Pediatric Diabetes最新文献

{"title":"Patient Characteristics Associated With Annual Nutrition Visits in Children With Type 1 Diabetes.","authors":"Svetlana Azova, Belinda S Lennerz, Carter R Petty, Erin Gordon, Hannah Michelson, Anna Schmidt, Katharine Garvey, Erinn T Rhodes","doi":"10.1155/pedi/4108685","DOIUrl":"https://doi.org/10.1155/pedi/4108685","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes organizations recommend nutrition education by a registered dietitian (RD) at least annually following type 1 diabetes (T1D) diagnosis in children. The study objectives were to describe differences over time in annual RD follow-up in children with T1D and to identify patient characteristics associated with RD engagement.</p><p><strong>Research design and methods: </strong>Data based on 6034 completed diabetes medical visits among 1982 patients aged <18 years with T1D for ≥1 year followed at a pediatric, tertiary care, academic medical center over a 5-year period (2018-2022) were analyzed. Generalized estimating equations models assessed for differences over time in the rates of RD visit completion in the year preceding the last diabetes medical encounter and identified sociodemographic, diabetes care-related, and clinical patient characteristics associated with RD follow-up. Models were fit for the whole sample and groups subset by race and ethnicity.</p><p><strong>Results: </strong>Observed annual RD follow-up rate over the 5-year period was 20.8%, with the lowest adjusted percentage in 2021 compared to 2018. In multivariable analysis, for each year increase in age (<i>p</i> = 0.004) and diabetes duration (<i>p</i><0.001), there was a 3% and 15% reduction in the odds of RD follow-up, respectively. RD follow-up was associated with lower hemoglobin A1c within the subsequent year in adjusted analysis (<i>p</i> = 0.029), with the greatest improvement among Hispanic patients.</p><p><strong>Conclusions: </strong>Annual RD visit frequency among children with T1D is suboptimal. Study findings provide insights for targeted intervention to improve RD engagement. RD follow-up may be associated with improved glycemic outcomes.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2025 ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049207","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":"Clinical Characteristics and Remission Monitoring of 6q24-Related Transient Neonatal Diabetes.","authors":"Michael E McCullough, Lisa R Letourneau-Freiberg, Tiana L Bowden, Balamurugan Kandasamy, Angela Ray, Kristen Wroblewski, Daniela Del Gaudio, Deborah J G Mackay, Louis H Philipson, Siri Atma W Greeley","doi":"10.1155/pedi/3624339","DOIUrl":"https://doi.org/10.1155/pedi/3624339","url":null,"abstract":"<p><p><b>Introduction:</b> Transient neonatal diabetes mellitus (TNDM) is a heterogeneous subtype of neonatal diabetes that usually presents within the first days or weeks of life, spontaneously remits in infancy, but can recur in childhood or adolescence as a permanent form of diabetes. Approximately 70% of TNDM cases are due to overexpression of genes at chromosome 6q24 (6q24-TNDM) caused by one of three potential mechanisms: paternal uniparental disomy (pUPD6), paternal duplication, or hypomethylation of the maternal allele. Our aim was to further elucidate the clinical characteristics of a relatively large group of individuals with this rare condition. <b>Methods:</b> Participants with a genetically confirmed diagnosis of 6q24-TNDM were identified through the University of Chicago Monogenic Diabetes Registry. Some participants had testing done on a clinical basis, with the remainder having received research-based genetic testing. Clinical information was extracted from survey responses and medical records. <b>Results:</b> There were 33 participants with 6q24-TNDM (58% were male). Eight (24%) had hypomethylation of the maternal allele, seven (21%) had paternal duplication, 17 (52%) had pUPD6, and one individual had 6q24 hypomethylation of unknown etiology. The median age of initial diabetes presentation was 2 days (<i>n</i> = 33). Remission occurred at a median age of 3 months (<i>n</i> = 28). The median age of relapse was 14 years (range 12-31 years, <i>n</i> = 9). The majority (71%) of participants were born small for gestational age and 32% of participants were born before 37 weeks gestation. The most common extra-pancreatic features were umbilical hernia (22%, <i>n</i> = 6/27), macroglossia (56%, <i>n</i> = 15/27), and speech pathologies (36%, <i>n</i> = 10/28). No significant differences in clinical characteristics were identified across the three genetic etiologies (pUPD6, paternal duplication, maternal hypomethylation). <b>Conclusions:</b> Clinical characteristics were not different across underlying genetic mechanism groups, suggesting that genetic testing is required to definitively determine the mechanism and diagnosis of 6q24-TNDM. Clarification of the specific underlying mechanism is strongly encouraged to clarify recurrence risk, but whether these subcategories may have other clinically relevant differences remains to be elucidated. Early assessment for speech therapy should be considered for this patient population. We recommend that patients in remission be equipped to check blood glucose levels as needed, such as during illness, and should continue seeing a diabetes provider at least occasionally, especially around the time of puberty and thereafter.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"3624339"},"PeriodicalIF":3.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041995","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":"Non-surgical Treatment May be Appropriate for Most Chinese Children With Monogenic Congenital Hyperinsulinism Based on a Retrospective Study of 121 Patients.","authors":"Ming Cheng, Chang Su, Dongmei Wang, Yanning Song, Yang Li, He Zeng, Zheng Yuan, Xiaoqiao Li, Xi Meng, Yuan Ding, Bingyan Cao, Chunxiu Gong","doi":"10.1155/2024/3961900","DOIUrl":"https://doi.org/10.1155/2024/3961900","url":null,"abstract":"<p><p><b>Objective:</b> There is a notable absence of extensive Chinese studies involving monogenic congenital hyperinsulinism (CHI). The purpose of this large retrospective Chinese cohort with monogenic CHI from a national children's medical center was to analyze the genetic and clinical characteristics. <b>Methods:</b> We compared clinical characteristics grouped by genotypes based on CHI-targeted next-generation sequencing (tNGS) and performed subgroup analyses by onset time. <b>Results:</b> Totally, 121 non-consanguineous patients were enrolled. Among them, 79 patients (65.3%) had variants in ATP-sensitive potassium channel (<i>KATP</i>) genes (62 heterozygotes and 17 compound heterozygotes), 35 (28.9%) in glutamate dehydrogenase 1 (<i>GLUD1</i>), and 7 (5.8%) in rare genes (hydroxyacyl-CoA dehydrogenase [<i>HADH</i>], glucokinase [<i>GCK</i>], and hepatocyte nuclear factor 4 alpha [<i>HNF4A</i>]). Ten patients had ATP binding cassette subfamily C member 8 (<i>ABCC8</i>) variants (p.G111R), and 12 had <i>GLUD1</i> variants (p.S498L), suggesting two potential founder variants. Three <i>ABCC8</i> variants (p.G1478R, p.L580_S581insFASL, and p.S986<i>⁣</i> ^<i>∗</i> ) and two <i>HNF4A</i> variants (p.R63W and p.V382I) were previously reported to be associated with diabetes. Non-surgical treatment was effective in 65.9% of patients with <i>KATP</i> variants, while in 100% of those with non-<i>KATP</i> variants. For the subgroup of <i>KATP</i> variants, neonatal-onset patients tended to present with mild symptoms (67.9% versus 19.3%), had a higher proportion of surgical intervention (24.5% versus 3.8%), and displayed higher levels of serum insulin and C-peptide than non-neonatal onset ones (<i>p</i> < 0.001). <b>Conclusion:</b> The absence of homozygous variants in <i>KATP</i> genes and a quite higher proportion of <i>GLUD1</i> variants than previous cohorts, may explain a high response rate of non-surgical treatment in this study. Surgery might be considered for neonatal-onset children, especially when <i>KATP</i> variants were discovered but not for those carried variants reported to cause diabetes in later life. While expanding the genotypic spectrum, we also highlight the clinical significance of genetic screening.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"3961900"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024196","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":"Associations Between Arterial Stiffness and Metabolic Target in Children and Adolescents With Type 1 Diabetes Treated in a Modern Setting.","authors":"Julie A Damm, Amalie Dalgas-Madsen, Agnes M K Bech, Kasper A Pilgaard, Flemming Pociot, Tine W Hansen, Jesper Johannesen","doi":"10.1155/2024/5528717","DOIUrl":"https://doi.org/10.1155/2024/5528717","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the prevalence of elevated arterial stiffness and associations to known and potentially novel risk factors in a modern European technology-based cohort of children and adolescents with type 1 diabetes. <b>Research Design and Methods:</b> Cross-sectional study, including 127 children recruited from Pediatric Diabetes Departments across Eastern Denmark between May 2022 and January 2024. Arterial stiffness was assessed as carotid-femoral pulse-wave-velocity (cfPWV) using the Sphygmocor XCEL system. Unadjusted and adjusted linear regression models explored associations between cfPWV and other risk factors. Adjustments included age, sex, diabetes duration, time-in-range, hemoglobin A1c (HbA1c), body mass index (BMI) <i>z</i>-score, low-density lipoprotein (LDL)-cholesterol, and mean arterial pressure (MAP). <b>Results:</b> Median (interquartile range [IQR]) age was 14.2 years (12.0, 16.4), diabetes duration was 4.7 years (2.7, 8.4), HbA1c level was 7.0% (6.5, 7.9), (53 mmol/l: 48-63), time-in-range was 63% (53-75), and 52% were male. The majority were treated with continuous-subcutaneous-insulin-infusion (82%), and all (except two) used continuous-glucose-monitors. The prevalence of elevated arterial stiffness (cfPWV <i>z</i>-score over the 90th percentile) was 16%. Unadjusted analyses demonstrated higher cfPWV was associated with longer diabetes duration, higher age, HbA1c, MAP, and liver stiffness, and lower time-in-range and insulin sensitivity. Higher cfPWV remained associated with higher age (standardized <i>β</i> (confidence interval (CI) 95%): 0.38 (0.27, 0.48); <i>p</i>  < 0.001) and lower time-in-range (-0.15 ((-0.26), (-0.03)); <i>p</i>  < 0.011) after adjustment. <b>Conclusions:</b> Despite modern treatment technology and better overall metabolic control, children and adolescents with type 1 diabetes present with a high prevalence of elevated arterial stiffness. Higher arterial stiffness was associated with higher age and lower time-in-range, independent of other risk factors, including HbA1c.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"5528717"},"PeriodicalIF":3.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026816","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":"Adolescent-Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus.","authors":"David J Chenoweth, Benjamin A Palmer, Andrew W Norris, Michael J Tansey, Catherina T Pinnaro","doi":"10.1155/2024/5218915","DOIUrl":"https://doi.org/10.1155/2024/5218915","url":null,"abstract":"<p><p><b>Objectives:</b> Regular retrospective review of glucose data is an important aspect of type 1 diabetes (T1D) management. Continuous glucose monitors (CGMs) facilitate retrospective review by capturing glucose data and generating standardized reports. However, only a minority of adults with T1D retrospectively review their glucose data, and adolescents are understudied. The objectives of this study were to determine the prevalence of self-reported retrospective glucose data review by adolescents with T1D, determine factors associated with self-reported retrospective glucose data review, and assess whether self-reported retrospective glucose data review was associated with improved glycemia. <b>Methods:</b> We conducted a cross-sectional survey of adolescents aged 12-18 years with T1D in conjunction with review of the associated electronic medical record, which included age, sex, date of diagnosis, clinic hemoglobin A1c (HbA1c), type of insurance, and CGM data. The survey included the Hypoglycemia Fear Survey (HFS) and questions regarding habits and attitudes associated with retrospective review. <b>Results:</b> 112 out of 218 eligible individuals completed the survey (51%). Fifty-three percent of adolescents who completed the survey reported that they had engaged in retrospective glucose data review. Of these, 88% of individuals reported that they reviewed data regularly. Age, sex, race, type of insurance, and CGM use were not associated with retrospective review status. Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and time in range (TIR) compared to adolescents who indicated they do not review glucose data (<i>p</i>=0.006 and <i>p</i>=0.04, respectively). There was no difference in HFS scores between reviewers and nonreviewers including the behavioral subscale, worry subscale, and total score. <b>Conclusions:</b> Self-report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and TIR. Adolescent-initiated glucose data self-review does not appear to be driven by fear of hypoglycemia (FoH).</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"5218915"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037640","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":"Efficacy and Safety of SGLT2 Inhibitors in Pediatric Patients and Young Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Rafael Dos Santos Borges, Ana Flávia Conegundes, Luiza Haikal de Paula, Rodrigo Lara Santos, Samuel Norberto Alves, Raquel Amaral Machado, Isadora Bussolaro Viana, Ana Cristina Simões E Silva","doi":"10.1155/2024/6295345","DOIUrl":"https://doi.org/10.1155/2024/6295345","url":null,"abstract":"<p><p><b>Introduction:</b> In recent decades, an increase in the incidence of type 2 diabetes mellitus (T2DM) in children and adolescents has been observed. Pediatric-onset T2DM differs from the adult-onset form, particularly regarding the durability of glycemic control and earlier appearance of complications. However, the scarcity of approved treatments and comprehensive studies on T2DM management in youth persists. Ongoing clinical trials seek to ascertain the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in patients aged between 10 and 24 years with T2DM. Therefore, we aimed to perform a meta-analysis exploring the efficacy and safety of SGLT2i in pediatric patients and young adults with T2DM. <b>Methods:</b> We searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled clinical trials on the efficacy and safety of SGLT2i in children, adolescents, and young adults with T2DM compared with placebo. Statistical analysis was performed using RevMan 5.4 and R statistical software 4.2.1. Heterogeneity was assessed with <i>I²</i> statistics. <b>Results:</b> We included three studies totaling 334 patients followed for 37.79 weeks. Reduction in HbA₁C (MD = -0.93; 95% CI = -1.36 to -0.49; <i>p</i>  < 0.0001; <i>I²</i>  = 0%) was significantly higher in SGLT2i group compared with placebo. The proportion of patients requiring rescue or discontinuation of study medication due to lack of efficacy was statistically lower in SGLT2i group compared with placebo (RR = 0.64; 95% CI = 0.43-0.94; <i>p</i>= 0.02; <i>I²</i>  = 0%). SGLT2i and placebo were similar in terms of any adverse event (RR = 1.10; 95% CI = 0.96-1.27; <i>p</i>= 0.17; <i>I²</i>  = 0%), serious side effects (RR = 1.06; 95% CI = 0.44-2.57; <i>p</i>=0.90; <i>I²</i>  = 0%), and individual adverse effects. <b>Conclusion:</b> In children, adolescents, and young adults with T2DM, SGLT2i appears to be effective and safe for glycemic control.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"6295345"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019741","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":"Assessing the Feasibility and Acceptability of a Virtual Food Skills and Food Sustainability Program Designed for Children Living With Type 1 Diabetes.","authors":"Sarah Goldstein, Olivia Chow, Joeie Schwartz, Vanita Pais, Susan Wright, Enza Gucciardi","doi":"10.1155/2024/3821265","DOIUrl":"https://doi.org/10.1155/2024/3821265","url":null,"abstract":"<p><p><b>Objective:</b> To assess the feasibility and acceptability of a virtual food skills program for children with type 1 diabetes. <b>Methods:</b> Forty-three patients, aged 6-14 years with type 1 diabetes, participated in an 8-week online programme, summerlunch+ At Home, that included weekly live cooking classes, asynchronous learning modules, and quizzes accessed through Google Classroom. Grocery delivery or gift cards were provided to all participants to support equitable access to participation. Descriptive results were summarized, and thematic analysis was performed on answers to a post-intervention questionnaire, parent/caregivers interview transcripts, and facilitators' field notes. <b>Results:</b> Participants reported having a positive experience and would recommend the programme to others. Acceptable elements included the online format, the cooking class demonstrations, and the well-organized content. Families enjoyed the recipes, expressed an improvement in the families' cooking skills and nutrition knowledge, and noted the program as a way to improve family bonding and reduce participants' sense of social isolation given the opportunity of meeting peers with diabetes. The intervention also appears to increase participants' independence, confidence, and self-esteem. While grocery cards were easier to coordinate compared with meal kits, both were deemed acceptable by caregivers. Barriers to participation include a distracting home environment and not feeling comfortable on camera. Factors that negatively impacted satisfaction were the large age range of participants and the class timing and duration. Caregivers noted a desire for more diabetes education, enhanced peer-to-peer interaction, and incorporation of animal-based protein recipes in future programmes. <b>Conclusion:</b> The current study demonstrates the feasibility and acceptability of the virtual summerlunch+ At Home cooking and nutrition program that was adapted for children with diabetes. Similar food skills programmes may support the development of food skills imperative to diabetes self-management long-term. Further research can continue to assess food literacy skills, glycemic management, and the social benefits of such interventions.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"3821265"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006876","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":"Effectiveness of Educational and Psychoeducational Self-Management Interventions in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta-Analysis.","authors":"Emma J Cockcroft, Ross Clarke, Renuka P Dias, Jenny Lloyd, Robert H Mann, Parth Narendran, Charlotte Reburn, Ben Smith, Jane R Smith, Robert C Andrews","doi":"10.1155/2024/2921845","DOIUrl":"https://doi.org/10.1155/2024/2921845","url":null,"abstract":"<p><p><b>Aim:</b> Type 1 diabetes (T1D) is one of the most common chronic conditions in children and adolescents. Approximately 1.5 million young people are currently living with T1D throughout the world. Despite recent improvement in overall indices of metabolic control in children and adolescents with T1D, control remains suboptimal and additional approaches are needed. The aim of the study was to conduct a systematic review and meta-analysis of educational and psychoeducational self-management interventions, to help optimize future interventions including physical activity support. <b>Methods:</b> A systematic review and meta-analysis were conducted according to our registered protocol (PROSPERO CRD42022295932) and are reported in line with the PRISMA 2020 guidance. We searched five databases (MEDLINE, EMBASE, PsycINFO [via Ovid], CINAHL [via EBSCO], Cochrane Library) from 1994 up to May 2024. We included randomized controlled trials assessing the effectiveness of self-management interventions. Outcomes of interest included HbA1c and quality of life (QoL) as well as self-care behaviors, diabetes knowledge, and self-efficacy. Meta-analyses were conducted using a random effects model. <b>Results:</b> In total, 46 papers were included, reporting on 30 interventions. Meta-analyses showed small short-term improvements in HbA1c (MD = -2.58 mmol/L, 95% CI -4.44 to -0.71, <i>p</i>=0.007) and QoL (mean difference [MD] = 1.37, 95% CI 0.19-2.54, <i>p</i>=0.02). Prespecified subgroup analyses suggested no significant difference in effectiveness of psychoeducational and education-only interventions. Quality of included studies was low with 27 having a high risk of bias. <b>Conclusion:</b> There is a lack of robust evidence that current self-management interventions result in clinically meaningful improvements in HbA1c and QoL. Future research should focus on redefining approaches to supporting and encouraging self-management.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"2921845"},"PeriodicalIF":3.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986723","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":"Effect of Oral Insulin on Early Combined Glucose and C-Peptide Endpoints in Individuals at High-Risk for Type 1 Diabetes.","authors":"Taylor M Triolo, Laura M Jacobsen, David Cuthbertson, Emily K Sims, Heba M Ismail, Maria J Redondo, Markus Lundgren, Linda A DiMeglio, Peter A Gottlieb, Mark A Atkinson, Jeffrey P Krischer, Desmond A Schatz, Jay M Sosenko","doi":"10.1155/2024/8343868","DOIUrl":"https://doi.org/10.1155/2024/8343868","url":null,"abstract":"<p><p><b>Background:</b> The TrialNet Oral Insulin (OI) prevention trial showed no overall treatment effect, using the diagnosis of type 1 diabetes as an endpoint. A significant delay in onset was only found in a high-risk stratum (termed secondary stratum 1) of participants with low first-phase insulin release (FPIR). <b>Methods:</b> Since trials with an endpoint of type 1 diabetes take years to complete, in this post hoc analysis, we assessed whether a novel combination of glucose and C-peptide markers could identify a therapeutic benefit after 1 year of follow-up (trial participants followed for a median 2.7 years). <b>Results:</b> Participants were relatives with multiple islet autoantibodies and low FPIR (<i>n</i> = 40). Glucose rose, and C-peptide declined in the placebo group, whereas glucose rose minimally, and C-peptide increased in the OI group. When glucose and C-peptide were plotted on two-dimensional grids using 30-120-min oral glucose tolerance test (OGTT) time points, changes in ratios of their central points (centroid ratio) differed between groups (<i>p</i>=0.037 adjusted for age, BMI, and baseline C-peptide and glucose). <b>Conclusions:</b> These findings support a favorable early effect of OI on combined glucose and C-peptide endpoints in high-risk individuals, indicating metabolic benefit. With further study, these measures may allow for shorter trials compared to the standard endpoint of type 1 diabetes diagnosis.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"8343868"},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976334","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 Journey to Adulthood: A Systematic Review of Interventions in Type 1 Diabetes Paediatric to Adult Transition Care.","authors":"Nada Aljohani, Sara Donetto, Mette Due-Christensen, Angus Forbes","doi":"10.1155/2024/1773726","DOIUrl":"https://doi.org/10.1155/2024/1773726","url":null,"abstract":"<p><p>Young people with type 1 diabetes mellitus (T1DM) transition from paediatric to adult services when they reach late adolescence. This can be a risky period for young people, and it has been associated with a deterioration in glycaemic control and disengagement from diabetes services. This review aimed to identify current interventions addressing the following questions: What adolescents with T1DM healthcare transition interventions have been evaluated? What are the underlying theories and components of these interventions? What outcomes have been considered in these evaluations? Databases, trial registries and other sources were searched using the population and intervention keywords. Studies were included if they explicitly reported a transition intervention targeting young people aged 10-25 years. Studies were critically apprised, and data were extracted. Both tabular and narrative data synthesis were used. The review included 22 studies. Most interventions were service-oriented, with little use of theory. The interventions included transition planning, service coordination, pre-transition education, transition clinics, prompting strategies and other less frequent components. Most studies reported metabolic outcomes, with limited data on psychological outcomes such as diabetes adaptation, acceptance and self-management activation. It is inconsistent how each outcome was defined, measured or reported. Consequently, effective theory-based interventional transition models are yet to be identified.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"2024 ","pages":"1773726"},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036486","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}