresia With Persistent Poor Bowel Function Can Occur After Surgical Correction for Hirschsprung Disease.

Front Pediatr 2022 20;10:907179. Epub 2022 May 20.

Department of Paediatrics, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.

Jejunoileal atresia (JIA) is one of the common etiologies of intestinal obtrusion in neonates. However, cases of concomitant ileal atresia and Hirschsprung disease (HD) rarely occur. We report the case of a male infant who had JIA concomitantly with HD that was re-anastomosed. Read More

View Article and Full-Text PDF

Hypoglycemia-Associated Autonomic Failure in Type 1 Diabetes: Beyond Hypoglycemia Unawareness.

Clin Diabetes 2022 15;40(2):250-252. Epub 2022 Apr 15.

Division of Endocrinology, Department of Pediatrics, Medical School, University of Patras, Patras, Greece.

View Article and Full-Text PDF

Variation in the hemoglobin glycation index.

J Diabetes Complications 2022 Jun 2:108223. Epub 2022 Jun 2.

Pennington Biomedical Research Center, Baton Rouge, LA, USA.

A high hemoglobin glycation index (HGI) has been repeatedly associated with greater risk for hypoglycemia in people with diabetes and greater risk for chronic vascular disease in people with or without diabetes. This review explores how different sources of analytical and biological variation in HbA1c and blood glucose individually and collectively affect the clinical information value of HGI. We conclude that HGI is a complex quantitative trait that is a clinically practical biomarker of risk for both hypoglycemia and chronic vascular disease. Read More

View Article and Full-Text PDF

Intralymphatic GAD-alum (Diamyd®) improves glycaemic control in Type 1 diabetes with HLA DR3-DQ2.

J Clin Endocrinol Metab 2022 Jun 6. Epub 2022 Jun 6.

Division of Pediatrics, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences and Crown Princess Victoria Children´s Hospital, Linköping University, Linköping, Sweden.

Aims: Residual beta cell function in Type 1 diabetes (T1D) is associated with lower risk of complications. Autoantigen therapy with GAD-alum (Diamyd®) given in three intralymphatic injections with oral Vitamin D has shown promising results in persons with T1D carrying the HLA DR3-DQ2 haplotype in the phase IIb trial DIAGNODE-2. We aimed to explore the efficacy of intralymphatic GAD-alum on blood glucose recorded by continuous glucose monitoring (CGM). Read More

View Article and Full-Text PDF

Cerebral Effects of Neonatal Dysglycemia.

Clin Perinatol 2022 06 21;49(2):405-426. Epub 2022 Apr 21.

Department of Pediatrics, University of Minnesota Medical School, Academic Office Building, 2450 Riverside Avenue S AO-401, Minneapolis, MN 55454, USA; Masonic Institute for the Developing Brain, 2025 East River Parkway, Minneapolis, MN 55414.

This article summarizes the available evidence reporting the relationship between perinatal dysglycemia and long-term neurodevelopment. We review the physiology of perinatal glucose metabolism and discuss the controversies surrounding definitions of perinatal dysglycemia. We briefly review the epidemiology of hypoglycemia and hyperglycemia in fetal, preterm, and term infants. Read More

View Article and Full-Text PDF

Neonatal Glucose Homeostasis.

Clin Perinatol 2022 06 21;49(2):393-404. Epub 2022 Apr 21.

Division of Neonatology, Department of Pediatrics, UT Health San Antonio, 7703 Floyd Curl, San Antonio, TX 78229, USA.

Hypoglycemia is a common condition in the newborn period. Several intrinsic and extrinsic factors play a role in the degree/duration of hypoglycemia. Multiple thresholds have been proposed as a potential point whereby hypoglycemia may have short and long-term adverse effects. Read More

View Article and Full-Text PDF

Diabetic Ketoacidosis at the Onset of Type 1 Diabetes Mellitus Among Children and Adolescents in Jeddah, Saudi Arabia: A Study From the Emergency Department.

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

View Article and Full-Text PDF

Hypoglycemia and Ketosis in the Setting of Pediatric Ethanol Intoxication: A Case Report.

Cureus 2022 Apr 27;14(4):e24538. Epub 2022 Apr 27.

Pediatrics, Southeastern Regional Medical Center, Lumberton, USA.

Acute alcohol intoxication is a common presentation to emergency departments. The intoxication of young pediatric patients is extremely rare. We present a case of a two-year-old female who presented to the emergency department with altered mentation, incontinence, and hypoglycemia. Read More

View Article and Full-Text PDF

HMG-CoA Lyase Deficiency: A Retrospective Study of 62 Saudi Patients.

Front Genet 2022 13;13:880464. Epub 2022 May 13.

Genetics and Precision Medicine Department, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City MNG-HA, Riyadh, Saudi Arabia.

3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency (HMG-CoA lyase) is a rare inborn error of leucine degradation and ketone body synthesis, caused by homozygous or compound heterozygous disease-causing variants in . To understand the natural history of this disease, we reviewed the biochemical, clinical, and molecular data of 62 patients from 54 different families with confirmed HMG-CoA lyase deficiency (HMGCLD) diagnosis from Saudi Arabia. The majority of the affected individuals were symptomatic. Read More

View Article and Full-Text PDF

Additional insulin dosing for fat and protein in children with type 1 diabetes using multiple daily injections.

Pediatr Diabetes 2022 May 30. Epub 2022 May 30.

Department of Paediatrics, University of Oxford, Oxford, UK.

Objective: High-fat high-protein (HFHP) meals are associated with post-prandial hyperglycemia in type 1 diabetes (T1D), administration of additional insulin for such meals is recommended in order to optimize glucose levels. Optimal timing of additional insulin for HFHP meals in children and young people receiving multiple daily injections (MDI) remains unclear.

Aim: To investigate the glycemic impact of additional insulin doses given before or after eating a HFHP meal in children with T1D using MDI. Read More

View Article and Full-Text PDF

Evaluation of real-life clinical outcomes in Australian youth with type 1 diabetes on hybrid closed-loop therapy: A retrospective study.

J Paediatr Child Health 2022 May 31. Epub 2022 May 31.

Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Western Australia, Australia.

Aim: To determine the clinical outcomes and evaluate the perspectives of children with Type 1 diabetes (T1D) and their parents managing their child on hybrid closed-loop (HCL) therapy.

Methods: Children with T1D on HCL attending a tertiary diabetes centre between April 2019 and July 2021 were included. A retrospective analysis of glycaemic data was conducted to determine the clinical outcomes. Read More

View Article and Full-Text PDF

The challenges of keeping clinicians unaware of their participation in a national, cluster-randomised, implementation trial.

BMC Med Ethics 2022 May 30;23(1):55. Epub 2022 May 30.

Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland Mail Centre, PO BOX 92019, Auckland, New Zealand.

Background: Implementation of recommendations from clinical practice guidelines is essential for evidence based clinical practice. However, the most effective methods of implementation are unclear. We conducted a national, cluster-randomised, blinded implementation trial to determine if midwife or doctor local implementation leaders are more effective in implementing a guideline for use of oral dextrose gel to treat hypoglycaemic babies on postnatal wards. Read More

View Article and Full-Text PDF

A homozygous exonic variant leading to exon skipping in ABCC8 as the cause of severe congenital hyperinsulinism.

Am J Med Genet A 2022 May 27. Epub 2022 May 27.

Division of Endocrinology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.

Congenital hyperinsulinism (CHI) is genetically heterogeneous, caused by pathogenic variants in multiple known genes regulating insulin secretion from the pancreatic β-cells. The ABCC8 gene encodes the sulfonylurea receptor 1 (SUR1), a key player in insulin secretion, and pathogenic variants in ABCC8 are the most common cause of CHI. With increased application of genetic testing in clinical practice, variants of unknown clinical significance (VUS) are commonly reported. Read More

View Article and Full-Text PDF

Clinical characteristics and long-term outcomes of patients with glycogen storage disease type 1b: a retrospective multi-center experience in Poland.

Pediatr Endocrinol Diabetes Metab 2022 May 27. Epub 2022 May 27.

Department of Pediatrics, Nutrition and Metabolic Disorders, Children's Memorial Health Institute, Warsaw, Poland.

Glycogen storage disease type 1b (GSD 1b) is an inherited metabolic defect caused by a deficiency of microsomal glucose-6-phosphate (G6P) transport protein across the endoplasmic reticulum membrane. Patients with GSD 1b have hypoglycemia episodes, lactate acidosis, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, neutropenia and in imaging studies hepatomegaly and/or nephromegaly. The primary goals of treatment are to maintain proper blood glucose levels and to increase the number of properly functioning neutrophils. Read More

View Article and Full-Text PDF

Influence of the SARS-CoV-2 pandemic on paediatric patients with type 1 diabetes mellitus after one year of follow-up.

J Pediatr Endocrinol Metab 2022 May 30. Epub 2022 May 30.

Pediatrics, Hospital Universitario Miguel Servet, Zaragoza, Aragón, Spain.

Objectives: Lockdown during the SARS-CoV-2 pandemic generated uncertainty regarding its effects on the control of type 1 diabetes (DM1). Our study aims to evaluate the influence of the pandemic on the control of paediatric patients with DM1.

Methods: Longitudinal, retrospective, observational study in patients with DM1 attended between 15/10/2019 and 15/03/2020. Read More

View Article and Full-Text PDF

The ventromedial hypothalamic nucleus: watchdog of whole-body glucose homeostasis.

Cell Biosci 2022 May 26;12(1):71. Epub 2022 May 26.

USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street #8066, Houston, TX, 77030, USA.

The brain, particularly the ventromedial hypothalamic nucleus (VMH), has been long known for its involvement in glucose sensing and whole-body glucose homeostasis. However, it is still not fully understood how the brain detects and responds to the changes in the circulating glucose levels, as well as brain-body coordinated control of glucose homeostasis. In this review, we address the growing evidence implicating the brain in glucose homeostasis, especially in the contexts of hypoglycemia and diabetes. Read More

View Article and Full-Text PDF

Comparison of Fenton, INTERGROWTH-21, and Population-Based Growth Charts in Predicting Outcomes of Very Preterm Small-for-Gestational-Age Neonates.

Indian J Pediatr 2022 May 23. Epub 2022 May 23.

Department of Neonatology, NICU, Unit 2, Fernandez Foundation, Opposite Old MLA Quarters, Hyderguda, Hyderabad, Telangana, 500029, India.

Growth chart aids in management by identifying at-risk neonates with abnormal growth. In this retrospective analysis of 1067 neonates of 26-31 wk gestational age, the utility of 3 growth charts (local population-based, Fenton-2013, and INTERGROWTH-21) was studied in identifying very preterm neonates at risk of developing complications secondary to intrauterine growth retardation (hypoglycemia, mortality, and BPD at 36 wk). The proportion of neonates classified as small for gestational age was 9% (n = 96) with Fernandez chart, 16. Read More

View Article and Full-Text PDF