These BSPED guidelines are believed to be as safe as possible in the light of current evidence.However, no guidelines can be considered entirely safe as complications may still arise. In particularthe pathophysiology of cerebral oedema is still poorly understood (the British Society for Paediatric Endocrinology and Diabetes)
Diabetes News
Category: Paediatrics
Educational and Health Outcomes of Children Treated for Type 1 Diabetes: Scotland-Wide Record Linkage Study of 766,047 Children
Children with type 1 diabetes fare worse than their peers in respect of education and health outcomes, especially if they have higher mean HbA1c. Interventions are required to minimize school absence and ensure that it does not affect educational attainment (Diabetes Care)
Inequalities in glycaemic control in childhood onset type 2 diabetes in England and Wales – A national population‐based longitudinal study
About two thirds of children with childhood‐onset T2D were non‐White, female adolescents, just under half of whom live in the most disadvantaged areas of England and Wales. Additionally, there are substantial socioeconomic and ethnic inequalities in diabetes control (Pediatric Diabetes)
Diabetes (type 1 and type 2) in children and young people: diagnosis and management
The guideline recommends strict targets for blood glucose control to reduce the long-term risks associated with diabetes (NICE)
Pancreas size and exocrine function is decreased in young children with recent‐onset Type 1 diabetes
Pancreatic area and accompanying subclinical exocrine function were reduced in very young children with recent‐onset Type 1 diabetes. This supports changes in the exocrine pancreas in the pathophysiology of Type 1 diabetes presenting in early life (Diabetic Medicine)
Liraglutide in Children and Adolescents with Type 2 Diabetes
In children and adolescents with type 2 diabetes, liraglutide, at a dose of up to 1.8 mg per day (added to metformin, with or without basal insulin), was efficacious in improving glycemic control over 52 weeks. This efficacy came at the cost of an increased frequency of gastrointestinal adverse events (NEJM)
Is there an optimal strategy for real‐time continuous glucose monitoring in pediatrics? A 12‐month French multi‐center, prospective, controlled randomized trial (Start‐In!)
None of the three long‐term RT‐CGM strategies evaluated in pediatric type 1 diabetes was superior to the others in terms of HbA1c levels. CGM‐use for three months decreased rates of severe hypoglycemia. Our results confirm the feasibility of long‐term RT‐CGM‐use and the need to improve educational support for patients and caregivers (Pediatric Diabetes)
Youth-Onset Type 2 Diabetes and the Developing Brain
Youth with type 2 diabetes demonstrate lower cognitive scores and structural brain differences. Although causality has not yet been established, these findings are important because these individuals are still undergoing neurodevelopmental maturation (Current Diabetes Reports)
Predicting Progression to Type 1 Diabetes from Ages 3 to 6 in Islet Autoantibody Positive TEDDY Children
This study highlights the application of precision medicine techniques to predict progression to diabetes over a 3‐year window in TEDDY subjects. This multifaceted model provides preliminary improvement in prediction over simpler prediction tools. Additional tools are needed to maximize the predictive value of these approaches (Pediatric Diabetes)
Individual glucose responses to prolonged moderate intensity aerobic exercise in adolescents with type 1 diabetes: The higher they start, the harder they fall
Youth with T1D have variable glycemic responses to prolonged aerobic exercise, but this variability is partially explained by their pre‐exercise blood glucose levels. When no implementation strategies are in place to limit the drop in glycemia, the incidence of exercise‐associated hypoglycemia is ~44% and having a high pre‐exercise blood glucose concentration is only marginally protective (Pediatric Diabetes)
Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association
Although all types of diabetes result in hyperglycemia, the pathophysiology of each type of diabetes is different. These guidelines summarize available data specific to the comprehensive care of youth with type 2 diabetes (Diabetes Care)
A Prospective Cohort Study on the Management of Young Patients with Newly Diagnosed Type 2 Diabetes Using Mobile Medical Applications
A mobile medical app is helpful to young patients with newly diagnosed T2DM for monitoring their blood glucose level and improving their blood glucose control to meet the standard (Diabetes Therapy)
Closing the Loop on Managing Youth With Type 1 Diabetes: Children Are Not Just Small Adults
To ensure these systems are well poised to deliver the promise of more targeted control, it is essential to understand the unique characteristics and factors of childhood (Diabetes Care)
A randomized comparison of three prandial insulin dosing algorithms for children and adolescents with Type 1 diabetes
The Pankowska Equation resulted in reduced postprandial hyperglycaemia at the expense of an increase in hypoglycaemia. There were no significant differences when carbohydrate counting was compared to the Food Insulin Index. Further research is required to optimize prandial insulin dosing (Diabetic Medicine)
Effectiveness and safety of long-term treatment with sulfonylureas in patients with neonatal diabetes due to KCNJ11 mutations: an international cohort study
High-dose sulfonylurea therapy is an appropriate treatment for patients with KCNJ11 permanent neonatal diabetes from diagnosis. This therapy is safe and highly effective, maintaining excellent glycaemic control for at least 10 years (The Lancet Diabetes & Endocrinology)
Admissions of inequality: emergency hospital use for children and young people
Unplanned admissions for diabetes (all types) have been stable or have decreased for younger children (0–14). However, when children transition into adult services, there has been a striking growth for all 20–24-year-olds (between 40 and 90 per cent across the different deprivation groups) and the inequality gap remains significant (Nuffield Trust)
Pediatric diabetes training for healthcare professionals in Europe: Time for change
There is a severe shortage of high quality, standardized training for HCPs across the majority of European countries. Lack of trained HCPs for CYP with diabetes will result in the delivery of suboptimal care and impact on health, wellbeing and clinical and psychological outcomes (Pediatric Diabetes)
Early childhood infections precede development of beta-cell autoimmunity and type 1 diabetes in children with HLA-conferred disease risk
Early childhood infections may play an important role in the pathogenesis of T1D. Current findings may reflect either differences in microbial exposures or early immunological aberrations making diabetes-prone children more susceptible to infections (Pediatric Diabetes)
Primary islet autoantibody at initial seroconversion and autoantibodies at diagnosis of type 1 diabetes as markers of disease heterogeneity
Autoantibody patterns at diagnosis may be informative on primary autoantibodies initiating autoimmunity in young children developing type 1 diabetes (Pediatric Diabetes)
Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant – A Framework for Practice
In 2016 NHS Improvement and British Association of Perinatal Medicine (BAPM) convened a working group to develop a Framework for Practice (FfP) to: address variation in practices in the identification, management and admission thresholds of babies admitted to neonatal units for hypoglycaemia; and to promote safer practices that avoid unnecessary separation of mother and baby (British Association of Perinatal Medicine)
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