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The article previews the International Society for Pediatric and Adolescent Diabetes (ISPAD)-European Society for Paediatric Endocrinology (ESPE) electronic learning global web portal at www.espe-elearning.org.

An editorial is presented to the aticle Type 1 diabetes (T1DM) has completely overshadowed by adult type 2 diabetes mellitus (T2DM) in the Indian subcontinent because of the high prevalence of the latter. Topics include the incidence rates of both T1DM and T2DM in expatriate Indian children appeared to be following the worldwide increasing trend; and regarding children residing within India, one center has documented a significant shift toward younger age at onset of T1DM.

Objective In this cohort of severely obese children and adolescents in Sweden we investigate the prevalence of impaired fasting glucose ( IFG), impaired glucose tolerance, ( IGT) and silent type 2 diabetes ( T2D), in relation to insulin resistance, insulin secretion, disposition index and cardio respiratory fitness. Methods A total of 134 obese children and adolescents [57 females, 77 males, age 13.7 ± 2.7, body mass index ( BMI) standard deviation score ( SDS) 3.6 ± 0.6] consecutively referred to the National Childhood Obesity Centre performed an oral glucose tolerance test ( OGTT), frequently sampled intravenous glucose tolerance test (fs- IVGTT), dual X-ray absorptiometry ( DEXA), bicycle ergometer test and fasting levels of glucose, insulin and c-peptide were obtained and homeostatic model of insulin resistance (HOMA-IR) was calculated. Results Isolated impaired fasting glucose (i-IFG) were present in 35.8 and 6% had isolated IGT. Combined IGT and IFG were present in 14.2%. The subjects with combined IGT/ IFG had significantly lower acute insulin response (AIR) compared with subjects who had normal glucose metabolism or i- IFG (p < 0.05). Among the prepubertal children (n = 24), 25% (6/24) had i- IFG and 25% (6/24) had IGT/ IFG and it was predominantly males. Disposition index was the major determinant of 2-h glucose levels (β = −0.49, p = 0.0126). No silent diabetes was detected. Conclusion In this cohort of severely obese children and adolescents the prevalence of prediabetes was very high. IFG was two times higher in this cohort of severely obese children than in a recently published unselected cohort of obese children in Sweden. In spite of the high prevalence of prediabetes, no subjects with silent diabetes were found. [ABSTRACT FROM AUTHOR]

Aims Intravenous glucose tolerance testing ( IVGTT) is a common test of β-cell function in which a glucose load is administered and insulin and/or C-peptide responses are monitored. Since the first IVGTT may be more stressful and stress may alter β-cell secretion or hepatic insulin extraction, we asked whether there was a first test effect. Methods Insulin and C-peptide responses were compared from two sequential IVGTTs performed within 6 months during staging for the Diabetes Prevention Trial-Type 1 ( DPT-1) in 368 people at high risk for type 1 diabetes. Insulin data (1+3 min) were used because the first phase insulin response (and peak insulin concentration) occurs within this time frame. Areas under the curve ( AUC) calculations represent early insulin or C-peptide responses from 0 through 10 min post-glucose challenge. Results More than half of all subjects were found to have first test values lower than the second. This was true for all measures of both insulin and C-peptide but the frequency was significantly different only for insulin measures corrected for basal and for insulin AUC (p < 0.05). However, for subjects (n = 99) whose 1+3 min insulin response was <10th percentile on the first test, there was a significant increase on the second test (p < 0.05). The C-peptide: insulin ratio did not change significantly between tests, indicating that differences are due to changes in β-cell secretion rather than hepatic insulin uptake. Conclusions A statistically significant first test effect occurs during the IVGTT attributable to variations in insulin secretion rather than hepatic uptake. [ABSTRACT FROM AUTHOR]

Background Overweight and obesity in adolescents are associated with a subsequent increased mortality due to cardiovascular disease in adulthood. The reactive hyperemia-peripheral artery tonometry ( RH-PAT) is a non-invasive method for endothelial function assessment. Objective The goal of this study is to investigate endothelial function as assessed with the RH-PAT in adolescents with overweight or obesity. Methods In 27 adolescents with overweight or obesity (16 males, 11 females) and 25 control subjects (12 males, 13 females) (age 12-20 yr) RH-PAT score and baseline pulse amplitude were measured after an overnight fast. Confounding risk factors for endothelial dysfunction, including smoking and diabetes mellitus were excluded. Results RH-PAT score was lower in adolescents with overweight or obesity compared to healthy controls, whereas their baseline pulse amplitude was higher (p = 0.027 and p < 0.0001, respectively). A significantly positive correlation was seen between baseline pulse amplitude and body mass index standard deviation score in the group with overweight or obese subjects. Conclusions Endothelial dysfunction, measured by lower RH-PAT score and higher baseline pulse amplitude, was present in overweight adolescents. Interestingly, we also report for the first time in the literature a significant difference in baseline pulse amplitude between overweight adolescents compared to their peers. [ABSTRACT FROM AUTHOR]

Programming refers to events during critical developmental windows that shape progeny health outcomes. Fetal programming refers to the effects of intrauterine ( in utero) events. Lactational programming refers to the effects of events during suckling (weaning). Developmental programming refers to the effects of events during both fetal and lactational life. Postnatal programming refers to the effects of events either from birth (lactational life) to adolescence or from weaning (end of lactation) to adolescence. Islets are most plastic during the early life course; hence programming during fetal and lactational life is most potent. High fat (HF) programming is the maintenance on a HF diet (HFD) during critical developmental life stages that alters progeny metabolism and physiology. HF programming induces variable diabetogenic phenotypes dependent on the timing and duration of the dietary insult. Maternal obesity reinforces HF programming effects in progeny. HF programming, through acute hyperglycemia, initiates beta cell compensation. However, HF programming eventually leads to chronic hyperglycemia that triggers beta cell exhaustion, death and dysfunction. In HF programming, beta cell dysfunction often co-presents with insulin resistance. Balanced, healthy nutrition during developmental windows is critical for preserving beta cell structure and function. Thus early positive nutritional interventions that coincide with the development of beta cells may reduce the overwhelming burden of diabetes and metabolic disease. [ABSTRACT FROM AUTHOR]

Medication-induced diabetes ( MID) is seen in children treated for acute lymphoblastic leukemia ( ALL) mostly during induction, due to the use of l-asparaginase and glucocorticoids. Our objective was to assess whether MID during induction, is a risk factor for future impaired glucose tolerance ( IGT), diabetes, or metabolic syndrome. Ninety survivors of pediatric ALL, ages 10 yr and older were recruited, 30 with history of MID and 60 controls. Waist/height ratio >0.5 was considered as an increased risk for central adiposity and insulin resistance. Lipid profile and an oral glucose tolerance test ( OGTT) were performed. Study patients were older than controls (17.2 vs. 14.9, p < 0.05). The groups had similar sex distribution, body mass index ( BMI) z-score, and Tanner staging. A waist/height ratio of >0.5 was seen in 60 and 31.7% of the study and control groups, respectively (p = 0.01). Increased frequency of IGT in the study group compared with the control group was seen (13.3 and 1%, respectively) (p = 0.07). We observed a trend toward higher proportion of patients with multiple features of metabolic syndrome in the study compared with control group (16.7 vs. 5%, p = 0.09). In conclusion, MID during induction may be an early marker for metabolic disturbances later in life. The higher rates of increased waist/height ratio, and subjects with multiple metabolic syndrome features, may predict a metabolic risk in children with history of MID. Rates of IGT were four fold higher in the study group although not statistically significant. MID may be a 'red flag' indicating the need for ongoing metabolic screening and lifestyle modifications to prevent future metabolic disease. [ABSTRACT FROM AUTHOR]

Objectives To determine whether children with type 1 diabetes mellitus ( T1DM) have evidence of increased aortic stiffness or early atherosclerosis as measured by magnetic resonance imaging ( MRI). Background T1DM increases risk for cardiovascular disease in adults but whether this process starts in childhood is unknown. Subjects A total of 54 T1DM patients (15.4 ± 2.6 yr) and 30 age-matched controls (14.8 ± 2.7 yr) participated. Methods MRI was performed to assess aortic arch pulse wave velocity ( PWV), strain, and distensibility of the ascending and descending thoracic aorta and measures of atherosclerosis. Results Groups were well-matched for age, pulse pressure, and gender. Low-density lipoprotein-cholesterol ( LDL-C) was higher in T1DM (119.3 ± 50 vs. 76.1 ± 13.5 mg/dL, p < 0.0001). There was a trend toward decreased strain and distensibility in T1DM vs. controls in the ascending (distensibility: T1DM 62.2 ± 19.9 kPa−1 × 10−3, control 71.6 ± 26.4 kPa−1 × 10−3, p = 0.08) and descending aorta (strain: T1DM 25.8 ± 6.2% vs. control 28.3 ± 6.8%, p = 0.09). There was no difference in arch PWV. Advancing age and male gender was negatively associated with aortic stiffness. Hemoglobin A1c ( HbA1c) was inversely related to descending aorta strain and distensibility (p < 0.05). Children with diabetes in the lowest two tertiles of insulin sensitivity demonstrated thoracic descending aortas with significantly lower strain (p = 0.027) and distensibility (p = 0.039) and increased measures of wall irregularity (p = 0.005). There were no differences in measurements of atherosclerosis between the two groups. Conclusions Adolescents with T1DM, especially those with lower insulin sensitivity, demonstrated a trend toward stiffer, less compliant thoracic aortas, which was inversely associated with diabetes control. These data suggest large vessel aortopathy starts early in T1DM. [ABSTRACT FROM AUTHOR]

Background Obesity is associated with a mild chronic inflammatory response, which has been suggested to be pivotal in the development of cardiometabolic alterations of obesity. However, little is known about the involvement of acute inflammation. Objective To evaluate whether circulating neutrophils, markers of acute inflammation, are associated (quantitatively and qualitatively) with adolescent obesity and whether leptin modulates these associations. Subjects and methods We assessed 528 adolescents (16.8 yr old, 47% females), without chronic/acute illness. We measured anthropometry and dual energy X-ray absorptiometry and calculated fat mass percentage ( FM%). Fasting serum glucose, high-density lipoprotein ( HDL)-cholesterol, and triglycerides were used with blood pressure and waist circumference to compute a metabolic z-score. Leukocyte and neutrophil counts were obtained, together with levels of serum leptin. In a subsample of 23 males, flow cytometry was used to assess degranulation ( CD66b expression) of neutrophils. Results Female sex and obesity were positively related to mean neutrophil counts (p < 0.05). When accounting for sex and weight status, leptin was associated with neutrophil counts (p < 0.05), partially explaining the association between obesity and neutrophil counts. Neutrophil counts were related to metabolic risk z-scores, controlling for fat mass. Participants with elevated FM% showed more neutrophil degranulation than controls (p < 0.05). Conclusions Participants with increased adiposity had higher circulating neutrophil counts, suggesting acute inflammation. Furthermore, the neutrophils showed more degranulation, indicating inflammation. Obesity-induced alteration of the adipose secretory pattern (i.e., changes in leptin levels) could be involved in acute inflammation. [ABSTRACT FROM AUTHOR]

Type 1 diabetes ( T1D) is rarely a component of primary immune dysregulation disorders. We report two cases in which T1D was associated with thrombocytopenia. The first patient, a 13-year-old boy, presented with immune thrombocytopenia ( ITP), thyroiditis, and, 3 wk later, T1D. Because of severe thrombocytopenia resistant to immunoglobulins, high-dose steroids, and cyclosporine treatment, anti-cluster of differentiation ( CD20) therapy was introduced, with consequent normalization of thrombocytes and weaning off of steroids. Three and 5 months after anti- CD20 therapy, levothyroxin and insulin therapy, respectively, were stopped. Ten months after stopping insulin treatment, normal C-peptide and hemoglobin A1c ( HbA1c) levels and markedly reduced anti-glutamic acid decarboxylase ( GAD) antibodies were measured. A second anti- CD20 trial for relapse of ITP was initiated 2 yr after the first trial. Anti- GAD antibody levels decreased again, but HbA1c stayed elevated and glucose monitoring showed elevated postprandial glycemia, demanding insulin therapy. To our knowledge, this is the first case in which insulin treatment could be interrupted for 28 months after anti- CD20 treatment. In patient two, thrombocytopenia followed a diagnosis of T1D 6 yr previously. Treatment with anti- CD20 led to normalization of thrombocytes, but no effect on T1D was observed. Concerning the origin of the boys' conditions, several primary immune dysregulation disorders were considered. Thrombocytopenia associated with T1D is unusual and could represent a new entity. The diabetes manifestation in patient one was probably triggered by corticosteroid treatment; regardless, anti- CD20 therapy appeared to be efficacious early in the course of T1D, but not long after the initial diagnosis of T1D, as shown for patient two. [ABSTRACT FROM AUTHOR]

Primary mitochondrial diseases refer to a group of heterogeneous and complex genetic disorders affecting 1:5000 people. The true prevalence is anticipated to be even higher because of the complexity of achieving a diagnosis in many patients who present with multisystemic complaints ranging from infancy to adulthood. Diabetes is a prominent feature of several of these disorders which might be overlooked by the endocrinologist. We here review mitochondrial disorders and describe the phenotypic and pathogenetic differences between mitochondrial diabetes mellitus ( mDM) and other more common forms of diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objective Most youth with type 1 diabetes do not meet the American Diabetes Association ( ADA) and International Society for Pediatric and Adolescent Diabetes ( ISPAD) targets for hemoglobin A1c ( HbA1c), blood pressure (BP), lipids, and body mass index ( BMI). We hypothesized that ISPAD/ ADA goal achievement at baseline would be associated with cardiorenal risk factors at baseline and 2 yr follow-up in adolescents with type 1 diabetes. Methods We assessed the cross-sectional and longitudinal relationships between ISPAD/ ADA goal achievement at baseline and cardiorenal health at baseline and 2-yr follow-up (n = 297; 15.4 ± 2.1 yr at baseline) in adolescents with type 1 diabetes. Goal achievement was defined as HbA1c < 7.5%, BP < 90th percentile for age, sex, and height, low density lipoprotein-cholesterol ( LDL-C) <100 mg/ dL, high density lipoprotein-cholesterol ( HDL-C) >35 mg/ dL, triglycerides ( TG) <150 mg/ dL and BMI <85th percentile for age and sex. Cardiorenal outcomes included pulse-wave velocity ( PWV), brachial distensibility ( BrachD), augmentation index ( AIx), and epidermal growth factor receptor ( eGFR) continuously and categorically as hyperfiltration ( eGFR ≥ 135 mL/min/1.73 m2). Results Adolescents with type 1 diabetes who met 1-3 goals, had significantly greater (P < 0.05) baseline PWV (5.1 ± 0.1 vs. 5.4 ± 0.1 m/s), follow-up PWV (5.5 ± 0.1 vs. 5.7 ± 0.1 m/s), greater follow-up eGFR (104 ± 2 vs. 116 ± 3 mL/min/1.73 m2), and greater odds of renal hyperfiltration at follow-up (odds ratio ( OR): 20.0, 95% confidence interval ( CI): 3.8-105.2) compared to those who met 4-6 goals after adjusting for Tanner stage, sex, age, and diabetes duration. No statistically significant differences in the cardiorenal outcomes were observed between adolescents with type 1 diabetes who met 4-6 goals and non-diabetic controls (n = 96). Conclusions In adolescents with type 1 diabetes, baseline ADA/ ISPAD goal achievement was associated with cardiorenal protection at baseline and 2-yr follow-up. [ABSTRACT FROM AUTHOR]

Objective Recent literature suggests an association between type 1 diabetes ( T1D) and depression. So far, most studies explored this link in adult populations, with few data being available on diabetes and depression from minors and young adults. This study aimed to look for associations between symptoms of depression/antidepressant treatment and metabolic outcomes of T1D. Methods We conducted an observational study using the German diabetes database (Diabetes-Patienten-Verlaufsdokumentation - DPV) and searched for patients up to the age of 25 yr, with depressive symptoms and/or receiving antidepressant medication. Results Of 53 986 T1D patients below the age of 25 yr, antidepressant medication and/or depressive symptoms were reported in 419 (0.78%). After adjustment for age, gender, diabetes duration and center heterogeneity, minors and young adults with depressive symptoms showed worse outcome parameters such as a higher rate of severe hypoglycemia (0.56 vs. 0.20/patient year, p = 0.005) and more episodes of diabetic ketoacidosis (0.20 vs. 0.07/patient year, p < 0.001). Hemoglobin A1c ( HbA1c) was higher in the depression group (74.50 vs. 67.58 mmol/mol, p < 0.001) and young patients with T1D and depression showed longer duration of inpatient treatment (7.04 vs. 3.10 hospital days/patient year, p < 0.001) and more frequent admissions to hospital care (0.63 vs. 0.32/patient year, p < 0.001). Antidepressant medication was recorded in 52.3% of the depressed patients, with selective serotonin reuptake inhibitors ( SSRIs) being the most widely described class of antidepressants (29.1%). Conclusions Our findings demonstrate an adverse treatment outcome for young patients with T1D and comorbid depressive symptoms underlining an urgent need for collaborative mental and somatic health care for patients with T1D and depression. [ABSTRACT FROM AUTHOR]

Background In type 1 diabetes (T1D), the use of continuous subcutaneous insulin infusion (CSII) has increased steadily in the last years. Compared with conventional insulin injection regimes, major advantages might be a nearly physiological insulin secretion, lower rates of hypoglycemia, higher flexibility in daily life, and increased quality of life. Data on CSII in cystic fibrosis-related diabetes (CFRD) are scarce. Objective To analyze current use of insulin pumps in CFRD and compare demographics of pump-treated patients between CFRD and T1D. Methods Data from the prospective German/Austrian diabetes patient registry on insulin-treated patients with either CFRD (n = 515) or T1D (n = 43 165) aged >10 yr at manifestation of diabetes were analyzed. Results A total of 4.1% (n = 21) of CFRD and 17.7% (n = 7647) of T1D patients received insulin pump treatment within the recent year of care (p < 0.001). Pump-treated patients with CFRD had a significantly shorter duration of diabetes [median (Q1; Q3): 5.8 (2.9; 9.5) vs. 7.8 (4.3; 20.4) yr, p = 0.026] and tended to be younger [22.0 (18.2; 30.1) vs. 24.9 (17.3; 45.9) yr] than pump-treated T1D patients. Age at initiation of CSII seemed to be lower in CFRD [19.2 (16.5; 29.2) vs. 23.3 (14.8; 43.5) yr]. Insulin pump therapy was used slightly more often in male CFRD patients than females (4.7 vs. 3.6%), whereas in T1D the opposite was observed (14.9 vs. 21.2%, p < 0.001). Discontinuation rate of CSII was higher in CFRD than T1D (30.0 vs. 12.7%, p = 0.005). Conclusions Despite potential advantages, insulin pump therapy was rarely used among adolescent and young adult CFRD patients. [ABSTRACT FROM AUTHOR]

The article discusses research studies on the hemoglobin A1c (HbA1c) targets in children with type 1 diabetes. Details about the Diabetes Control and Complications Trial (DCCT), the Epidemiology of Diabetes Interventions and Complications (EDIC), and the Hvidoere Childhood Diabetes Study Group Centre Differences Study are provided. Some research findings are given related to the adverse effects of hypoglycemia and the association of lower HbA1c targets with benchmarking results.

Heterozygous mutations in GATA6 have been linked to pancreatic agenesis and cardiac malformations. The aim of this study was to describe a new mutation in GATA6 in an infant with pancreatic agenesis, associated with truncus arteriosus and absent gallbladder. Clinical data were obtained from chart review. Gene sequencing was performed on genomic DNA. The patient was a female infant diagnosed shortly after birth with a severe cardiac malformation, absent gallbladder, anomalous hepatic blood flow, unilateral hydronephrosis and hydroureter, neonatal diabetes, and pancreatic exocrine insufficiency. Despite prolonged intensive management care, she died at 3 months of age because of cardiac complications. Analysis of her genomic DNA revealed a novel missense mutation of GATA6. The novel mutation described in this case extends the list of GATA6 mutations causing pancreatic agenesis and cardiac malformations. [ABSTRACT FROM AUTHOR]

Background Cow's milk intake has been inconsistently associated with islet autoimmunity ( IA) and type 1 diabetes ( T1D) development. Genetic and environmental factors may modify the effect of cow's milk on IA and T1D risk. Methods The Diabetes Autoimmunity Study in the Young ( DAISY) follows children at increased T1D risk of IA (presence of autoantibodies to insulin, GAD65, or IA-2 twice in succession) and T1D development. We examined 1835 DAISY children with data on cow's milk intake: 143 developed IA, 40 subsequently developed T1D. Cow's milk protein and lactose intake were calculated from prospectively collected parent- and self-reported food frequency questionnaires ( FFQ). High risk HLA-DR genotype: HLA-DR3/4, DQB1*0302; low/moderate risk: all other genotypes. We examined interactions between cow's milk intake, age at cow's milk introduction, and HLA-DR genotype in IA and T1D development. Interaction models contained the base terms (e.g., cow's milk protein and HLA-DR genotype) and an interaction term (e.g., cow's milk protein* HLA-DR genotype). Results In survival models adjusted for total calories, FFQ type, T1D family history, and ethnicity, greater cow's milk protein intake was associated with increased IA risk in children with low/moderate risk HLA-DR genotypes [hazard ratio ( HR): 1.41, 95% confidence interval ( CI): 1.08-1.84], but not in children with high risk HLA-DR genotypes. Cow's milk protein intake was associated with progression to T1D ( HR: 1.59, CI: 1.13-2.25) in children with IA. Conclusions Greater cow's milk intake may increase risk of IA and progression to T1D. Early in the T1D disease process, cow's milk intake may be more influential in children with low/moderate genetic T1D risk. [ABSTRACT FROM AUTHOR]

Data on cardiovascular disease ( CVD) risk in adolescents with type 2 diabetes ( T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth ( TODAY) clinical trial (median 4½ yr from diagnosis of T2D, average age 18 yr), including MMode and 2D measurements of left ventricular ( LV) and left atrial ( LA) dimensions, LV tissue Doppler imaging ( TDI), and tricuspid annular plane systolic excursion ( TAPSE). Relationships between cardiac structure and function with demographic characteristics and baseline and change-from-baseline in CVD risk factors were examined in 455 participants. Mean LV mass ( LVM) was high/normal and 16.2% had adverse LV geometry (8.1% concentric geometry, 4.5% LV hypertrophy, and 3.6% both). Determinants of higher LVM were male gender, black race, baseline and increasing body mass index ( BMI), baseline and increasing systolic blood pressure ( SBP), use of blood pressure ( BP) medications, maintenance of glycemic control, and smoking; heart rate ( HR) was inversely related. LV shortening fraction was high/normal and related to increasing BMI and higher baseline SBP. LV relative wall thickness was related to race-ethnicity, change in BMI, baseline glycated hemoglobin (HbA1c), and baseline and change in SBP. Mean LA internal dimension was high/normal and gender, baseline and increasing BMI, increasing SBP, and HR (inverse) were related. LV TDI was positively related to obesity (higher with adverse geometry). TAPSE was normal and related to higher baseline BMI and lower HR. There was no effect of T2D treatment on cardiac target organ injury. Adolescents with T2D have adverse measures of cardiac structure and function positively related to BMI and BP. [ABSTRACT FROM AUTHOR]

Background Patients with type 1 diabetes mellitus ( T1DM) may experience poor muscle health as a result of chronic hyperglycemia. Despite this, muscle function in children with T1DM with good or poor glycemic control has yet to be examined in detail. Objective To assess differences in muscle-related fitness variables in children with T1DM with good glycemic control ( T1DM-G), as well as those with poor glycemic control ( T1DM-P), and non-diabetic, healthy controls. Subjects Eight children with T1DM-G [glycosylated hemoglobin ( HbA1c) ≤ 7.5% for 9 months], eight children with T1DM-P ( HbA1c ≥ 9.0% for 9 months), and eight healthy controls completed one exercise session. Methods Anaerobic and aerobic muscle functions were assessed with a maximal isometric grip strength test, a Wingate test, and an incremental continuous cycling test until exhaustion. Blood samples were collected at rest to determine HbA1c at the time of testing. Physical activity was monitored over 7 d using accelerometry. Results Children with T1DM-P displayed lower peak oxygen consumption ( VO2peak) values (mL/kg/min) compared to healthy controls ( T1DM-P: 33.2 ± 5.6, controls: 43.5 ± 6.3, p < 0.01), while T1DM-G (43.5 ± 6.3) had values similar to controls and T1DM-P. There was a negative relationship between VO2peak and HbA1c% (r = −0.54, p < 0.01). All groups were similar in all other fitness variables. There were no group differences in physical activity variables. Conclusion Children with T1DM-G did not display signs of impaired muscle function, while children with T1DM-P have signs of altered aerobic muscle capacity. [ABSTRACT FROM AUTHOR]

The article discusses the use of automated algorithms in determining cases of diabetes in children and diabetes type classification based on demographic characteristics. Topics include how administrative and electronic health record data can be used in these algorithms, how age, race, and ethnicity impact the risk of diabetes, and how effective the algorithms were at identifying childhood diabetes of both types.

Objective In their Strategic Impact Goal Statement, the American Heart Association focused on primordial prevention of cardiovascular risk factors by defining metrics for ideal cardiovascular health ( ICH). The prevalence of ICH among youth with type 1 diabetes is unknown. Youth with type 1 diabetes face an increased risk of cardiovascular disease ( CVD) as they age. The purpose of this report was to examine the prevalence of ICH in a population of youth with type 1 diabetes and to examine the association of ICH with measures of cardiovascular structure and function. Research design and methods This report is based on SEARCH CVD an ancillary study to the SEARCH for Diabetes in Youth. A total of 190 adolescents with type 1 diabetes had complete data on all of the ICH metrics at baseline and had measures of arterial stiffness [pulse wave velocity ( PWV), brachial distensibility ( BrachD), and augmentation index ( AIx)] and carotid intima-media thickness completed at a follow-up visit [on average 5 yr after baseline (interquartile range 4-5)]. Results No subjects met the ICH criteria for all 7 metrics. Meeting an increasing number of ICH metrics was significantly associated with lower arterial stiffness [lower PWV of the trunk (β = −0.02 ±0.01; p = 0.004) and AIx (β = −2.2 ±0.66; p = 0.001), and increased BrachD (β = 0.14 ±0.07; p = 0.04)]. Conclusions Increasing number of ICH metrics was significantly associated with decreased arterial stiffness, but prevalence of ICH in this population was low. Youth with type 1 diabetes could benefit from improvements in their cardiovascular health. [ABSTRACT FROM AUTHOR]

An appendix is presented of the varied resources used in the guidelines on pediatric diabetes in the International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2014 Compedium.

The article presents abstracts on medical topics which include the discovery of insulin, treatment for type 1 diabetes, and the role of clinical outcomes trials in clinical medicine.

Aims The aim of this study was to explore whether islet cell antibodies ( ICA) could be identified in children with newly onset diabetes mellitus but negative for autoantibodies against glutamic acid decarboxylase ( GADA), islet antigen-2 ( IA-2A), insulin ( IAA), or any of the three variants with arginine (R), tryptophan (W), or glutamine (Q) at position 325 of the zinc transporter 8 ( ZnT8A). Methods A population-based analysis of autoantibodies was performed from 1 May 2005 to 2 September 2010 in Swedish children newly diagnosed with diabetes. ICA was analyzed with an enzyme-linked immunosorbent assay and if positive, reanalyzed in the classical ICA immunofluorescence assay, in 341 samples among 3545 children who had been tested negative for all of GADA, IA-2A, IAA, or ZnT8A (R, W, Q). Results An isolated positivity for ICA was identified in 5.0% (17/341) of the newly diagnosed children. The levels of ICA in positive subjects ranged from 3 to 183 JDF-U (median 30). This finding increased the diagnostic sensitivity of islet autoimmunity as 3204/3545 patients (90.4%) were islet autoantibody positive without the ICA analyses and 3221 patients (90.9%) were positive with the inclusion of ICA. Conclusions The finding of an isolated positivity for ICA despite negativity for GADA, IA-2A, IAA, and ZnT8A (R, W, Q) suggests that still another yet unidentified autoantigen(s) may contribute to the ICA immunofluorescence. Hence, ICA is important to analyze in type 1 diabetes children and adolescents that would otherwise be islet autoantibody negative. [ABSTRACT FROM AUTHOR]

An introduction is presented where the editor discusses various reports published within the issue on topics including the prevention of type 1 diabetes (TID), a review of present and future prevention efforts and a review of the Swedish approach to preventing TID through a discussion of the Diabetes Prediction in Skane Study.

An introduction to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2014 Compedium on pediatric diabetes is presented.

The article reflects on International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines on diabetes care. It mentions that the guidelines will be widely consulted and are freely available to be used to improve awareness among governments and health care providers; and provide evidence-based advice to improve the care of children. It informs that the guidelines has been endorsed by the Pediatric Endocrine Society.

The article offers information on the October 2017 edition of "Pediatric Diabetes" which features the abstracts presented at the 43rd Annual Meeting of the International Society for Pediatric and Adolescent Diabetes held in Innsbruck, Austria.

The article presents the editorial staff of the journal "Pediatric Diabetes" Volume 17, Issue 4 June 2016 issue including Editor-in-Chief Mark A. Sperling, Deputy Editor Olga Kordonouri and Associate Editors Silva Arslanian, Dorothy J. Becker and Ram K. Menon.

Information about the journal is offered including its editor in chief, aims and scopes, and copyright.

The front cover of the journal is presented along with the issue's editors and information on membership and subscriptions.

The front cover of the journal is presented along with the issue's editors and information on membership and subscriptions.

The front cover of the journal is presented along with the issue's editors and information on scope and subscriptions.