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Wright SR, Graham CD, Houghton R, Ghiglieri C, Berry E. Acceptance and commitment therapy (ACT) for caregivers of children with chronic conditions: A mixed methods systematic review (MMSR) of efficacy, process, and acceptance. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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McCutcheon E, Richardson C, Adi S, Zuijdwijk C. Successful Management of Type 1 Diabetes in a Young Child With Insulin Pump Therapy and Diluted Insulin. Can J Diabetes 2021; 45:496-499. [PMID: 34176614 DOI: 10.1016/j.jcjd.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/24/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Emma McCutcheon
- Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Christine Richardson
- Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Saleh Adi
- Division of Endocrinology, Department of Pediatrics, The Madison Clinic for Pediatric Diabetes, University of California, San Francisco, California, United States
| | - Caroline Zuijdwijk
- Division of Endocrinology and Metabolism, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
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Zhu J, Volkening LK, Laffel LM. Distinct Patterns of Daily Glucose Variability by Pubertal Status in Youth With Type 1 Diabetes. Diabetes Care 2020; 43:22-28. [PMID: 31308020 PMCID: PMC6925575 DOI: 10.2337/dc19-0083] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate glycemia and metrics of glucose variability in youth with type 1 diabetes, and to assess patterns of 24-h glucose variability according to pubertal status. RESEARCH DESIGN AND METHODS Metrics of glycemia, glucose variability, and glucose patterns were assessed by using 4 weeks of continuous glucose monitoring (CGM) data from 107 youth aged 8-17 years with type 1 diabetes for ≥1 year. Glucose values per hour were expressed as percentages relative to the mean glucose over 24 h for a 4-week period. Glucose data were compared on the basis of pubertal status-prepubertal (Tanner stage [T] 1), pubertal (T2-4), and postpubertal (T5)-and A1C categories (<7.5% [<58 mmol/mol], ≥7.5% [≥58 mmol/mol]). RESULTS Youth (50% female, 95% white) had a mean ± SD age of 13.1 ± 2.6 years, diabetes duration of 6.3 ± 3.5 years, and A1C of 7.8 ± 0.8% (62 ± 9 mmol/mol); 88% were pump treated. Prepubertal youth had a higher mean glucose SD (86 ± 12 mg/dL [4.8 ± 0.7 mmol/L]; P = 0.01) and coefficient of variation (CV) (43 ± 5%; P = 0.06) than did pubertal (SD 79 ± 13 mg/dL [4.4 ± 0.7 mmol/L]; CV 41 ± 5%) and postpubertal (SD 77 ± 14 mg/dL [4.3 ± 0.8 mmol/L]; CV 40 ± 5%) youth. Over 24 h, prepubertal youth had the largest excursions from mean glucose and the highest CV across most hours compared with pubertal and postpubertal youth. Across all youth, CV was strongly correlated with the percentage of time with glucose <70 mg/dL (<3.9 mmol/L) (r = 0.79; P < 0.0001). CONCLUSIONS Prepubertal youth had greater glucose variability independent of A1C than did pubertal and postpubertal youth. A1C alone does not capture the full range of glycemic parameters, highlighting the added insight of CGM in managing youth with type 1 diabetes.
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Affiliation(s)
- Jia Zhu
- Pediatric, Adolescent, and Young Adult Section, Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, MA.,Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Lisa K Volkening
- Pediatric, Adolescent, and Young Adult Section, Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, MA
| | - Lori M Laffel
- Pediatric, Adolescent, and Young Adult Section, Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, MA .,Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, MA
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Miller D, Mamilly L, Fourtner S, Rosen-Carole C. ABM Clinical Protocol #27: Breastfeeding an Infant or Young Child with Insulin-Dependent Diabetes. Breastfeed Med 2017; 12:72-76. [PMID: 28135112 DOI: 10.1089/bfm.2017.29035.djm] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
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Affiliation(s)
- Diana Miller
- 1 Pediatric Endocrinology, University at Buffalo , Buffalo, New York.,2 Division of General Pediatrics, Maternal Fetal Medicine and General Pediatrics, University of Rochester , Rochester, New York
| | - Leena Mamilly
- 1 Pediatric Endocrinology, University at Buffalo , Buffalo, New York
| | - Shannon Fourtner
- 1 Pediatric Endocrinology, University at Buffalo , Buffalo, New York
| | - Casey Rosen-Carole
- 3 Division of Neonatology, Maternal Fetal Medicine and General Pediatrics, University of Rochester , Rochester, New York
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Williams KM, Fazzio P, Oberfield SE, Gallagher MP, Aranoff GS. Cortisol Levels in Children With Diabetic Ketoacidosis Associated With New-Onset Type 1 Diabetes Mellitus. Clin Pediatr (Phila) 2017; 56:117-122. [PMID: 28145127 PMCID: PMC5310834 DOI: 10.1177/0009922816684595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is little data documenting cortisol levels in children with diabetic ketoacidosis (DKA), despite the fact that untreated adrenal insufficiency (AI) could worsen the outcome of DKA. In this cross-sectional study, we assessed serum cortisol levels in 28 children with DKA and new onset type 1 diabetes mellitus evaluated at our center over a 5-year period. Average duration of diabetes-related symptoms was positively associated with age ( P = .002), and significantly lower hemoglobin A1c levels were observed in the youngest children. The mean cortisol level was 40.9 µg/dL, with a range of 7.8 to 119 µg/dL. Cortisol levels were found to be inversely associated with serum pH ( P = .007). There was no difference in the clinical outcome of the 4 patients who had cortisol levels less than 18 µg/dL. Overall, we did not find clinical or laboratory evidence of diminished cortisol reserve; however, the possibility of AI must be kept in mind when treating children with DKA.
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Affiliation(s)
| | - Pamela Fazzio
- Columbia University Medical Center, New York, NY, USA,Children’s Hospital of Philadelphia, Philadelphia, PA
| | | | - Mary P. Gallagher
- Columbia University Medical Center, New York, NY, USA,New York University School of Medicine, New York, New York
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Park JH, Shin SY, Shim YJ, Choi JH, Kim HS. Multiple daily injection of insulin regimen for a 10-month-old infant with type 1 diabetes mellitus and diabetic ketoacidosis. Ann Pediatr Endocrinol Metab 2016; 21:96-8. [PMID: 27462587 PMCID: PMC4960022 DOI: 10.6065/apem.2016.21.2.96] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 01/28/2016] [Accepted: 02/05/2016] [Indexed: 11/29/2022] Open
Abstract
The incidence of type 1 diabetes is increasing worldwide, and the greatest increase has been observed in very young children under 4 years of age. A case of infantile diabetic ketoacidosis in a 10-month-old male infant was encountered by these authors. The infant's fasting glucose level was 490 mg/dL, his PH was 7.13, his pCO2 was 15 mmHg, and his bicarbonate level was 5.0 mmol/L. The glycosylated hemoglobin level had increased to 9.4%. Ketonuria and glucosuria were detected in the urinalysis. The fasting C-peptide and insulin levels had decreased. The infant was positive for anti-insulin and antiglutamic acid decarboxylase antibodies. Immediately after the infant's admission, fluid therapy and intravenous insulin infusion therapy were started. On the second day of the infant's hospitalization and after fluid therapy, he recovered from his lethargic condition, and his general condition improved. Feeding was started on the third day, and he was fed a formula 5 to 7 times a day and ate rice, vegetables, and lean meat. Due to the frequent feeding, the frequency of rapid-acting insulin injection was increased from 3 times before feeding to 5 times, adjusted according to the feeding frequency. The total dose of insulin that was injected was 0.8-1.1 IU/kg/day, and the infant was discharged on the 12th day of his hospitalization. The case is presented herein with a brief review of the relevant literature.
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Affiliation(s)
- Ji Hyun Park
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - So Young Shin
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Ye Jee Shim
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Hyeok Choi
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Heung Sik Kim
- Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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Petit-Bibal C, Rothenbuhler A, Lucchini P, Aboumrad B, Castell AL, Le Fur S, Bougnères P. Decrease in clinical hypoglycemia in young children with type 1 diabetes treated with free-mixed aspart and detemir insulin: an open labeled randomized trial. Pediatr Diabetes 2015; 16:345-53. [PMID: 24888575 DOI: 10.1111/pedi.12156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/28/2014] [Accepted: 04/24/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To compare the effectiveness of a free-mix of aspart (A) and detemir (D) insulins (ADIM) with a commonly used premixed fixed-ratio aspart and neutral protamine Hagedorn (NPH) insulin mixture (ANIM) in young children with type 1 diabetes (T1D) treated with twice-daily injections. The trial thus compares not only D vs. NPH, but also flexible, personalized insulin preparations vs. a fixed premixed preparation. RESEARCH DESIGN AND METHODS This single-center, open-label, randomized trial included 82 children with T1D. Patients stayed on ANIM for 1 yr of optimization of disease management, then were randomized to either ANIM (N = 41) or ADIM (N = 41) for another year. OUTCOMES Frequency of severe or symptomatic episodes, glycated hemoglobin A1c (HbA1c), and blood glucose (BG) values. RESULTS Compared with ANIM, ADIM decreases symptomatic hypoglycemia by approximately 2 fold (p < 0.001) and severe hypoglycemia by 7-10 fold (p = 0.04). ADIM somewhat reduced BG variation. Mean HbA1c was comparable on ADIM (7.9 ± 0.8 %; 63 ± 9 mmol/mol) and ANIM (8.2 ± 0.7 %; 66 ± 8 mmol/mol). CONCLUSIONS Using a free-mixing preparation of aspart and detemir insulin decreases hypoglycemia in young children with type 1 diabetes.
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Affiliation(s)
- C Petit-Bibal
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - A Rothenbuhler
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - P Lucchini
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - B Aboumrad
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - A L Castell
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - S Le Fur
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
| | - P Bougnères
- AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France
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Monaghan M, Younge TB, McCarter R, Cogen FR, Streisand R. Average Daily Risk Range (ADRR) in Young Children With Type 1 Diabetes. J Diabetes Sci Technol 2014; 8:70-73. [PMID: 24876540 PMCID: PMC4454111 DOI: 10.1177/1932296813511734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective was to examine the utility of the average daily risk range (ADRR) in young children with type 1 diabetes. METHODS Self-monitored blood glucose (BG) data and A1c values were collected from 134 children (ages 2-6). Other measures of BG variability and diabetes care were calculated using self-monitored BG data. ADRR, A1c, and other glycemic indices were compared to assess their distinctiveness and utility as measures of BG variability and glycemic control. RESULTS Of young children's ADRR values, 72% were in the "high-risk" range using adult guidelines. ADRR and A1c were highly correlated with indicators of hyperglycemia but only weakly correlated with measures of hypoglycemia. ADRR was moderately correlated with minimum BG value in the past 30 days but not percentage of BG values below 70 mg/dL. A1c was not correlated with either measure of hypoglycemia. CONCLUSIONS ADRR values confirm the high degree of BG variability present in young children with type 1 diabetes, particularly as compared with adults. New ADRR risk guidelines are needed for pediatric patients. ADRR and A1c are adequate indicators of hyperglycemia in young children. However, both ADRR and A1c failed to effectively capture hypoglycemia risk in this sample, and neither ADRR nor A1c can take the place of review of raw BG data to evaluate BG variability in young children.
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Affiliation(s)
- Maureen Monaghan
- Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
| | | | - Robert McCarter
- Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
| | - Fran R Cogen
- Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
| | - Randi Streisand
- Children's National Medical Center, Washington, DC, USA George Washington University School of Medicine, Washington, DC, USA
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Elding Larsson H, Vehik K, Bell R, Dabelea D, Dolan L, Pihoker C, Knip M, Veijola R, Lindblad B, Samuelsson U, Holl R, Haller MJ. Reduced prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes in young children participating in longitudinal follow-up. Diabetes Care 2011; 34:2347-52. [PMID: 21972409 PMCID: PMC3198296 DOI: 10.2337/dc11-1026] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 08/17/2011] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Young children have an unacceptably high prevalence of diabetic ketoacidosis (DKA) at the clinical diagnosis of type 1 diabetes. The aim of this study was to determine whether knowledge of genetic risk and close follow-up for development of islet autoantibodies through participation in The Environmental Determinants of Diabetes in the Young (TEDDY) study results in lower prevalence of DKA at diabetes onset in children aged <2 and <5 years compared with population-based incidence studies and registries. RESEARCH DESIGN AND METHODS Symptoms and laboratory data collected on TEDDY participants diagnosed with type 1 diabetes between 2004 and 2010 were compared with data collected during the similar periods from studies and registries in all TEDDY-participating countries (U.S., SEARCH for Diabetes in Youth Study; Sweden, Swediabkids; Finland, Finnish Pediatric Diabetes Register; and Germany, Diabetes Patienten Verlaufsdokumenation [DPV] Register). RESULTS A total of 40 children younger than age 2 years and 79 children younger than age 5 years were diagnosed with type 1 diabetes in TEDDY as of December 2010. In children <2 years of age at onset, DKA prevalence in TEDDY participants was significantly lower than in all comparative registries (German DPV Register, P < 0.0001; Swediabkids, P = 0.02; SEARCH, P < 0.0001; Finnish Register, P < 0.0001). The prevalence of DKA in TEDDY children diagnosed at <5 years of age (13.1%) was significantly lower compared with SEARCH (36.4%) (P < 0.0001) and the German DPV Register (32.2%) (P < 0.0001) but not compared with Swediabkids or the Finnish Register. CONCLUSIONS Participation in the TEDDY study is associated with reduced risk of DKA at diagnosis of type 1 diabetes in young children.
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Affiliation(s)
- Helena Elding Larsson
- Department of Pediatrics, Skåne University Hospital, Lund University, Malmö, Sweden,
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