Pediatric Endocrinology, Diabetes and Metabolism最新文献

{"title":"Atypical parathyroid adenoma: Severe manifestations in an adolescent girl.","authors":"Hiya Boro,&nbsp;Sarah Alam,&nbsp;Vijay Kubihal,&nbsp;Saurav Khatiwada,&nbsp;Suraj Kubihal,&nbsp;Shipra Agarwal,&nbsp;Rajesh Khadgawat","doi":"10.5114/pedm.2021.109127","DOIUrl":"https://doi.org/10.5114/pedm.2021.109127","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperparathyroidism (PHPT) is a disease that is usually diagnosed in an asymptomatic state during routine biochemical screening. It generally manifests as a sporadic disease in post-menopausal women. However, in India and developing countries, we continue to see severe skeletal and renal manifestations of the disease.</p><p><strong>Case report: </strong>Herein, we describe the case of a 16-year-old adolescent girl who presented with severe manifestations of primary hyperparathyroidism. Biochemically, she had severe parathyroid hormone (PTH)-dependent hypercalcaemia with hypophosphataemia and vitamin D deficiency (serum total Ca - 18.5 mg/dl [8.5-10.5 mg/dl], serum PO4 - 1.9 mg/dl [2.5-4.5 mg/dl], serum ALP - 2015 IU/l [80-240 IU/l], serum 25[OH]D - 19.1 ng/ml [30-100 ng/ml] and serum iPTH > 5000 pg/ml [15-65 pg/ml]). Pre-operatively, she required management with saline diuresis, bisphosphonate, and calcitonin. After surgery, the patient had severe hungry bone syndrome (serum Ca - 4.1 mg/dl, serum PO4 - 2.1 mg/dl, serum ALP > 10,000 IU/l) that required treatment with calcium infusions for almost 3 months. Although the clinical and biochemical picture was suggestive of parathyroid carcinoma, histopathology revealed atypical parathyroid adenoma with low proliferative index. Atypical parathyroid adenoma is a term applied to a neoplasm with 'worrisome' features but not fulfilling the 'absolute histopathological criteria of malignancy'.</p><p><strong>Conclusions: </strong>Atypical parathyroid adenoma, a rare cause of PHPT, may be associated with severe manifestations. Although malignancy was not discerned in the immediate post-operative period, we plan to continue long-term follow-up of the patient to look for any signs of recurrence or development of parathyroid carcinoma.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"91-100"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/32/PEDM-28-45150.PMC10226359.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial hypercholesterolemia - treatment update in children, systematic review.","authors":"Sabina Ziółkowska, Noëlle Kijek, Iga Zendran, Ewa Szuster, Ewa Barg","doi":"10.5114/pedm.2022.116112","DOIUrl":"10.5114/pedm.2022.116112","url":null,"abstract":"<p><p>Familial hypercholesterolaemia is one of the most common genetic diseases, and its first symptoms occur in childhood. Proper diagnosis and treatment prevent young patients from severe consequences in their future. The treatment of this dyslipidaemia is still evolving, and new promising agents are being discovered. In this review we summarize the old and new treatment methods of familial hypercholesterolaemia, giving an update estimated on the latest publications.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 2","pages":"152-161"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/2a/PEDM-28-46997.PMC10214937.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10117336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary thyroid microcarcinoma in a boy with Graves' disease: a case report and review of the literature.","authors":"Gerdi Tuli,&nbsp;Jessica Munarin,&nbsp;Daniele Tessaris,&nbsp;Francesco Quaglino,&nbsp;Luisa de Sanctis","doi":"10.5114/pedm.2021.107725","DOIUrl":"https://doi.org/10.5114/pedm.2021.107725","url":null,"abstract":"<p><p>A 16-years old boy with diagnosis of Grave's disease was treated with methimazole for one year before radical total thyroidectomy treatment due to persistence of clinical hormonal hyperthyroidism. Histological analysis revealed the presence of a papillary microcarcinoma. The management of Grave's disease in pediatric age is still under discussion. Therefore, close monitoring of the disease is required, as well as case-by-case tailored decision on how to manage treatment and when to perform the radical one, taking into account the association of Grave's disease with differentiated thyroid cancer in adults and the higher malignancy of thyroid cancer in childhood.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"88-90"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/fa/PEDM-28-44680.PMC10226340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, immunological, and genetic investigations in a rare association of type 1 diabetes with xeroderma pigmentosum.","authors":"Ach Taieb,&nbsp;Imen Nacef,&nbsp;Nadia Ghariani,&nbsp;Nadia Nabli,&nbsp;Yosra Hasni,&nbsp;Maha Kacem,&nbsp;Molka Chaieb,&nbsp;Amel Maaroufi,&nbsp;Mohamed Denguezli,&nbsp;Koussay Ach","doi":"10.5114/pedm.2022.118318","DOIUrl":"https://doi.org/10.5114/pedm.2022.118318","url":null,"abstract":"<p><p>Xeroderma pigmentosum (XP) is a rare genodermatosis predisposing to skin cancers. Autoimmune diseases related to XP are rarely discussed in the literature. Type 1 diabetes (T1D) has been associated with other genodermatoses like Cockayne syndrome, but it has never been described in XP. In the present study, we report the rare occurrence of T1D in XP patients. Five XP patients belonging to 4 consanguineous families originating from different regions of Tunisia were investigated. Their ages ranged between 8 and 18 years. All the patients had a severe hypovitaminosis D. All the patients had positive GAD antibody levels, and 4 of them had familial history of other autoimmune diseases. The spectrum of XP was variable in all the patients, with dermatological and neurological symptoms, and the occurrence of some cancers. Various hypotheses have been proposed to explain this association, among of which we cite the role of immunomodulation and down-regulation of ATP-dependent DNA excision repair protein genes, implying that impaired DNA repair may contribute to the development of some autoimmune diseases. Vitamin D3 deficiency secondary to sun protective measures was found in all patients and thus may play a role in increasing T1D risk in these patients.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 3","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/45/PEDM-28-47552.PMC10214951.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenocortical adenoma manifesting as Cushing's syndrome and pseudo-precocious puberty in a toddler.","authors":"Hiya Boro,&nbsp;Suraj Kubihal,&nbsp;Rimlee Dutta,&nbsp;Vijay Kubihal,&nbsp;Sarah Alam,&nbsp;Nikhil Tandon","doi":"10.5114/pedm.2021.109122","DOIUrl":"https://doi.org/10.5114/pedm.2021.109122","url":null,"abstract":"<p><p>Cushing's syndrome is a rare disease in the paediatric age group. Adrenocortical carcinomas (ACC) constitute the most common cause of Cushing's syndrome between 1 and 5 years of age. Often, adrenocortical carcinomas co-secrete other hormones such as androgens (testosterone), deoxy-corticosterone (DOCA), or 17-hydroxy-progesterone [17(OH)P] in addition to cortisol. This may manifest with symptoms and signs of precocious puberty along with Cushing's syndrome. It is rare for a benign adrenocortical adenoma to co-secrete androgens and other hormones in addition to cortisol. Differentiation between adenoma and carcinoma is difficult in all aspects: clinical, radiological, and histopathological. Here, we describe the case of a 2.5-year-old male child who presented with Cushing's syndrome and virilization. Although we suspected ACC clinically, the radiological and histopathological findings were suggestive of benign adrenocortical adenoma. Our case represents the diagnostic challenge that exists in paediatric adrenocortical tumours.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/64/PEDM-28-45145.PMC10226367.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9946759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe malnutrition as a cause of transient carbohydrate metabolism disorders which evolved into hyperosmolar hyperglycaemic state.","authors":"Magdalena Sokołowska-Gadoux,&nbsp;Agnieszka Pietrusik,&nbsp;Agata Chobot,&nbsp;Przemysława Jarosz-Chobot","doi":"10.5114/pedm.2022.114668","DOIUrl":"https://doi.org/10.5114/pedm.2022.114668","url":null,"abstract":"<p><p>The hyperosmolar hyperglycaemic state (HHS) is a very severe condition characterised by hyperosmolality, hyperglycaemia and dehydration without significant ketosis. The article presents the case of a 14.5-year-old cachectic patient with diagnosed HHS. Appropriate treatment per the ISPAD Guidelines was implemented. After metabolic stabilisation was achieved, the patient was transferred for further treatment to the Pediatric Gastroenterology Department due to her life-threatening cachexia. Normal glucose levels were observed during hospitalisation and the patient required no further insulin supplementation. Unfortunately, two months after discharge from hospital, the patient suffered sudden death at home. The patient did not live until full diabetological diagnostics could be performed. The transient hyperglycaemia may have been caused by a very early stage of type 1 diabetes (pre-diabetes), malnutrition-related diabetes mellitus (MRDM) or stress-induced hyperglycaemia (SIH). The case demonstrates that HHS can develop not only secondary to diabetes, but also be a severe complication of transient carbohydrate metabolism disorders in the course of cachexia.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 2","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/dc/PEDM-28-46647.PMC10214934.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of hyperglycaemic disorders in children and adolescents with obesity.","authors":"Aneta Chylińska-Frątczak,&nbsp;Arkadiusz Michalak,&nbsp;Anna Baranowska-Jaźwiecka,&nbsp;Beata Mianowska,&nbsp;Agnieszka Szadkowska","doi":"10.5114/pedm.2022.121369","DOIUrl":"https://doi.org/10.5114/pedm.2022.121369","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of obesity in the paediatric population has increased significantly in recent decades. To date, the rarest metabolic disturbance associated with obesity has been the hyperglycaemia, including diabetes. The aim of the study was to compare the prevalence of hyperglycaemic disorders diagnosed on the basis of (1) the oral glucose tolerance test (OGTT) and (2) the HbA1c value, and to estimate the prevalence of hyperglycaemia in continuous glucose monitoring (CGM) records in adolescents with obesity.</p><p><strong>Material and methods: </strong>The study included patients aged 9-18 years with obesity (BMI ≥ 95th percentile). The height, body weight, and waist circumference were measured, and the BMI and BMI Z-score were calculated. Sexual maturity was assessed on the Tanner scale. OGTT was performed, and the HbA1c value was measured. Six-day retrospective blinded CGM was performed.</p><p><strong>Results: </strong>In the group of 143 children (mean age 13.4 years), the severity of obesity positively increased with patients age (r = 0.36 and p < 0.0001). Abdominal obesity was found in 93.4% of children. Based on OGTT, 18.8% of the subjects had hyperglycaemic disorders; impaired glucose tolerance was the most common one (16.1%). Impaired fasting glucose was found in 4 patients (2.8%), and type 2 diabetes was found in 2. The mean HbA1c was 5.4%. HbA1c values ranged from 5.7 to 6.4% in 20.3% of the patients, and it did not exceed 6.4% in any patient. In 27.6% of patients with HbA1c 5.7-6.4%, abnormalities in OGTT were observed (IGT 17.25%, IFG 6.9%, DM2 3.45%). There was a significant discrepancy between OGTT results and HbA1c in the diagnosis of hyperglycaemic disorders (diagnosis agreement - 69.92%). In CGM 1.4% of results were above 140 mg/dl.</p><p><strong>Conclusions: </strong>Hyperglycaemic disorders are diagnosed in nearly 20% of children with obesity. However, there are significant discrepancies in the diagnosis of glucose disturbances using OGTT and HbA1c. Concordance in the diagnosis of hyperglycaemic disorders was achieved only in 70% of patients. CGM may be useful in the diagnosis of pre-diabetes in people with obesity.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"274-280"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/ac/PEDM-28-48231.PMC10214972.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between food consumption and high levels of low density lipoprotein cholesterol among obese children.","authors":"Marcela Pandolfi,&nbsp;Jane de Eston Armond,&nbsp;Carolina Nunes França,&nbsp;Fabiana Salatino Fangueiro,&nbsp;Luiz da Silva Nali,&nbsp;Ana Ribeiro,&nbsp;Patricia Colombo-Souza","doi":"10.5114/pedm.2022.112864","DOIUrl":"https://doi.org/10.5114/pedm.2022.112864","url":null,"abstract":"<p><strong>Introduction: </strong>The increase in the prevalence of obesity and obesity in children is a pattern of the last decades. This public health issue results in metabolic disorders such as dyslipidemia with increased LDL-C. Previous findings shows that most of the Brazilian children does not follow the recommended consumption of fruits and vegetables.</p><p><strong>Aim of the study: </strong>To evaluate the association of dietary intake characteristics with elevated serum cholesterol from low density lipoprotein in obese children.</p><p><strong>Material and methods: </strong>Cross-sectional study involving 137 obese children (5-10 years). The mean age of the studied children was 8.27 years, 55.5% were male The weight measurements were performed on a digital anthropometric scale. The body mass index was calculated for each child and the Food Frequency Questionnaire was applied. The peripheral blood was collected for lipid profile analysis. Stata 12.0 statistical package was used to analyze the data, considering a significance level of p < 0.05.</p><p><strong>Results: </strong>The prevalence of hypercholesterolemia based on the serum cholesterol from low density lipoprotein fraction was 14.6%. It was observed that children in the group who consumed the lower difference of risky and protective foods on a daily basis were not less likely to have a high cholesterol from low density lipoprotein level as a criterion for hypercholesterolemia (p = 0.218).</p><p><strong>Conclusions: </strong>A large proportion of the individuals presented levels of lipid profile classified as undesirable for age, as well as food rich in components capable of increasing this profile, which should encourage the intensification in measures of prevention of cardiovascular diseases since childhood.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/3e/PEDM-28-46242.PMC10226342.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of adrenal function in pediatric cancer survivors.","authors":"Barbara Hull,&nbsp;Anna Wędrychowicz,&nbsp;Magdalena Ossowska,&nbsp;Aleksandra Furtak,&nbsp;Szymon Skoczeń,&nbsp;Jerzy B Starzyk","doi":"10.5114/pedm.2022.118324","DOIUrl":"https://doi.org/10.5114/pedm.2022.118324","url":null,"abstract":"<p><strong>Introduction: </strong>Oncological therapy can temporarily or permanently disrupt adrenal gland function. The aim of our study was to assess the function of adrenal glands in cancer survivors and to find the best diagnostic tools for it.</p><p><strong>Material and methods: </strong>Sixty patients aged 1.2-14.9 years (mean 8.3 ±3.5) with diagnosed malignancies and 45 healthy children as controls were recruited to the study. Patients were assessed 0-8 years (mean 2.4 ±2.0 years) after the oncological therapy. In all patients fasting blood samples were collected to measure: glucose, sodium, potassium, cortisol, aldosterone, plasma renin activity (PRA), dehydroepiandrostenedione-sulphate (DHEA-S), adrenocorticotropic hormone (ACTH) and antibodies against the adrenal cortex (AAA). Moreover, 24-hour urinary free cortisol (UFC) was assessed. Test with synthetic ACTH was carried out with 250 µg in neuroblastoma and nephroblastoma patients and with 1 µg in other oncological patients.</p><p><strong>Results: </strong>The levels of morning cortisol and sodium were significantly lower and blood glucose were higher in cancer survivors than in controls (p = 0.006, p = 0.043, p = 0.008). Basal laboratory tests confirmed adrenal insufficiency (AI) in 1 patient with neuroblastoma. Low-dose ACTH revealed AI in 3 patients with acute lymphoblastic leukemia. In the study group, UFC correlated with evening and midnight cortisol (p = 0.001, p = 0.006). In the control group UFC correlated with DHEA-S (r = 0.623, p = 0.0001). None of assessed parameters correlated with the time since the completion of oncological therapy.</p><p><strong>Conclusions: </strong>The study confirmed possibility of developing asymptomatic AI in cancer survivors even several years after therapy. Instead of morning cortisol, classical diagnostic low-dose ACTH test seems to be an optimal tool for adrenal function's assessment.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"250-256"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/7d/PEDM-28-47558.PMC10214973.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycaemic control and factors affecting it in type 1 diabetes in children: experience from a tertiary care centre in India.","authors":"Devi Dayal,&nbsp;Jaivinder Yadav,&nbsp;Rakesh Kumar,&nbsp;Saniya Gupta,&nbsp;Arti Yadav,&nbsp;Pamali Nanda","doi":"10.5114/pedm.2022.118326","DOIUrl":"https://doi.org/10.5114/pedm.2022.118326","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal glycaemic control is essential for the prevention of future micro- and macrovascular complications in type 1 diabetes (T1D). The type of insulin, the type of insulin delivery device, the caregiver's knowledge, the patient's age, duration of diabetes, and self-monitoring of blood glucose affect glycaemic control in type 1 diabetes. In the present study, we analysed glycaemic control and factors affecting it at a tertiary care centre in northern India.</p><p><strong>Material and methods: </strong>A retrospective review of records of patients registered between 2015 and 2018 was done. The data on demographic and disease-related factors were collected from the records. The different groups were compared with the t-test, one-way ANOVA, or Kruskal-Wallis test.</p><p><strong>Results: </strong>The mean age at the time of evaluation was 10.43 ±4.04 years (2-21 years), and the mean disease duration was 46.61 ±28.49 months (16-141 months). Most of the patients were prepubertal and using a basal-bolus regimen. The mean glycated haemoglobin (HbA1c ) was 7.96 ±1.46%, but only 24% had HbA1c below the International Society of Paediatric and Adolescent Diabetes (ISPAD) recommended desirable level of below 7%. Forty-six patients suffered one or more micro-macrovascular complications, and dyslipidaemia was the most common complication. Children with a longer duration of disease (8.39 ±1.42% vs. 7.59 ±1.65%), an episode of DKA (diabetes ketoacidosis) within a year of evaluation (9.19 ±2.54% vs. 7.93 ±1.39%), lower maternal (8.22 ±1.37% vs. 7.56 ±1.45%) and paternal education (8.26 ±1.67% vs. 7.78 ±1.30%), and hyperthyroid state (9.43 ±2.28% vs. 7.91 ±1.45%) had higher HbA1c.</p><p><strong>Conclusions: </strong>Better diabetes education focusing on parents with lower education strata and children with longer disease duration and poor compliance can help improve glycaemic control in developing countries like India.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"281-286"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/2f/PEDM-28-47560.PMC10214966.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}