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Three Australian children are diagnosed daily and at least one in three are diagnosed late, presenting with life-threatening diabetic ketoacidosis (DKA) requiring emergency medical care. DKA is traumatic and results [...]

Cytokines are upregulated in prediabetes, but their relationship with Enterovirus (EV) infection and development of islet autoimmunity is unknown. Cytokines (n = 65) were measured using Luminex xMAP technology in a nested case-control study of 67 children with a first-degree relative with type 1 diabetes: 27 with islet autoantibodies ([Ab.sup.+]) and 40 age-matched persistently autoantibody negative ([Ab.sup.-]) control subjects. Of 74 samples, 37 (50%) were [EV-PCR.sup.+] in plasma and/or stool ([EV.sup.+]) and the remainder were negative for EV and other viruses (EV). Fifteen cytokines, chemokines, and growth factors were elevated (P [less than or equal to] 0.01) in [Ab.sup.+] versus [Ab.sup.-] children (interleukin [IL]-1β, IL-5, IL-7, IL-12(p70), IL-16, IL-17, IL-20, IL-21, IL-28A, tumor necrosis factor-α, chemokine C-C motif ligand [CCL] 13, CCL26, chemokine C-X-C motif ligand 5, granulocyte-macrophage colony-stimulating factor, and thrombopoietin); most have proinflammatory effects. In [EV.sup.+] versus [EV.sup.-] children, IL-10 was higher (P = 0.005), while IL-21 was lower (P = 0.008). Cytokine levels did not differ between [Ab.sup.+][EV.sup.+] and [Ab.sup.+[EV.sup.-] children. Heat maps demonstrated clustering of some proinflammatory cytokines in [Ab.sup.+] children, suggesting they are coordinately regulated. In conclusion, children with islet autoimmunity demonstrate higher levels of multiple cytokines, consistent with an active inflammatory process in the prediabetic state, which is unrelated to coincident EV infection. Apart from differences in IL-10 and IL-21, EV infection was not associated with a specific cytokine profile., Type 1 diabetes is characterized by selective pancreatic β-cell destruction, accompanied by an inflammatory response within the islets (insulitis), which has a patchy distribution (1). Cytokines and chemokines play an [...]

OBJECTIVE--To examine the relationship between retinal vascular geometry parameters and development of incident renal dysfunction in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS--This was a prospective cohort [...]

OBJECTIVE--To examine trends in microvascular complications in adolescents with type 1 diabetes between 1990 and 2009 in Sydney, Australia. RESEARCH DESIGN AND METHODS--We used analysis of complications in 1,604 adolescents [...]

OBJECTIVE--To examine the association between retinal vascular geometry and subsequent development of incident retinopathy in young patients with type 1 diabetes. RESEARCH DESIGN AND METHODS--A prospective cohort study of 736 [...]

OBJECTIVE--In type 1 diabetes, plantar fascia, a collagen-rich tissue, is susceptible to glycation and oxidation. Paraoxonase-1 (PON1) is an HDL-bound antioxidant enzyme. PON1 polymorphisms have been associated with susceptibility to [...]

OBJECTIVE--Direct measurement of collagen glycation requires skin biopsy, which is invasive. We hypothesized that measurement of plantar fascia thickness (PFT) by ultrasound is an alternative index of tissue glycation and [...]

OBJECTIVE--Cardiac autonomic nerve tests have predicted increased mortality in adults with diabetes, predominantly due to nephropathy, cardiac disease, and hypoglycemia. The significance of subclinical autonomic nerve test abnormalities has not [...]

OBJECTIVE--To describe the natural history and risk factors for persistent microalbuminuria in children and adolescents with type 1 diabetes followed for up to 15 years. RESEARCH DESIGN AND METHODS--This study [...]

OBJECTIVE--This 7-year longitudinal study examines the potential impact of aldose reductase gene (AKR1B1) polymorphisms on the decline of nerve function in an adolescent diabetic cohort. RESEARCH DESIGN AND METHODS--Patients with [...]

OBJECTIVE--To compare the prevalence of diabetes complications and their risk factors in youth with type 1 versus type 2 diabetes. RESEARCH DESIGN AND METHODS--We performed a comparative clinic-based study of [...]

OBJECTIVE--The purpose of this study was to explore whether the presence of thyroid and endomysial autoantibodies at diagnosis of type 1 diabetes in children predicts development of thyroid and celiac [...]

OBJECTIVE--Since the Diabetes Control and Complications Trial, diabetes management goals have changed. The aims of the present study were to assess complication rates, including nerve abnormalities, in adolescents from 1990 [...]

OBJECTIVE--This study was designed to explore the timeline of protection against complications in prepubertal children with diabetes, in particular the effects of diabetes duration before age 5 years. RESEARCH DESIGN [...]

OBJECTIVE--To examine the hypothesis that vitamin D deficiency (VDD) is associated with an increased prevalence of microvascular complications in young people with type 1 diabetes. RESEARCH DESIGN AND METHODS--In a [...]

Increased adiposity, as measured by BMI, has been described in younger children at diagnosis of type 1 diabetes compared with older children (1-3) in support of the 'accelerator hypothesis' (1). [...]

The incidence of type 2 diabetes mellitus (T2DM) studies among indigenous and non-indigenous Australian young people less than 19 years conducted in 2001-2006 accounted for 11% of incident cases of diabetes due to overweight.

Vitamin D deficiency and nutritional rickets are re-emerging as major pediatric health issues in Australia and New Zealand, with complications including hypocalcaemic seizures, rickets, limb pain and fracture. A review of the vitamin D metabolism includes the risk factors for, and features of, vitamin D deficiency in infants, children and adolescents as well as recommendations for treatment and subsequent prophylaxis.

The incidence of childhood type 1 diabetes mellitus (T1DM) in New South Wales (NSW) from 1997 to 2002 was determined to compare with previously published rates and analyze trends in incidence from 1990 to 2002. Results reveal that the incidence of childhood-onset T1DM has increased significantly in all age groups in NSW since 1990.

A study was conducted to evaluate the benefits and adverse effects of a Diabetes Day Care Program (DDCP), and to compare the outcomes in two cohorts, which were diagnosed before and after implementing the DDCP. It is found that ambulatory programs that outpatient stabilisation of children and adolescents newly diagnosed with type 1 diabetes are safe, efficacious and cost-effective.

Type 1 diabetes, the most common chronic childhood disease, is discussed. The predictors of glycaemic control in children and adolescents is researched and reported on this paper.

Stefansson's letter (1) and previous publication (2) strengthens our recommendation to extend the retinal screening interval for some children and adolescents who access specialist diabetes services to 2 years (3). [...]

In response to the letter from Amin (1), we provide further details on the risk factors for progression and regression of retinopathy in our natural history study (2). Of 136 [...]

The reasons behind the observed increase in the incidence of type 1 diabetes mellitus (T1DM) in Australia are determined and discussed. The analysis proves that the risk of diabetic ketoacidosis is highly increased by the delayed referral of the onset type 1 diabetes.