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Background and Objective: Epicardial adipose thickness (EAT) is increased in adults with type 1 diabetes (T1D) and is thought to contribute to cardiovascular disease (CVD) in this population. Given that CVD risk factors emerge early in life, the purpose of this study was to identify whether EAT is increased in pediatric patients with T1D compared with non‐diabetic controls. Methods: Anthropometric data, blood pressure (BP), and EAT were evaluated in 20 youth with T1D and 20 age, sex, and body mass index (BMI) matched healthy controls between the ages of 5 and 18 years. Results: EAT was 18.5% higher among youth with T1D compared to healthy controls (1.65 ± 0.44 mm vs 1.37 ± 0.27 mm, P = .02). In the entire cohort, EAT was correlated with age (r = 0.71, P < .001), BMI (r = .69, P < .001), waist circumference (r = 0.60, P < .001), systolic BP (r = .34, P =.03), and diastolic BP (r = 0.41, P =.009). Among youth with T1D, there were no significant correlations between EAT and HbA1c (r = −0.16, P = .50), insulin dose (r = .09, P = .71), or duration of disease (r = 0.06, P = .82). Conclusions: Youth with T1D exhibited significantly higher EAT compared to controls. Increased EAT was associated with adiposity and BP, but not duration of disease, insulin dose, or glycemic control. Increased EAT may represent a pathophysiologic mechanism leading to premature CVD in pediatric patients with T1D. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) is a chronic medical condition that can negatively impact both physical and psychological health. Diabetes resilience can be protective against the physical and social/emotional consequences among children with T1D yet few studies have examined the ability to increase resiliency in the pediatric population. Forty children with T1D (Age 14.1±2.3 years, 48% female, Hba1c 12.0±1.6%) were enrolled in a 4-month multi-disciplinary intervention that included medical management, Psychology-led motivational interviewing, and frequent support from a Certified Diabetes Care and Education Specialist (CDCES). Participants completed the Diabetes Strengths and Resilience (DSTAR) measure at baseline and post-intervention. The DSTAR is a validated assessment tool aimed to assess both self and parent reported measures of general and diabetes-related child self-efficacy and level of perceived support, as well as diabetes distress. HbA1c was assessed at baseline and 4 months. At baseline, higher DSTAR scores were associated with lower HbA1c (r=-0.34, p=0.03). DSTAR scores increased significantly in response to the intervention from 43.9±6.4 to 47.2±6.9 at 4 months (p<0.001). Additionally, HbA1c significantly improved from baseline to post-intervention (12.0±1.6% to 11.0±1.9%, p<0.001). A multifaceted approach to children with diabetes can improve levels of resilience, a factor involved in improving and maintaining both physical and psychological health. Disclosure: S. S. Puffenberger: None. F. Hoekstra: None. C. R. Kapadia: None. G. Q. Shaibi: None. M. Chambers: None. Funding: Thomas J. Beatson Jr. Foundation [ABSTRACT FROM AUTHOR]

Background: Youth with poorly controlled type 1 diabetes (T1D) are at increased risk for morbidity yet very few interventions have targeted this vulnerable population. The purpose of this study was to test the feasibility, acceptability and preliminary efficacy of an intensive, team-based intervention program for youth with HbA1c ≥ 9.5%. Methods: Forty patients (age 14.1±2.3 years, 53% male) with T1D (duration 6.5±4.3 years) were enrolled in an intensive, 4-month team-based intervention that included a visit with their primary endocrinologist and a pediatric psychologist at baseline as well as up to 6 encounters (in-person visits and calls) with a Certified Diabetes Educator (CDE). The CDE encounters were designed to establish goals, support behavior changes, review glucose logs, and make interim dose adjustments as needed. Feasibility was measured by the number of patients approached and the number of patients who ultimately agreed to participate, acceptability was measured by attendance and attrition rates, and preliminary efficacy was assessed by changes in HbA1c and diabetes-related Quality of Life (QoL). Data were collected at baseline and 4 months. Results: Of the 42 patients who were approached, 40 agreed to participate, and 35 (87.5%) completed the 4-month program. CDE engagement with patients included an average of 3 phone calls and 3 in-person visits. Compared to baseline, HbA1c reduced from 12.0%±1.6 at baseline to 11.0%±1.9 at the 4 month visit (p<0.001) and QoL increased from 61.0±12.3 to 64.7±11.0 (P<0.05). Conclusion: Intensive team-based interventions in pediatric patients with poorly controlled T1D can improve glycemic control and QoL. Disclosure: M. Chambers: None. G.Q. Shaibi: None. C.R. Kapadia: None. F. Hoekstra: None. S.S. Puffenberger: None. L. Touger: None. I.K. Radcliffe: None. L. Holzmeister: None. K.A. Olsen: None. Funding: Thomas J. Beatson, Jr. Foundation [ABSTRACT FROM AUTHOR]

Objective: We hypothesized that most patients with 22q11.2 deletion and a history of hypocalcemia have inadequate parathyroid function, manifested by intact parathyroid hormone levels below normal. We aimed to evaluate intact parathyroid hormone levels both during normocalcemia and at hypocalcemia, in this population., Study Design: Retrospective chart review of 103 patients with 22q11.2 deletion born since 1997 and cared for at the Children's Hospital of Philadelphia. Calcium and intact parathyroid hormone drawn simultaneously were recorded, along with clinical presentation at hypocalcemia., Results: Forty-seven simultaneous Ca/intact parathyroid hormone values were available. Seventy-nine percent of calcium levels and 81% of parathyroid hormone levels were within normal range. There were 19 patients with a history of symptomatic hypocalcemia, for whom any available simultaneous Ca/parathyroid hormone levels, before, during, or after hypocalcemia were analyzed. In this subgroup, 59% of calcium and 76% of parathyroid hormone levels were normal. None had an intact parathyroid hormone of >39.2 pg/mL at hypocalcemia. Seventy-three percent of hypocalcemic events had a precipitating stressor., Conclusions: Hypoparathyroidism in 22q11.2 deletion is mild, manifesting as a phenomenon of decreased parathyroid hormone reserve. Subjects are normocalcemic most of the time, but are unable to mount elevated intact parathyroid hormone levels, and therefore unable to correct hypocalcemia, in response to stressors.