Pediatric Diabetes最新文献

{"title":"Diabetes Distress and Transition Readiness in Youths with Type 1 Diabetes Transitioning from Pediatric to Adult Care","authors":"Joseph M. W. S. Leung, Naseem Y. Al-Yahyawi, Heywood S. Choi, Laura L. Stewart, Jeffrey N. Bone, Tricia S. Tang, Shazhan Amed","doi":"10.1155/2023/5580180","DOIUrl":"https://doi.org/10.1155/2023/5580180","url":null,"abstract":"Background. Youths with type 1 diabetes transitioning from pediatric to adult care are known to experience significant glycemic excursions and medical complications. Diabetes distress and transition readiness are two potentially related constructs involved in this transition process, but the relationship between them has not been extensively studied. Hypothesis. Lower diabetes distress is associated with increased transition readiness among youths with type 1 diabetes transitioning to adult care. Subjects. One hundred one adolescents and emerging adults with type 1 diabetes transitioning to adult care complete data in 63 study participants. Methods. In this cross-sectional study, we collected diabetes distress scale scores (via T1-DDS) and transition readiness scores (via Am I ON TRAC) at the last pediatric diabetes visit. We fitted regression models to estimate the relationship between T1-DDS scores and ON TRAC scores. Results. The total mean T1-DDS score was associated with ON TRAC knowledge score (β = −2.73, 95% CI −4.41,−1.06, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> <mo>=</mo> <mn>0.002</mn> </math> ), behavior score (β = −2.61, 95% CI −4.39,−0.84, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> <mo>=</mo> <mn>0.005</mn> </math> ), and transition readiness indicator (β = −0.18, −0.34,−0.01, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> <mo>=</mo> <mn>0.03</mn> </math> ). Multiple T1-DDS subscales were associated with ON TRAC knowledge score: powerlessness, management distress, negative social perceptions, eating distress, physician distress, and family/friend distress. Multiple T1-DDS subscales were also associated with ON TRAC behavior score: management distress, negative social perceptions, eating distress, and family/friend distress. Conclusions. Diabetes distress and transition readiness have an inversely proportional relationship in youths with type 1 diabetes transitioning to adult care. Targeting diabetes distress may also improve transition readiness (and vice versa) in this population.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135769914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreas Imaging of Children with Type 1 Diabetes Reveals New Patterns and Correlations with Pancreatic Functions","authors":"Olivier G. Pollé, Antoine Delfosse, Nicolas Michoux, Frank Peeters, Gaetan Duchêne, Jacques Louis, Brieuc Van Nieuwenhuyse, Philippe Clapuyt, Philippe A. Lysy","doi":"10.1155/2023/3295812","DOIUrl":"https://doi.org/10.1155/2023/3295812","url":null,"abstract":"Context. Type 1 diabetes (T1D) is a heterogeneous disease affecting the islets and the exocrine pancreas. How the topographical distribution of the involved tissue lesions correlates with the patient phenotype and pancreas functions is uncertain. Objective. To perform a longitudinal characterization of the pancreas in patients with new-onset T1D and investigate the correlations between magnetic resonance imaging (MRI) parameters and pancreatic functions during the first year postdiagnosis. Methods. Thirty-one pediatric patients with new-onset T1D and 29 retrospective age-, body mass index-, and sex-matched controls were included in the study. Following hypotheses were investigated: (H1) the value of pancreas volume (PV) parameters in T1D and in controls, (H2) the association between MRI parameters and markers of pancreatic functions, (H3) the ability of MRI parameters to predict glucose homeostasis, (H4) the longitudinal evolution of MRI parameters and glucose homeostasis, per-organ (whole pancreas) and per-subregion (head, body, and tail). Results. Patients with new-onset T1D demonstrated a significant decrease of PV at diagnosis compared to controls (−45%), with prepubertal patients having increased pancreas atrophy (+25%) (H1). PV parameters were correlated with C-peptide, and trypsinogen (PVTail and PVHead, respectively). Biparametric regression models including MRI parameters predicted pancreas functions during the first year postdiagnosis (H3). Longitudinal evolution of PV parameters at 1 year postdiagnosis was correlated with PV at diagnosis (R = −0.72) but not with markers of glucose homeostasis (H4). Conclusion. Our study shows that longitudinal analysis of pancreases of children with T1D using multiparametric MRI improve the understanding of T1D heterogeneity both in the context of its onset and its evolution.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136016857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Presentations of Diabetic Ketoacidosis in a Large Cohort of Children","authors":"Lise E. Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E. Schunk, Michael J. Stoner, Arleta Rewers, Julie K. McManemy, Kimberly S. Quayle, Jennifer L. Trainor, Leah Tzimenatos, Jonathan E. Bennett, Maria Y. Kwok, Sage R. Myers, Kathleen M. Brown, T. Charles Casper, Cody S. Olsen, Nicole S. Glaser, Pediatric Emergency Care Applied Research Network (PECARN) DKA FLUID Study Group","doi":"10.1155/2023/6693226","DOIUrl":"https://doi.org/10.1155/2023/6693226","url":null,"abstract":"Background. Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined. Methods. We included children from 12 centers who were <18 years with DKA (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate <15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups. Results. Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH < 7.1). Newly diagnosed children <6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children. Conclusions. Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent- and Young Adult-Reported Outcomes and Use of Continuous Glucose Monitoring Features: A Report from the CITY Trial","authors":"Laurel H. Messer, Colleen Bauza, Kellee M. Miller, Mark A. Clements, Daniel J. DeSalvo, Jennifer Sherr, Ruth S. Weinstock, Korey Hood, Lori M. Laffel","doi":"10.1155/2023/6906023","DOIUrl":"https://doi.org/10.1155/2023/6906023","url":null,"abstract":"Objective. To evaluate patterns of continuous glucose monitor (CGM) use and perceptions of quality of life in adolescents/young adults with type 1 diabetes (T1D) after using CGM for up to 52 weeks in the CGM Intervention in Teens and Young (CITY) Adults randomized clinical trial (RCT). Subjects and Methods. Participants with T1D were initially randomized 1 : 1 to use of CGM or blood glucose meter (BGM) for 26 weeks. Following the RCT, participants in the BGM group initiated CGM (BGM–CGM cohort) and participants in the CGM group continued CGM (CGM–CGM cohort) for another 26 weeks. Problem Areas in Diabetes Survey-Pediatric Version (PAID-peds), Glucose Monitoring Satisfaction Survey (GMSS), Hypoglycemia Confidence Scale (HCS), Diabetes Technology Attitudes (DTA), Pittsburgh Sleep Quality Index (PSQI), Benefits of CGM, and Burdens of CGM were completed at baseline, 26 and 52 weeks. Results. In both cohorts, >70% of participants were wearing CGM > 5 days/week at 52 weeks; 5% discontinued CGM. The majority used the mobile app to receive glucose data. Adolescents (14 to <19 years) were more likely to use SHARE features than young adults (80% versus 41%). CGM–CGM participants had significantly higher scores on GMSS, DTA, and HCS at 52 weeks compared with baseline, and reported higher benefit and lower burden perceptions than at baseline. Similar results were observed for the BGM–CGM cohort. Conclusions. Improvements in self-reported measures were observed in adolescents and young adults using CGM. As CGM use is also associated with better glycemic control, utilizing CGM may contribute to improving both medical outcomes and emotional health.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"239 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135394725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Household Food Insecurity and Cognition in Youth and Young Adults with Youth-Onset Diabetes","authors":"Andrea D. Brown, Angela D. Liese, Allison L. B. Shapiro, Edward A. Frongillo, Greta Wilkening, Julius Fridriksson, Anwar T. Merchant, Leora Henkin, Elizabeth T. Jensen, Beth A. Reboussin, Amy S. Shah, Santica Marcovina, Lawrence M. Dolan, Dana Dabelea, Catherine Pihoker, Jason A. Mendoza","doi":"10.1155/2023/6382663","DOIUrl":"https://doi.org/10.1155/2023/6382663","url":null,"abstract":"Objective. We evaluated the association of household food insecurity (FI) with cognition in youth and young adults with type 1 diabetes (T1D) or type 2 diabetes (T2D). Design. In this cross-sectional study, age-adjusted scores for composite fluid cognition, and sub-domain scores for receptive language and inhibitory control and attention, were stratified by diabetes type using linear regression, with FI in the past year as the predictor, controlling for covariates. Tests for processing speed, inhibitory control/attention, working memory, episodic memory, and cognitive flexibility were administered to measure the composite fluid cognition score. The NIHT-CB Picture Vocabulary Test was used to assess the crystallized cognition score, and rapid identification of congruent versus noncongruent items was used to assess inhibitory control and attention score. Setting. The SEARCH for Diabetes in Youth study is representative of five U.S. states. Participants. Included 1,574 youth and young adults with T1D or T2D, mean age of 21 years, mean diabetes duration of 11 years, 51% were non-Hispanic white, and 47% had higher HbA1c levels (>9% HbA1c). Results. Approximately 18% of the 1,240 participants with T1D and 31% of the 334 with T2D experienced FI. The food-insecure group with T1D had a lower composite fluid cognition score (β = −2.5, 95% confidence interval (CI) = −4.8, −0.1) and a lower crystallized cognition score (β = −3.4, CI = −5.6, −1.3) than food-secure peers. Findings were attenuated to non-significance after adjustment for demographics. Among T2D participants, no associations were observed. In participants with T1D, effect modification by glycemic levels was found in the association between FI and composite fluid cognition score but adjustment for socioeconomic characteristics attenuated the interaction ( p = 0.0531 ). Conclusions. Food-insecure youth and young adults with T1D or T2D did not have different cognition compared to those who were food-secure after adjustment for confounders. Longitudinal research is needed to further understand relations amongst these factors.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134910904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of After-Hours Nurse Line in an Academic Pediatric Endocrinology Practice","authors":"Abha Choudhary, Soumya Adhikari, Perrin C. White","doi":"10.1155/2023/2550101","DOIUrl":"https://doi.org/10.1155/2023/2550101","url":null,"abstract":"Background. After-hours triage of pediatric patients by trained nurses improves consistency of triage decisions, access, and quality of care, and decreases burden on physicians on-call. There is a lack of published experience with this approach in the pediatric diabetes population. Methods. An after-hours call service was established in September 2019 in our large urban pediatric teaching hospital. Barton Schmitt guidelines, which are widely accepted as the standard for telephone triage care, were modified to include institution specific diabetes management protocols. We analyzed demographics, reasons for call, clinical presentation to the emergency room, and clinical disposition of the callers. Results. The after-hours call service handled 70% of calls without physician involvement. There were no patients triaged to home care who subsequently required an emergency room visit or hospitalization. Patients who called the after-hours nurse line prior to coming to the emergency room were less sick and were discharged more often from the emergency room. Spanish-speaking parents utilized the service less than English speakers. There were no disparities in utilization based on the insurance status or race. Conclusions. The after-hours service accurately triaged calls and reduced physician burden. Patients of all races and insurance statuses utilized the after-hours service equally well. Language was a barrier in the utilization.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135938710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA Methylation Near DLGAP2 May Mediate the Relationship between Family History of Type 1 Diabetes and Type 1 Diabetes Risk","authors":"Randi K. Johnson, Amanda J. Ireton, Patrick M. Carry, Lauren A. Vanderlinden, Fran Dong, Alex Romero, David R. Johnson, Debashis Ghosh, Fan Yang, Brigitte Frohnert, Ivana V. Yang, Katerina Kechris, Marian Rewers, Jill M. Norris","doi":"10.1155/2023/5367637","DOIUrl":"https://doi.org/10.1155/2023/5367637","url":null,"abstract":"Given the differential risk of type 1 diabetes (T1D) in offspring of affected fathers versus affected mothers and our observation that T1D cases have differential DNA methylation near the imprinted DLGAP2 gene compared to controls, we examined whether methylation near DLGAP2 mediates the association between T1D family history and T1D risk. In a nested case–control study of 87 T1D cases and 87 controls from the Diabetes Autoimmunity Study in the Young, we conducted causal mediation analyses at 12 DLGAP2 region CpGs to decompose the effect of family history on T1D risk into indirect and direct effects. These effects were estimated from two regression models adjusted for the human leukocyte antigen DR3/4 genotype: a linear regression of family history on methylation (mediator model) and a logistic regression of family history and methylation on T1D (outcome model). For 8 of the 12 CpGs, we identified a significant interaction between T1D family history and methylation on T1D risk. Accounting for this interaction, we found that the increased risk of T1D for children with affected mothers compared to those with no family history was mediated through differences in methylation at two CpGs (cg27351978, cg00565786) in the DLGAP2 region, as demonstrated by a significant pure natural indirect effect (odds ratio (OR) = 1.98, 95% confidence interval (CI): 1.06–3.71) and nonsignificant total natural direct effect (OR = 1.65, 95% CI: 0.16–16.62) (for cg00565786). In contrast, the increased risk of T1D for children with an affected father or sibling was not explained by DNA methylation changes at these CpGs. Results were similar for cg27351978 and robust in sensitivity analyses. Lastly, we found that DNA methylation in the DLGAP2 region was associated ( <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>P</mi> <mo><</mo> <mn>0.05</mn> </math> ) with gene expression of nearby protein-coding genes DLGAP2, ARHGEF10, ZNF596, and ERICH1. Results indicate that the maternal protective effect conferred through exposure to T1D in utero may operate through changes to DNA methylation that have functional downstream consequences.","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135938706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subsequent Device Usage and Caregiver Attitudes to Do-It-Yourself Real-Time Continuous Glucose Monitoring (DIY-rtCGM) among Children with Type 1 Diabetes 3 Months after Participation in a Randomized Controlled Trial.","authors":"Yongwen Zhou, Mona M Elbalshy, Sara E Styles, Hamish Crocket, Craig Jefferies, Esko Wiltshire, Martin I de Bock, Benjamin J Wheeler","doi":"10.1155/2023/3435944","DOIUrl":"10.1155/2023/3435944","url":null,"abstract":"<p><strong>Aim: </strong>To assess children's subsequent device usage and caregiver attitudes to do-it-yourself real-time continuous glucose monitoring (DIY-rtCGM) at least 3 months after completing a randomized controlled trial (RCT).</p><p><strong>Methods: </strong>A brief online questionnaire or telephone call was used to collect the subsequent device usage and caregivers' attitudes from a total of 55 families at least 3 months after their completion of an RCT investigating DIY-rtCGM adapted from their preexisting intermittently scanned glucose sensors plus education on using DIY-rtCGM system. To be eligible for the RCT, children had to be aged 2-13 years, have type 1 diabetes ≥6 months, and be rtCGM naïve. Data collected investigated current CGM use post-RCT and attitudes/user experiences to DIY-rtCGM in the months since RCT study support ended.</p><p><strong>Results: </strong>Overall, responses from 81.8% (45/55) of caregivers were received. Mean age of children was 9.0 ± 2.7 years, and 31 (68.9%) children used insulin pumps. After 3 months, 44.4% (20/45) of responding caregivers reported ongoing DIY-rtCGM use, and of these, only 13 used DIY-rtCGM as the primary glucose monitoring method 100% of time. Of the 25 (55.6%) families who ceased DIY-rtCGM, 40% (10/25) had transitioned to commercial rtCGM. More than half of families (60%, 12/20) who continued DIY-rtCGM use had a very or extremely positive attitude toward the technology and 75% (15/20) of these families planned to continue DIY-rtCGM use. However, signal loss and sensor inaccuracy remained the major reasons among all responders both for decreased DIY-rtCGM wear time and eventual cessation. Burden of use primarily related to technical errors that could not be solved, and alarms, both of which were reported to contribute to discontinuation.</p><p><strong>Conclusions: </strong>This study highlights that, among families voluntarily using DIY-rtCGM at least 3 months following support from a trial, more than half have ceased using DIY-rtCGM, with 40% of those discontinuing switching to commercial rtCGM. While overall perceptions of DIY-rtCGM remain largely positive, burdens of use are high and contribute to discontinuation.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":" ","pages":"3435944"},"PeriodicalIF":3.9,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46254733","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":"Vascular and Myocardial Structure and Function in Adolescents with Type 1 Diabetes: The CARDEA Study.","authors":"Soren Harnois-Leblanc, Vanessa McNealis, Matthias G Friedrich, Jean-Luc Bigras, Andraea Van Hulst, Anne Monique Nuyt, Tracie A Barnett, Andrea Benedetti, Marie-Ève Mathieu, Vicky Drapeau, Marie-Pierre Sylvestre, Mélanie Henderson","doi":"10.1155/2023/8662038","DOIUrl":"10.1155/2023/8662038","url":null,"abstract":"<p><strong>Introduction: </strong>Despite heightened risk of cardiovascular disease (CVD) among individuals with type 1 diabetes, few studies in this population have investigated the development of CVD using early markers in adolescence. We compared risk factors (blood pressure (BP) and dyslipidemia) and early markers of CVD between adolescents with and without type 1 diabetes and explored effect modification by sex.</p><p><strong>Methods: </strong>Cross-sectional study using data from the CARdiovascular Disease risk in pEdiatric type 1 diAbetes (CARDEA) study. We recruited 100 adolescents with type 1 diabetes at the Sainte-Justine University Hospital Center and 97 adolescents without diabetes (14-18 years). We measured arterial stiffness by carotid-femoral pulse wave velocity, endothelial function by brachial artery flow-mediated dilation test, as well as left ventricular (LV) mass, papillary mass, and wall thickness by cardiac MRI. We used multivariable linear regression models to assess the impact of type 1 diabetes on each outcome adjusting for age, sex, ethnicity, adiposity, and familial income.</p><p><strong>Results: </strong>Adolescents with type 1 diabetes had 0.21 standard deviations (SD) (95% CI: 0.04; 0.38) higher diastolic blood pressure <i>z</i>-score (zDBP), 0.21 mmol/L (95% CI: 0.02; 0.40) higher low-density lipoprotein cholesterol (LDL-c) levels, and 17% (95% CI: 4; 29) higher triglyceride levels and lower endothelial function based on acceleration (-77.4 cm/s², 95% CI: -133.1; -21.6) compared with adolescents without diabetes. Girls with type 1 diabetes had higher systolic blood pressure <i>z</i>-score (zSBP), and boys with type 1 diabetes had lower LV mass and wall thickness compared to healthy peers.</p><p><strong>Conclusions: </strong>In addition to higher BP and abnormal lipid profiles, adolescents with type 1 diabetes present endothelial dysfunction and alterations in cardiac structure (in boys) compared to adolescents without diabetes, suggesting that CVD prevention should be incorporated into type 1 diabetes management early in the disease.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":"1 1","pages":"8662038"},"PeriodicalIF":3.9,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42010349","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":"A Comparison of Depressive Symptom Presentation in Adolescent Type 1 Diabetes and Pediatric Primary Care Samples.","authors":"Nasreen Bahreman, Mary S Dietrich, Sarah Jaser, Terrah Akard Foster, Shelagh Mulvaney","doi":"10.1155/2023/5597133","DOIUrl":"10.1155/2023/5597133","url":null,"abstract":"<p><strong>Background: </strong>Depression is a common comorbidity in adolescents with type 1 diabetes (T1D). It is unclear if patterns of responses from questionnaires used to screen for depressive symptoms are influenced by the burden of living with T1D and/or the consequences of hyperglycemia. Based on this gap in the adolescent research, we sought to identify potential differences in depression screening response patterns between adolescents with and without T1D and relate response patterns with glycemic outcomes.</p><p><strong>Methods: </strong>Using a retrospective case-control design, we analyzed electronic health records for age, sex, and race-matched adolescents 13-18 years of age from a pediatric diabetes clinic (<i>n</i> = 477) and a pediatric primary care clinic (<i>n</i> = 477) in the United States. Adolescents in both settings were screened for depressive symptoms during the same time period using the Patient Health Questionnaire-9 (PHQ-9).</p><p><strong>Results: </strong>Participant demographics for matched characteristics were: 53.5% male, 71.7% White, median age 13.0 (interquartile range = 13.0, 14.0). After controlling for type of insurance, adolescents with T1D were more likely to have higher total PHQ-9 scores (odds ratio (OR) = 1.51, 95% CI = 1.17, 1.98, <i>p</i> = 0.002) and higher somatic subscores (OR = 1.57, 95% CI = 1.20, 2.05, <i>p</i> = 0.001) compared to the primary care sample. The pattern of item endorsement greater than \"not at all\" indicated that adolescents with T1D were more likely to have higher values for somatic items such as \"trouble falling asleep\" and \"feeling tired\" than those in the primary care sample. Item-total correlations and Cronbach's <i>α</i> indicated that all items were contributing to the overall score in the same manner in each group.</p><p><strong>Conclusions: </strong>Symptom endorsement for sleep and fatigue were higher for adolescents with T1D and without T1D. Study results support the need for further examination of the origins of somatic symptoms in T1D and for an additional examination of the specificity of depression screening instruments used in routine pediatric diabetes care.</p>","PeriodicalId":19797,"journal":{"name":"Pediatric Diabetes","volume":" ","pages":"5597133"},"PeriodicalIF":3.9,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44684507","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}