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    Complications During Ketogenic Diet Initiation: Prevalence, Treatment, and Influence on Seizure Outcomes.
    Pediatr Neurol 2017 Jan 16. Epub 2017 Jan 16.
    Department of Pediatrics, The Johns Hopkins Hospital, Baltimore, Maryland; Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland. Electronic address:
    Background: Many centers still admit children for several days to start the ketogenic diet. The exact incidence of adverse effects during the admission and their potential later impact on seizure reduction has not been widely studied.

    Methods: We performed a retrospective study of children with intractable epilepsy electively admitted for ketogenic diet initiation at our institution from 2011 to 2016. Read More

    Phase I/II multicenter ketogenic diet study for adult superrefractory status epilepticus.
    Neurology 2017 Feb 8. Epub 2017 Feb 8.
    From the Departments of Neurology (M.C.C., E.H.K., A.L.H., J.C.P., D.R.B., A.V., B.R., M.D., F.M.C., P.N.), Pediatrics (E.H.K., A.L.H.), and Anesthesiology-Critical Care Medicine (R.G.G.), Neurosurgery and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (S.H.), Mayo Clinic, Rochester, MN; Neuroscience Institute (M.K., E.C.H., D.D., T.S.), Queen's Medical Center, Honolulu, HI; Department of Neurology (B.B.), Loyola University Health System, Maywood, IL; Institute for Clinical and Translational Research (B.H.-B.), Johns Hopkins University, Baltimore, MD; and Department of Neurology (P.W.K.), Johns Hopkins Bayview Medical Center, Baltimore, MD.
    Objective: To investigate the feasibility, safety, and efficacy of a ketogenic diet (KD) for superrefractory status epilepticus (SRSE) in adults.

    Methods: We performed a prospective multicenter study of patients 18 to 80 years of age with SRSE treated with a KD treatment algorithm. The primary outcome measure was significant urine and serum ketone body production as a biomarker of feasibility. Read More

    Seasonal variation in hospital encounters with hypoglycaemia and hyperglycaemia.
    Diabet Med 2017 Feb 7. Epub 2017 Feb 7.
    Department of Medicine, Division of Nephrology, Western University.
    Aim: To assess whether rates of hospital encounters with hypoglycaemia and hyperglycaemia display seasonal variation.

    Methods: Time series analyses of the monthly rates of hospital encounters (emergency room visits or inpatient admissions) with hypoglycaemia and hyperglycaemia from 2003 to 2012 using linked healthcare databases in Ontario, Canada.

    Results: Over the study period, there were 129 887 hypoglycaemia and 79 773 hyperglycaemia encounters. Read More

    A severe case of hyperinsulinism due to hemizygous activating mutation of glutamate dehydrogenase.
    Pediatr Diabetes 2017 Feb 6. Epub 2017 Feb 6.
    Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
    Activating mutations in the GLUD1 gene, which encodes glutamate dehydrogenase (GDH), result in the hyperinsulinism-hyperammonemia syndrome. GDH is an allosterically regulated enzyme responsible for amino acid-mediated insulin secretion via the oxidative deamination of glutamate to 2-oxoglutarate, leading to ATP production and insulin release. This study characterizes a novel combination of mutations in GLUD1 found in a neonate who presented on the first day of life with severe hypoglycemia, hyperammonemia, and seizures. Read More

    Systemic primary carnitine deficiency with hypoglycemic encephalopathy.
    Ann Pediatr Endocrinol Metab 2016 Dec 31;21(4):226-229. Epub 2016 Dec 31.
    Department of Pediatrics, Fatima Hospital, Daegu, Korea.
    Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Read More

    Hypogonadotropic Hypogonadism in Males with Glycogen Storage Disease Type 1.
    JIMD Rep 2017 Feb 4. Epub 2017 Feb 4.
    Division of Endocrinology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
    Background: Glycogen storage disease type 1 is an autosomal recessive disorder with an incidence of 1 in 100,000. Long-term complications include chronic blood glucose lability, lactic academia, short stature, osteoporosis, delayed puberty, gout, progressive renal insufficiency, systemic or pulmonary hypertension, hepatic adenomas at risk for malignant transformation, anemia, vitamin D deficiency, hyperuricemic nephrocalcinosis, inflammatory bowel syndrome (type 1b), hypertriglyceridemia, and irregular menstrual cycles. We describe hypogonadotropic hypogonadism as a novel complication in glycogen storage disease (GSD) type 1. Read More

    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

    The effect of adding metformin to insulin therapy for type 1 diabetes mellitus children: A systematic review and meta-analysis.
    Pediatr Diabetes 2017 Feb 1. Epub 2017 Feb 1.
    Department of Pediatrics, Universidad de Antioquia, Medellin, Colombia.
    We aimed to assess the effectiveness of adding metformin to insulin in type 1 diabetes mellitus (T1DM) children for improving metabolic outcomes. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) conducted on children age 6 to 19 years who are diagnosed with T1DM, and examined the effect of adding Metformin to standard insulin therapy. We performed literature searches on Ovid Midline, Ovid Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from the date of inception of the database to February 15, 2016. 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

    An alternative sensor-based method for glucose monitoring in children and young people with diabetes.
    Arch Dis Child 2017 Jan 30. Epub 2017 Jan 30.
    Southampton Children's Hospital, Southampton General Hospital, Southampton, UK.
    Objective: To determine accuracy, safety and acceptability of the FreeStyle Libre Flash Glucose Monitoring System in the paediatric population.

    Design, Setting And Patients: Eighty-nine study participants, aged 4-17 years, with type 1 diabetes were enrolled across 9 diabetes centres in the UK. A factory calibrated sensor was inserted on the back of the upper arm and used for up to 14 days. Read More

    Exercise management in type 1 diabetes: a consensus statement.
    Lancet Diabetes Endocrinol 2017 Jan 23. Epub 2017 Jan 23.
    Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA.
    Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Read More

    Clinical, molecular, and genetic evaluation of galactosemia in Turkish children.
    Turk Pediatri Ars 2016 Dec 1;51(4):204-209. Epub 2016 Dec 1.
    Clinic of Pediatrics, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.
    Aim: Galactosemia is a carbohydrate metabolism disorder with autosomal recessive inheritance. The most frequent enzyme deficiency is galactose-1-phosphate-uridylytransferase, which causes classic galactosemia. When the enzyme is absent, an infant cannot metabolize galactose-1-phosphate and it cumulates in liver, kidney, brain, tongue, lens, and skin. Read More

    Reexamining the Hypoglycemia Fear Survey for Parents of Young Children in a Sample of Children Using Insulin Pumps.
    Diabetes Technol Ther 2017 Feb;19(2):103-108
    6 Division of Clinical Psychology and Behavioral Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
    Background: We update the psychometric properties of the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC), a 26-item measure of parents' hypoglycemia fear for young children using an insulin pump.

    Methods: We combined three similar datasets for the analyses. The data analyzed included parents' responses to the HFS-PYC and a demographic form. Read More

    The additional dose of insulin for high-protein mixed meal provides better glycemic control in children with type 1 diabetes on insulin pumps: randomized cross-over study.
    Pediatr Diabetes 2017 Jan 24. Epub 2017 Jan 24.
    Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland.
    Background: Delivery of insulin for high-protein low-fat meals with carbohydrates on the basis of carbohydrates leads to higher late postprandial glycemia. Studies with mixed meals demonstrated lower blood glucose level after dual wave bolus. The objective of our study was to assess the impact of additional dose of insulin in dual wave bolus for high-protein mixed meal on the postprandial glycemia. Read More

    Closed-loop for type 1 diabetes - an introduction and appraisal for the generalist.
    BMC Med 2017 Jan 23;15(1):14. Epub 2017 Jan 23.
    University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Wellcome Trust-MRC Institute of Metabolic Science, Box 289, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
    Background: Rapid progress over the past decade has been made with the development of the 'Artificial Pancreas', also known as the closed-loop system, which emulates the feedback glucose-responsive functionality of the pancreatic beta cell. The recent FDA approval of the first hybrid closed-loop system makes the Artificial Pancreas a realistic therapeutic option for people with type 1 diabetes. In anticipation of its advent into clinical care, we provide a primer and appraisal of this novel therapeutic approach in type 1 diabetes for healthcare professionals and non-specialists in the field. Read More

    Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh.
    PLoS One 2017 23;12(1):e0170267. Epub 2017 Jan 23.
    The Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada.
    Introduction: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Read More

    Hyperinsulinemic hypoglycemia in Beckwith-Wiedemann, Sotos, and Kabuki syndromes: A nationwide survey in Japan.
    Am J Med Genet A 2017 Feb 7;173(2):360-367. Epub 2016 Nov 7.
    Department of Pediatrics, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
    Beckwith-Wiedemann syndrome (BWS) is a congenital overgrowth syndrome that is occasionally associated with hyperinsulinemic hypoglycemia (HH) in the neonatal period. Sotos syndrome (SS) and Kabuki syndrome (KS) are other malformation syndromes that may be complicated with HH, however, the detailed clinical characteristics of HH accompanied with these syndromes remain unclear. We herein conducted a nationwide questionnaire survey in Japan. 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 Jan 18. Epub 2017 Jan 18.
    Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Stanford, California.
    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

    Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study.
    Lancet Diabetes Endocrinol 2017 Jan 13. Epub 2017 Jan 13.
    Wellcome Trust-Medical Research Council Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK. Electronic address:
    Background: Tight control of blood glucose concentration in people with type 1 diabetes predisposes to hypoglycaemia. We aimed to investigate whether day-and-night hybrid closed-loop insulin delivery can improve glucose control while alleviating the risk of hypoglycaemia in adults with HbA1c below 7·5% (58 mmol/mol).

    Methods: In this open-label, randomised, crossover study, we recruited adults (aged ≥18 years) with type 1 diabetes and HbA1c below 7·5% from Addenbrooke's Hospital (Cambridge, UK) and Medical University of Graz (Graz, Austria). Read More

    The relationships among fear of hypoglycaemia, diabetes-related quality of life and psychological well-being in Norwegian adults with Type 1 diabetes.
    Diabetes Res Clin Pract 2017 Feb 27;124:11-19. Epub 2016 Dec 27.
    Department of Global Public Health and Primary Care, the Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department for Research and Development, Haukeland University Hospital, Bergen, Norway.
    Aims: To examine the associations among fear of hypoglycaemia, diabetes-related quality of life and psychological well-being, and determine whether diabetes-related quality of life is a mediator of the relationship between fear of hypoglycaemia and psychological well-being in adults with Type 1 diabetes.

    Methods: A total of 235 of 319 invited adults (18-69years) with Type 1 diabetes agreed to participate. Hierarchical linear regression was applied to 188 individuals with complete data. Read More

    Acute Liver Failure Meets SOPH Syndrome: A Case Report on an Intermediate Phenotype.
    Pediatrics 2017 Jan;139(1)
    Institute of Human Genetics and
    Acute liver failure (ALF) is a life-threatening condition in the absence of preexisting liver disease in children. The main clinical presentation comprises hepatic dysfunction, elevated liver biochemical values, and coagulopathy. The etiology of ALF remains unclear in most affected children; however, the recent identification of mutations in the neuroblastoma amplified sequence (NBAS) gene in autosomal recessively inherited ALF has shed light on the cause of a subgroup of fever-triggered pediatric ALF episodes. Read More

    A novel mutation of ABCC8 gene in a patient with diazoxide-unresponsive congenital hyperinsulinism.
    Korean J Pediatr 2016 Nov 30;59(Suppl 1):S116-S120. Epub 2016 Nov 30.
    Department of Pediatrics, Gyeongsang National Unviersity School of Medicine, Jinju, Korea.
    Congenital hyperinsulinism (CHI) is a rare condition that can cause irreversible brain damage during the neonatal period owing to the associated hypoglycemia. Hypoglycemia in CHI occurs secondary to the dysregulation of insulin secretion. CHI has been established as a genetic disorder of islet-cell hyperplasia, associated with a mutation of the ABCC8 or KCNJ11 genes, which encode the sulfonylurea receptor 1 and the inward rectifying potassium channel (Kir6. 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

    Understanding bolus insulin dose timing: the characteristics and experiences of people with diabetes who take bolus insulin.
    Curr Med Res Opin 2017 Jan 24:1-7. Epub 2017 Jan 24.
    a Department of Pediatrics , Yale School of Medicine , New Haven , CT , USA.
    Objective: Despite the increased popularity of newer, fast-acting bolus insulin treatment options that allow for more flexibility in the timing of bolus insulin dosing in recent years, relatively little is known about people with diabetes who administer bolus insulin at differing times in relation to their meals. The purpose of this study was to investigate bolus insulin dose timing in relation to meals among people with type 1 (T1D) and type 2 (T2D) diabetes, as well as to better understand the characteristics and experiences of people who bolus dose at differing times.

    Methods: A web-based survey of adults with T1D and T2D treated with bolus insulin therapy in Germany, the UK, and USA was conducted. Read More

    Adolescent life with diabetes-Gender matters for level of distress. Experiences from the national TODS study.
    Pediatr Diabetes 2016 Dec 22. Epub 2016 Dec 22.
    Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Linköping, Sweden.
    Objective: To examine the relationship between diabetes distress and gender, and the association with glycemic control, social support, health behaviors, and socio-economic status.

    Methods: All adolescents, aged 15 to 18 years, in the national, pediatric diabetes registry SWEDIABKIDS with type 1 diabetes were invited to complete an online questionnaire. A total of 2112 teenagers were identified. Read More

    Effectiveness of Medium-Chain Triglyceride Oil Therapy in Two Japanese Citrin-Deficient Siblings: Evaluation Using Oral Glucose Tolerance Tests.
    Tohoku J Exp Med 2016 ;240(4):323-328
    Department of Pediatrics, Graduate School of Medicine, Gifu University.
    Citrin deficiency, an inherited defect of the liver-type mitochondrial aspartate/glutamate carrier isoform (citrin), may cause impairment of glycolysis because of an increase in the cytosolic NADH/NAD(+) ratio. We report a Japanese boy whose main complaint was recurrent hypoglycemic episodes. He was suspected as having citrin deficiency because of his peculiar preference for protein- and fat-rich food. Read More

    Mitigating Reductions in Glucose During Exercise on Closed-Loop Insulin Delivery: The Ex-Snacks Study.
    Diabetes Technol Ther 2016 Dec;18(12):794-799
    Yale School of Medicine , Yale Pediatric Endocrinology & Diabetes, New Haven, Connecticut.
    Objective: To assess whether snacking could be used with closed-loop (CL) insulin delivery to avoid exercise-induced reductions in plasma glucose (PG), as well as elevations in PG at the end of exercise.

    Research Design And Methods: Twelve type 1 diabetes (T1D) subjects (age 13-36 years, duration 10.7 ± 8. Read More

    An emerging evidence base for the management of neonatal hypoglycaemia.
    Early Hum Dev 2017 Jan 15;104:51-56. Epub 2016 Dec 15.
    Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, 2 Park Rd, Grafton, Auckland 1023, New Zealand; Kidz First Neonatal Care, Counties Manukau Health, Private Bag 93311, Otahuhu, Auckland, New Zealand. Electronic address:
    Neonatal hypoglycaemia is common, and screening and treatment of babies considered at risk is widespread, despite there being little reliable evidence upon which to base management decisions. Although there is now evidence about which babies are at greatest risk, the threshold for diagnosis, best approach to treatment and later outcomes all remain uncertain. Recent studies suggest that treatment with dextrose gel is safe and effective and may help support breast feeding. Read More

    Physical activity and sedentary behavior levels in children and adolescents with type 1 diabetes using insulin pump or injection therapy - The importance of parental activity profile.
    J Diabetes Complications 2017 Feb 8;31(2):381-386. Epub 2016 Dec 8.
    Department of Kinesiology, University of Montreal, Montreal, QC, Canada, H3C 3J7; Department of Pediatrics, University of Montreal and CHU Sainte-Justine, Montreal, QC, Canada, H3T 1C5. Electronic address:
    In children and adolescents, treatments for type 1 diabetes (T1D) have recently evolved with the introduction of the insulin pump. However, little is known about how a pump is associated with physical activity (PA) patterns. The goal of the study was to examine the activity profile of Canadian children and adolescents with T1D according to their insulin treatment (pump vs. 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

    Novel Hypoglycemia Phenotype in Congenital Hyperinsulinism Due to Dominant Mutations of Uncoupling Protein 2 (UCP2).
    J Clin Endocrinol Metab 2016 Dec 14:jc20163164. Epub 2016 Dec 14.
    2 Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
    Context: The rarest genetic form of congenital hyperinsulinism (HI) has been associated with dominant inactivating mutations in uncoupling protein 2 (UCP2), a mitochondrial inner membrane carrier that modulates the oxidation of glucose vs amino acids.

    Objective: To evaluate the frequency of UCP2 mutations in children with HI and phenotypic features of this form of HI.

    Design: We examined 211 children with diazoxide-responsive HI seen at The Children's Hospital of Philadelphia (CHOP) between 1997 and October 2016. Read More

    Neonatal Morbidity After Maternal Use of Antidepressant Drugs During Pregnancy.
    Pediatrics 2016 Nov;138(5)
    Centre of Reproduction Epidemiology, Tornblad Institute, Institution of Clinical Science, Lund University, Lund, Sweden.
    Objectives: To estimate the rate of admissions to NICUs, as well as infants' morbidity and neonatal interventions, after exposure to antidepressant drugs in utero.

    Methods: Data on pregnancies, deliveries, prescription drug use, and health status of the newborn infants were obtained from the Swedish Medical Birth Register, the Prescribed Drug Register, and the Swedish Neonatal Quality Register. We included 741 040 singletons, born between July 1, 2006, and December 31, 2012. Read More

    Developmental Outcomes of Preterm Infants With Neonatal Hypoglycemia.
    Pediatrics 2016 Dec 4;138(6). Epub 2016 Nov 4.
    Departments of Pediatrics and.
    Background And Objectives: Neonatal hypoglycemia has been associated with abnormalities on brain imaging and a spectrum of developmental delays, although historical and recent studies show conflicting results. We compared the cognitive, academic, and behavioral outcomes of preterm infants with neonatal hypoglycemia with those of normoglycemic controls at 3 to 18 years of age.

    Methods: A secondary analysis of data from the Infant Health and Development Program, a national, multisite, randomized controlled longitudinal intervention study of long-term health and developmental outcomes in preterm infants. 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

    Evaluation of central nervous system in patients with glycogen storage disease type 1a.
    Turk J Pediatr 2016 ;58(1):12-18
    Divisions of Pediatric Gastroenterology and Hepatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
    We aimed to evaluate structure and functions of central nervous system (CNS) in children with glycogen storage disease (GSD) type 1a. Neurological examination, psychometric tests, electroencephalography (EEG), magnetic resonance imaging (MRI), visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were performed. The results were compared between patients with good and poor metabolic control and healthy children. Read More

    Medium-chain acyl-Coenzyme A dehydrogenase deficiency (MCADD): a cause of severe hypoglycaemia in an apparently well child.
    BMJ Case Rep 2016 Nov 30;2016. Epub 2016 Nov 30.
    Department of Paediatrics, Cork University Hospital Group, Cork, Ireland.
    Medium-chain acyl-Coenzyme A dehydrogenase deficiency (MCADD) is a disorder of fatty acid β oxidation inherited in an autosomal recessive manner. The enzyme is useful in hepatic ketogenesis, a major source of energy once hepatic glycogen stores become depleted during prolonged fasting. It is a cause of hypoketotic hypoglycaemia in a previously well child. Read More

    Septooptic Dysplasia with an Associated Arachnoid Cyst.
    Case Rep Pediatr 2016 6;2016:5493769. Epub 2016 Nov 6.
    Section on Endocrinology, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
    A 4-week-old male infant presented with hypothermia, hypoglycemia, and hyperbilirubinemia. His medical history was remarkable for hydrocephalus secondary to an arachnoid cyst, intermittent hypoglycemia, hypothermia, and poor feeding requiring nasogastric tube for nutrition. Physical exam revealed retrognathia, mild hypotonia, micropenis, and clinodactyly. Read More

    Clinical and Psychosocial Outcomes of a Structured Transition Program Among Young Adults With Type 1 Diabetes.
    J Adolesc Health 2017 Feb 23;60(2):212-218. Epub 2016 Nov 23.
    Keck School of Medicine, University of Southern California, Los Angeles, California.
    Purpose: We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care.

    Methods: Individuals in their last year of pediatric care (CC group, n = 51) and individuals lost to follow-up in the transfer to adult care ("lapsed care" [LC] group, n = 24) were followed prospectively for 12 months. All participants were provided developmentally tailored diabetes education, case management, and clinical care through a structured transition program. Read More

    A randomised, open-labelstudy of insulin glargine or neutral protamine Hagedorn insulin in Chinese paediatric patients with type 1 diabetes mellitus.
    BMC Endocr Disord 2016 Nov 26;16(1):67. Epub 2016 Nov 26.
    Beijing Children's Hospital, Capital Medical University, No.56 South Lishi Road, Xicheng District, Beijing, China.
    Background: We aimed to describe the safety and efficacy of insulin glargine in Chinese paediatric patients with type 1 diabetes mellitus (T1DM). Neutral protamine Hagedorn (NPH) insulin was the reference therapy.

    Methods: This open-label, randomised, Phase III study was conducted at 10 sites in China. Read More

    Double pancreatic tumors in an adolescent: Imaging features.
    Pediatr Int 2016 Nov;58(11):1239-12342
    Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
    Insulinoma is generally identified as a single tumor and seldom occurs in children or adolescents. A 14-year-old girl with difficulty in waking was found to have hyperinsulinemic hypoglycemia. On abdominal ultrasonography two hypoechoic masses (8 and 12 mm in diameter) were seen in the pancreatic body: the larger mass was hypervascular, whereas the smaller one was hypovascular. Read More

    Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases.
    Pediatr Diabetes 2016 Nov 23. Epub 2016 Nov 23.
    University of Ulm, ZIBMT, Institute of Epidemiology and Medical Biometry, Ulm, Germany.
    Objective: To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care, by analysing data from the US Type 1 Diabetes Exchange (T1DX), German/Austrian Diabetes Patienten Verlaufsdokumenation (DPV), and Western Australian Children Diabetes Database (WACDD) diabetes registries.

    Methods: Data for patients with type 1 diabetes, aged <18 years with a minimum duration of diabetes of 2 years, were extracted from each registry for a 12-month observation period between 2011 and 2012 (7,102 T1DX, 18,887 DPV, and 865 WACDD). Rates of severe hypoglycemia (self-reported loss of consciousness/convulsion) were estimated per 100 patient-years and analyzed by HbA1c, source registry, treatment regimen, and age group. Read More

    Reduced prevalence of impaired awareness of hypoglycemia in a population-based clinic sample of youth with type 1 diabetes.
    Pediatr Diabetes 2016 Nov 11. Epub 2016 Nov 11.
    Department of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, Australia.
    Background: Impaired awareness of hypoglycemia (IAH) is associated with an increased risk for severe hypoglycemia (SH). However, reduced rates of SH raise the question as to whether there has been a reduction in IAH. The aim of this study was to determine the change in prevalence of IAH in a population-based cohort of adolescents with Type 1 diabetes (T1D). Read More

    Sirolimus therapy in a child with partially diazoxide-responsive hyperinsulinaemic hypoglycaemia.
    Endocrinol Diabetes Metab Case Rep 2016 25;2016. Epub 2016 Oct 25.
    Developmental Endocrinology Research Group , Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, London , UK.
    : Hyperinsulinaemic hypoglycaemia (HH), which causes persistent neonatal hypoglycaemia, can result in neurological damage and it's management is challenging. Diazoxide is the first-line treatment, albeit not all patients will fully respond to it, as episodes of hypoglycaemia may persist and it entails unpleasant adverse effects. Sirolimus, an mTOR inhibitor, has reportedly been successful in treating children with severe diffuse HH, thus obviating the need for pancreatectomy. Read More

    Diabetes in Patients with ß-thalassemia or other Hemoglobinopathies - Analysis from the DPV Database.
    Klin Padiatr 2016 Nov 15;228(6-07):307-312. Epub 2016 Nov 15.
    Central Institute for Biomedical Technology, ZIBMT, University of Ulm, Ulm, Germany.
    Background: Diabetes mellitus is a common endocrinopathy in patients with thalassemia major, but the occurrence of hemoglobinopathies is rare in Germany and Western Europe. The longitudinal German-Austrian DPV (Diabetes Patienten Verlaufsdokumentation) registry allows a comprehensive characterization of this group of patients. Patients/methods: Patients from the DPV-registry aged<30 years with thalassemia major or other hemoglobinopathies were compared to patients with type 1 diabetes (T1D) and type 2 diabetes (T2D) using the statistical software SAS 9. Read More

    Oral Dextrose Gel Reduces the Need for Intravenous Dextrose Therapy in Neonatal Hypoglycemia.
    Biomed Hub 2016 Sep-Dec;1(3). Epub 2016 Sep 10.
    Division of Neonatology, Department of Pediatrics, Women and Children's Hospital of Buffalo, Buffalo, N.Y., USA.
    Background: Newborn infants with risk factors may require intravenous (IV) dextrose for asymptomatic hypoglycemia. Administration of IV dextrose and transfer to the neonatal intensive care unit (NICU) may interfere with parent-infant bonding.

    Objective: To study the effect of implementing dextrose gel supplement with feeds in late preterm/term infants affected by asymptomatic hypoglycemia on reducing IV dextrose therapy. Read More

    Closed-loop insulin delivery in inpatients with type 2 diabetes: a randomised, parallel-group trial.
    Lancet Diabetes Endocrinol 2017 Feb 9;5(2):117-124. Epub 2016 Nov 9.
    Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK. Electronic address:
    Background: We assessed whether fully closed-loop insulin delivery (the so-called artificial pancreas) is safe and effective compared with standard subcutaneous insulin therapy in patients with type 2 diabetes in the general ward.

    Methods: For this single-centre, open-label, parallel-group, randomised controlled trial, we enrolled patients aged 18 years or older with type 2 diabetes who were receiving insulin therapy. Patients were recruited from general wards at Addenbrooke's Hospital, Cambridge, UK. Read More

    Association of a Blood Glucose Test Strip Quantity-Limit Policy With Patient Outcomes: A Population-Based Study.
    JAMA Intern Med 2017 Jan;177(1):61-66
    Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada2The Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada3Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada4Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada7Department of Medicine, University of Toronto, Toronto, Ontario, Canada10St Michael's Hospital, Toronto, Ontario, Canada.
    Importance: Given their high costs, payers have considered implementing quantity limits for reimbursement of blood glucose test strips. The effect of these limits on patient outcomes is unknown.

    Objective: To determine whether the introduction of quantity limits for blood glucose test strips in August 2013 was associated with changes in clinical outcomes. Read More

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