In this issue of JAMA, the US Preventive Services Task Force (USPSTF) addresses this important issue with a new Recommendation Statement on screening for prediabetes and type 2 diabetes in children and adolescents based on an Evidence Report and Systematic Review of the evidence on screening for prediabetes and type 2 diabetes in asymptomatic, nonpregnant persons younger than 18 year (JAMA)
Diabetes News
Category: Paediatrics
Two-age islet-autoantibody screening for childhood type 1 diabetes: a prospective cohort study
Our results show that initial screening for islet autoantibodies at two ages (2 years and 6 years) is sensitive and efficient for public health translation but might require adjustment by country on the basis of population-specific disease characteristics (The Lancet Diabetes & Endocrinology)
Diabetes (type 1 and type 2) in children and young people: diagnosis and management
This guideline covers the diagnosis and management of type 1 and type 2 diabetes in children and young people aged under 18. The guideline recommends how to support children and young people and their families and carers to maintain tight control of blood glucose to reduce the long-term risks associated with diabetes (NICE)
Psychosocial screening in a pediatric diabetes clinic: Adolescents’ and mothers’ perspectives
Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care (Pediatric Diabetes)
Risky self-management behaviors in adolescents with type 1 diabetes: Measurement validation for the Diabetes-Specific Risk-Taking Inventory (DSRI)
Overall, initial psychometrics suggest the DSRI is a reliable and valid measure of risks that adolescents may take with their T1D care. This innovative self-report measure has potential to be an actionable clinical tool to screen for high-risk behaviors not routinely assessed in T1D clinical care (Pediatric Diabetes)
Associations of Maternal Gestational Diabetes Mellitus with Alterations in Cardiovascular System in Early Childhood
Our results provide evidence that maternal GDM is associated with offspring cardiovascular adaptations at preschool age. Further studies are needed to replicate our results and the long-term effect of these adaptations on later cardiovascular risks needs further investigation (Diabetes/Metabolism Research and Reviews)
Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis. A prospective study
AKI is common among T1DM children hospitalized with DKA. Younger age, low GCS at hospital admission and increased serum chloride level during DKA management were associated with increased risk for moderate to severe AKI development (Pediatric Diabetes)
Additional Insulin Dosing for Fat and Protein in Children with Type 1 Diabetes using Multiple Daily Injections
We found no benefit in giving additional insulin as a split dose for HFHP meals in children using MDI, mild hypoglycaemia was common. Future studies would benefit from refinement of the insulin dose algorithm (Pediatric Diabetes)
Latent Autoimmune Diabetes in Youth Shows Greater Autoimmunity than Latent Autoimmune Diabetes in Adults: Evidence from a Nationwide, Multicenter, Cross-sectional Study
A high prevalence of LADY exists in youth with T2D phenotype. Latent autoimmune diabetes forms a continuous age-related spectrum from LADY to LADA, in which LADY shows greater autoimmunity (Pediatric Diabetes)
Associations between deduced first islet specific autoantibody with sex, age at diagnosis and genetic risk factors in young children with type 1 diabetes
Strong differences in sex and age distributions as well as in genetic associations could be observed between GADA- and IAA-initiated autoimmunity (Pediatric Diabetes)
Efficacy and safety of dapagliflozin in children and young adults with type 2 diabetes: a prospective, multicentre, randomised, parallel group, phase 3 study
A prespecified sensitivity analysis of protocol-compliant participants showed a significant difference in HbA1c concentration between groups. No new safety signals were identified and there was a low risk of severe hypoglycaemia (The Lancet Diabetes & Endocrinology)
Diabetes (type 1 and type 2) in children and young people: diagnosis and management
NICE guideline [NG18]Published: 01 August 2015 Last updated: 31 March 2022 (NICE)
Glycemic outcomes of Advanced Hybrid Closed Loop system in children and adolescents with Type 1 Diabetes, previously treated with Multiple Daily Injections (MiniMed 780G system in T1D individuals, previously treated with MDI)
Children and adolescents with T1D on MDI therapy who initiated the AHCL system following a 10-days structured protocol achieved the internationally recommended goals of glycemic control with TIR > 70% and a HbA1c of < 7% (BMC Endocrine Disorders)
Why don’t children and young people engage with diabetes services?
This study included children and young people who were labelled ‘disengaged’ with their diabetes care. Interviews explored what they would like to change about current diabetes services (NIHR)
Association of British Clinical Diabetologists, Diabetes Technology Network UK and Association of Children’s Diabetes Clinicians Survey of UK Healthcare Professional Attitudes Towards Open-Source Automated Insulin Delivery Systems
HCPs are generally supportive of OS-AID users but many feel uncomfortable with the technicalities of the systems given the lack of approval. Knowledge around the use of these systems was limited. Re-assessment of HCP perceptions should be performed in the future given the evolving landscape of diabetes technology, recent consensus statements and emerging ethical and legal perspectives (Diabetes Therapy)
A systematic review of the prevalence, risk factors and screening tools for autonomic and diabetic peripheral neuropathy in children, adolescents and young adults with type 1 diabetes
Prevalence of neuropathy in youth with type 1 diabetes varies depending on different screening methods and characteristics of the study populations. However, the assessed studies confirmed a relatively high prevalence of subclinical neuropathy, reiterating the importance of early identification of risk factors to prevent this complication (Acta Diabetologica)
Glomerular filtration rate abnormalities in children with type 1 diabetes
A notable proportion of children with T1D demonstrate eGFR abnormalities early in their T1D course. This finding along with evidence of eGFR declining over time is concerning for long-term risk of CKD and warrants systematic serum creatinine monitoring at diagnosis and regular intervals thereafter in children with T1D (Canadian Journal of Diabetes)
Randomized Trial of Closed-Loop Control in Very Young Children with Type 1 Diabetes
A hybrid closed-loop system significantly improved glycemic control in very young children with type 1 diabetes, without increasing the time spent in hypoglycemia (NEJM)
A Practical Approach to Continuous Glucose Monitoring (rtCGM) and FreeStyle Libre systems (isCGM) in Children and Young people with Type 1 Diabetes
This article, aims to provide a practical approach and help identify which patients may be most likely to benefit and how the technology may be implemented in order to maximise the clinical benefits (Diabetes Research and Clinical Practice)
Diabetes (type 1 and type 2) in children and young people: diagnosis and management – glucose monitoring
Consultation documents (NICE)
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