Pediatric Diabetes最新文献

{"title":"Mapping Lifestyle Factors in Blood Glucose Variability in Adolescents With Type 1 Diabetes Mellitus: A Pilot Study.","authors":"Aine Cronin, Therese Dunne, Clodagh O' Gorman, Alexandra Cremona","doi":"10.1155/pedi/6257886","DOIUrl":"https://doi.org/10.1155/pedi/6257886","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal glycaemic control in adolescents with type 1 diabetes (T1D) is essential to prevent complications but remains challenging due to changing lifestyle behaviours.</p><p><strong>Objective: </strong>This pilot study aims to assess whether adolescents with T1D in Ireland meet current nutrition and physical activity (PA) guidelines and to explore the impact of nutrition and PA on glycaemic variability (GV).</p><p><strong>Methods: </strong>Seven adolescents with T1D recorded their PA, diet and blood glucose levels over seven consecutive days. GV was determined using continuous glucose monitoring (CGM) data.</p><p><strong>Results: </strong>The majority of participants demonstrated low levels of PA, with 72% falling below recommended levels, and 86% consuming excessive amounts of saturated fat. Blood glucose levels were in the very high and high ranges for 23.6% ± 25.2% and 22.6% ± 7.3% of the time, respectively, with only 52.6% ± 21.8% of the time spent within the target range. Although no significant associations were found between PA or nutrition and GV, participants who met or exceeded PA and protein guidelines and consumed less fat exhibited better GV parameters.</p><p><strong>Conclusion: </strong>Adolescents with T1D in Ireland are not meeting recommended PA and nutrition guidelines and show poor glycaemic control. As a pilot study, the small sample size limited statistical power, but observed trends suggest that adhering to lifestyle recommendations could improve glycaemic control in this population.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"6257886"},"PeriodicalIF":5.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Glycemic Targets in and out-of-School: Real-World Data From 1341 Italian Children Using the MiniMed 780G System During Auto Mode.","authors":"Jen McVean, Riccardo Schiaffini, Marta Bassi, Barbara Piccini, Benedikt Voelker, Vittorino Smaniotto, Tim van den Heuvel, Ohad Cohen","doi":"10.1155/pedi/1653728","DOIUrl":"https://doi.org/10.1155/pedi/1653728","url":null,"abstract":"<p><p>In this real-world analysis, we evaluated glycemia and insulin delivery in Italian children using the MiniMed 780G system during auto mode use, comparing days with a school routine to out-of-school (OOS) days. Data from 1341 users, self-reported under 16 years old and with type 1 diabetes (T1D), showed no meaningful difference in time in range (TIR) between school days (73.4%) and OOS days (72.4%), and international targets were met on average during both types of day. Minor sensor glucose variations were observed during school hours, such as a more pronounced glucose peak after breakfast and a clearer dip before lunch on school days. The insulin delivery algorithm effectively managed these fluctuations. Maintaining optimized glycemia during both school and OOS days may enhance learning and support cognitive and brain development.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"1653728"},"PeriodicalIF":5.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13060754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Specific BMI Trajectories in Young People With Type 1 Diabetes: A 20-Year Retrospective Regional Audit.","authors":"Connor Oliver-Rose, Lourdes M Lagera, Aimee Cooper, Paul L Hofman, José G B Derraik, Yvonne C Anderson","doi":"10.1155/pedi/4106777","DOIUrl":"https://doi.org/10.1155/pedi/4106777","url":null,"abstract":"<p><strong>Background: </strong>The rates of obesity and type 1 diabetes (T1D) in children and adolescents are increasing in many settings worldwide, but data on weight gain in this group are limited in New Zealand. We examined temporal body mass index (BMI) changes and associated factors in young people with T1D in a mixed urban-rural region.</p><p><strong>Methods: </strong>This study was a 20-year retrospective audit of clinical data from a regional paediatric diabetes service (June 2000-March 2021). The primary outcome was BMI standard deviation score (BMI SDS), whose trajectories from diagnosis were examined in association with demographic and clinical factors.</p><p><strong>Results: </strong>A total of 106 young people with T1D (56% male) were followed for a median of 8.3 years [Q1 = 6.1, Q3 = 11.0; maximum 15.1 years] and attended a median of 21 multidisciplinary clinic visits [Q1 = 12, Q3 = 30; range 1-56 visits]. In females, age at diagnosis modified the association between diabetes duration and BMI SDS (interaction <i>p</i> = 0.0009). Girls diagnosed at 4.0 years (age at diagnosis 25^th percentile for girls in our cohort) had no statistically significant change in BMI SDS over the first 5 years after diagnosis [-0.13 SDS (95% confidence interval [CI] -0.32 to 0.06); <i>p</i> = 0.18], while those diagnosed at 9.5 years (75^th percentile) experienced an increase of ≈0.39 SDS (0.08-0.70; <i>p</i> = 0.014). Among males, increasing age at diagnosis was associated with lower BMI SDS (<i>p</i> < 0.0001), whereas there was no statistically significant association with diabetes duration (<i>p</i> = 0.087). At any given duration, boys diagnosed at 11.1 years (age at diagnosis 75^th percentile for boys) had a BMI SDS approximately 0.70 lower (95% CI -1.02 to -0.45; <i>p</i> < 0.0001) than those diagnosed at 4.7 years (25^th percentile).</p><p><strong>Conclusions: </strong>We observed sex-specific BMI trajectories in young people with T1D, with age at diagnosis exerting variable influences on BMI SDS trajectory in boys and girls. These findings support individualised T1D management strategies within multidisciplinary care.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"4106777"},"PeriodicalIF":5.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Youth-Onset Type 2 Diabetes: Focus on SGLT-2 Inhibitor Use.","authors":"Silva Arslanian, Timothy Barrett, Naim Shehadeh","doi":"10.1155/pedi/4555805","DOIUrl":"https://doi.org/10.1155/pedi/4555805","url":null,"abstract":"<p><p>The upward trajectory of childhood and adolescent type 2 diabetes (T2D; youth-onset T2D) is a global health issue, disproportionately affecting non-white, ethnically diverse, and socioeconomically disadvantaged subgroups. Youth-onset T2D displays a more aggressive phenotype, with faster disease progression and earlier onset of severe complications when compared to adult-onset T2D. Despite this, the therapeutic options for the management of youth-onset T2D have historically been limited. Over the last few years, multiple new therapies across a range of drug classes, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, have been approved for use in youth-onset T2D. Despite this, patient recruitment to pediatric and adolescent trials remains a major challenge in youth-onset T2D, and there is currently a lack of large-scale, long-term clinical evidence for new treatment classes in this patient population. In this review, we provide an overview of the current treatment landscape in youth-onset T2D and summarize the available clinical data for SGLT-2 inhibitors in patients with youth-onset T2D, based on a targeted literature search.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"4555805"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13042356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends and Seasonal Patterns in Childhood Type 1 Diabetes: Insights From 2001 to 2024 in Lithuania.","authors":"Ingrida Stankute, Dale Marciulionyte, Rytas Ostrauskas, Aiste Cemerkaite, Gryte Leonaviciute, Robertas Kemezys, Sigita Vainiene, Kastytis Smigelskas, Rasa Verkauskiene","doi":"10.1155/pedi/9968982","DOIUrl":"10.1155/pedi/9968982","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) incidence is rising globally, with significant regional variation. Data from highly homogeneous populations, such as Lithuanian, may contribute to a better understanding of contributing T1D factors. This study examines 24-year trends in childhood T1D incidence and seasonal patterns in Lithuania.</p><p><strong>Methods: </strong>The annual incidence rates (IRs) were computed utilizing established methodologies per 100,000 children <15 years. The study included 2369 (1181 boys) patients with T1D.</p><p><strong>Results: </strong>During 2001-2024, the mean IR was 21.4 per 100,000 < 15 years (95% CI: 20.89, 27.28). The incidence rose from 10.8 to 36.4 per 100,000 children under 15 years of age, with notable peaks observed in 2021 and 2022, temporally aligning with the highest COVID-19 infection waves. Subgroup analysis showed the most rapid increase in young teenagers (10-14 years). Most new cases (63.5%) were diagnosed from September to March.</p><p><strong>Conclusions: </strong>This study demonstrates a rapidly increasing incidence of T1D in Lithuanian children over a 24-year period and is one of the highest in European countries. The seasonal distribution of new cases has been speculated to be due to reduced sunlight exposure and lower vitamin D levels, as well as increased school related stress and viral infections during autumn and winter months. However, additional contributing factors are likely involved, underscoring the need for further research.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"9968982"},"PeriodicalIF":5.6,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Growth Outcomes of Children With Type 1 Diabetes According to Glycemic Control and Use of Continuous Glucose Monitoring: A Retrospective Cohort Study.","authors":"Sujin Kim, Seo Jung Kim, Kyoung Won Cho, Kyungchul Song, Youngha Choi, Hyun Wook Chae, Junghwan Suh","doi":"10.1155/pedi/9111583","DOIUrl":"10.1155/pedi/9111583","url":null,"abstract":"<p><strong>Background: </strong>Chronic diseases such as type 1 diabetes mellitus (T1DM) may alter linear growth; however, reports regarding growth in children with T1DM have been inconsistent. This study aimed to investigate the height and growth velocity of patients with T1DM, and whether they were affected by various factors 5 years after the diagnosis.</p><p><strong>Methods: </strong>This retrospective study included patients with T1DM between October 2005 and May 2022, with a follow-up period of at least 1 year. Patients with diabetes, thyroid disease, celiac disease, or any other chronic disease were excluded. We compared the mean height standard deviation score (H-SDS) and growth velocity between groups divided based on glycosylated hemoglobin (HbA1c) levels and use of continuous glucose monitoring (CGM) systems.</p><p><strong>Results: </strong>Among the 150 patients, 45.3% were male, with a mean age at diagnosis of 7.8 ± 3.6 years. At diagnosis, the mean H-SDS was 0.38 ± 1.11. In males, H-SDS significantly decreased overtime, with an estimated slope (<i>β</i>) of -0.054 (standard error [SE] = 0.013, 95% confidence interval [CI]: -0.079 to -0.029, <i>p</i>  < 0.01). The decline in H-SDS was more pronounced in the poorly-controlled group (mean HbA1c ≥7.0%) compared to the well-controlled group (mean HbA1c <7.0%; <i>β</i> = -0.081, SE = 0.016, 95% CI: -0.112 to -0.050 vs. <i>β</i> = -0.007, SE = 0.020, 95% CI: -0.047 to -0.033, <i>p</i>  < 0.01). Among males using CGM, the decrease in H-SDS over the 5-year follow-up was significantly less than that observed in the non-CGM group (<i>β</i> = -0.012, SE = 0.023, 95% CI: -0.057 to -0.034 vs. <i>β</i> = -0.072, SE = 0.015, 95% CI: -0.101 to -0.042, <i>p</i> = 0.03). In the multivariable linear mixed model analysis, younger age at diagnosis (<i>β</i> = -0.009, 95% CI: -0.017 to -0.002, <i>p</i> = 0.02), female (<i>β</i> = 0.067, 95% CI: 0.033 to 0.100, <i>p</i>  < 0.01) and lower HbA1c levels (<i>β</i> = -0.026, 95% CI: -0.038 to -0.015, <i>p</i> < 0.01) were significantly associated with greater improvement in H-SDS over 5 years.</p><p><strong>Conclusion: </strong>Glycemic control and CGM use positively affected linear growth in children with T1DM, especially in males. CGM use was associated with improved growth outcomes, which suggests that glucose monitoring may help mitigate the adverse effects of poor glycemic control on growth.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"9111583"},"PeriodicalIF":5.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Experience With Control-IQ Technology in Saudi Children With Insulin-Dependent Diabetes: A Single-Center Observational Study.","authors":"Afaf Alsagheir, Bassam Bin-Abbas, Razan Alsagheir, Raghad Alhuthil, Aseel Aljuwair, Norah H Alobailly, Sheikhah Almoaily","doi":"10.1155/pedi/6113065","DOIUrl":"10.1155/pedi/6113065","url":null,"abstract":"<p><strong>Objectives: </strong>The Tandem t:slim X2 insulin pump with the Control-IQ technology (Control-IQ) is an automated insulin delivery (AID) system for glycemic control but has limited data in Saudi pediatric and young adult populations. We aim to evaluate the efficacy and safety of Control-IQ therapy in children with insulin-dependent diabetes and previously treated with multiple daily injections (MDIs). The primary outcome is to assess the change in HbA1c 6 months after initiating Control-IQ technology.</p><p><strong>Methods: </strong>This prospective observational study evaluated children aged 2-14 years with insulin-dependent diabetes who transitioned from treatment with MDI to the Control-IQ technology in the diabetes clinic at the King Faisal Specialist Hospital and Research Centre (KFSHRC) in Saudi Arabia.</p><p><strong>Results: </strong>A total of 100 patients (44 boys and 56 girls; median age was 11 years) were included. Most (82%) had a history of severe hypoglycemia. Following Control-IQ initiation, median HbA1c significantly decreased from 9.2% to 6.9% at 6 months (-25.0%; <i>p</i> < 0.001), accompanied by a 24.4% reduction in the daily insulin dose. Time in range (TIR) (70-180 mg/dL) improved from 45.6% to 68.8% (+23.2%; <i>p</i> < 0.001), while time in significant hypoglycemia (<54 mg/dL) decreased by 88.9% (<i>p</i> < 0.001). At 6 months, 83% achieved ≥60% TIR, and 54% reached ≥70%. Adherence and engagement were high, with no severe hypoglycemia or discontinuations. Only 3% experienced mild/moderate ketoacidosis due to technical issues in the Control-IQ.</p><p><strong>Conclusions: </strong>The findings demonstrated that Control-IQ technology is both effective and safe in improving glycemic outcomes in children with insulin-dependent diabetes in a real-world clinical setting. However, successful implementation requires comprehensive training and continuous support.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"6113065"},"PeriodicalIF":5.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mediating Effects of Diabetes Self-Management on the Relationship Between Diabetes Distress and Quality of Life Among School-Age Children With Type 1 Diabetes Mellitus During the COVID-19 Pandemic.","authors":"Jiaxin Luo, Qingting Li, Yuwen Gao, Fang Liu, Jie Zhong, Ka Yan Ho, Robin Whittemore, Jia Guo","doi":"10.1155/pedi/2022750","DOIUrl":"https://doi.org/10.1155/pedi/2022750","url":null,"abstract":"<p><strong>Background: </strong>Diabetes distress is prevalent among youth with type 1 diabetes mellitus (T1DM) and can negatively impact their quality of life and metabolic control. Identifying modifiable factors to reduce this distress is crucial. This study investigates the interplay between diabetes distress, self-management, and quality of life in school-aged children with T1DM amidst the COVID-19 pandemic. Its primary objective is to identify modifiable factors that can assist these children as they navigate the challenges associated with transitioning into adolescence.</p><p><strong>Methods: </strong>A cross-sectional study with data from 341 Chinese school-age children aged 8-12 was conducted. Data were collected through an online self-report survey during the COVID-19 pandemic (June-December 2022). The data included sociodemographic and clinical characteristics, diabetes distress, diabetes care activities and diabetes problem solving of diabetes self-management and quality of life. Structural equation modeling assessed relationships and mediation effects.</p><p><strong>Results: </strong>All four domains of diabetes distress exhibited negative associations with quality of life (<i>r</i> = -0.74 to -0.77, <i>p</i> < 0.01). Care activities and problem-solving related to diabetes self-management mediated the associations of emotional burden and regimen-related distress with quality of life (both <i>p</i> < 0.05). Conversely, neither diabetes care activities nor diabetes problem-solving mediated the relationship between physician-related distress and quality of life.</p><p><strong>Conclusions: </strong>Our findings indicate that problem-solving techniques related to diabetes self-management might be more effective at alleviating various aspects of diabetes distress-such as emotional burden, regimen-related distress, and interpersonal distress-compared to diabetes care activities. Interventions that teach structured problem-solving strategies could be beneficial. Given the ongoing pandemic, these findings could also serve as useful guidance for developing support strategies for school-age children with chronic conditions during future public health emergencies.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"2022750"},"PeriodicalIF":5.6,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Celiac Disease and Uncontrolled Hemoglobin A1c Levels in Type 1 Diabetes Pediatric Patients.","authors":"Amy Lin, Michelle Jankowski, Shirley Qu, Virginia Uhley, Michael Brennan, Ramin Homayouni","doi":"10.1155/pedi/5225066","DOIUrl":"10.1155/pedi/5225066","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CD) occurs in ~6% of individuals with type 1 diabetes (T1D) and may complicate glycemic control due to conflicting dietary needs. Prior studies show mixed results regarding the impact of CD on Hemoglobin A1c (HbA1c), especially in pediatric populations. This study evaluates whether CD is associated with suboptimal glycemic control in pediatric patients with T1D.</p><p><strong>Methods: </strong>This retrospective chart review analyzed pediatric patients (<18 years) diagnosed with T1D between 2012 and 2023 across Corewell Health East. Patients were identified via ICD-10 codes and stratified by CD status and glycemic control (controlled HbA1c <7% vs. uncontrolled HbA1c ≥7%). Statistical analyses include chi-square or Fisher's exact tests for categorical variables, Wilcoxon tests for continuous variables, and logistic regression for multivariable analysis.</p><p><strong>Results: </strong>Among 2,203 pediatric patients with T1D, 101 (4.6%) had CD. Patients with both conditions were younger at T1D diagnosis (median age 9 vs. 12 years, <i>p</i> < 0.0001) and had more HbA1c measurements. A higher proportion of CD patients had uncontrolled diabetes (89.1% vs. 73.8%, <i>p</i> = 0.0006). CD was independently associated with uncontrolled HbA1c (adjusted OR: 2.59; 95% CI: 1.37-4.90; <i>p</i> = 0.003) after adjusting for age, sex, and race. Younger age and Black race were also associated with higher odds of uncontrolled diabetes.</p><p><strong>Conclusion: </strong>CD is significantly associated with poorer glycemic control in pediatric patients with T1D, independent of age, race, and sex. These findings suggest the need for closer monitoring, individualized dietary counseling, and targeted interventions in this high-risk group.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"5225066"},"PeriodicalIF":5.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Current Screening Availability for Early Stages of Type 1 Diabetes in Germany Related to the Population-Based Frequency of Diabetic Ketoacidosis at Clinical Manifestation in Children and Adolescents.","authors":"Alexander J Eckert, Joachim Rosenbauer, Clemens Kamrath, Marina Sindichakis, Ansgar Thimm, Martin Holder, Jantje Weiskorn, Daniel P Lorenz, Susanne Gonzalves, Gita Gemulla, Sven Golembowski, Ute Ohlenschläger, Dieter Hüseman, Katja Palm, Andreas Lemmer, Valentina Lahn, Antonia Müller, Donald Wurm, Marjatta Wütherich, Reinhard W Holl","doi":"10.1155/pedi/6905472","DOIUrl":"10.1155/pedi/6905472","url":null,"abstract":"<p><strong>Aims: </strong>Is the current screening for early-stage type 1 diabetes (T1D) associated with the rate of diabetic ketoacidosis (DKA) at T1D manifestation at population level?</p><p><strong>Materials and methods: </strong>Children with T1D manifestation in 2015-2023 in Germany, aged 0.5 to <15 years from the multicenter diabetes registry (DPV) were included and allocated to federal states (FSs) based on their residential postal code. The relative risk (RR) with 95% confidence interval for DKA at manifestation of T1D by FS with vs. without screening, and demographic/context factors was calculated using logistic regression models.</p><p><strong>Results: </strong>24,408 children (54.3% males) were included with median onset age of 8.8 (quartiles: 5.3; 11.8) years. The RR for DKA was not significantly lower in FS with vs. without screening (RR: 0.96 [0.93-1.03], <i>p</i> = 0.393) overall, but in the sub-group of children with the highest probability of being screened (age 1.75-10.99 years, manifestation in Bavaria from 2020 to 2023, RR: 0.88 [0.80-0.97], <i>p</i> = 0.012). The most important predictor for DKA was manifestation age <3 years (RR: 1.83, [1.66-2.03], <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Until 2023, current regional screening initiatives for early-stage T1D were not associated with lower frequency of DKA at population level, but might be helpful in the future if the coverage can be markedly increased.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2026 ","pages":"6905472"},"PeriodicalIF":5.6,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}