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Routine growth monitoring is crucial for all children. American Academy of Pediatrics guidelines state that children should be measured annually, but some children may not routinely be evaluated by primary care providers. Inpatient admissions provide the opportunity to identify growth disorders. The purpose of this study was to obtain data on the linear measuring practices in an urban children's hospital. Charts were reviewed from a random sample of 200 children who were admitted; 57% were measured, 42% had measurements plotted on growth charts, and 24% had measurements plotted correctly. Ongoing education is necessary for nursing staff to accurately obtain and plot measurements. © Elsevier Inc. [ABSTRACT FROM AUTHOR]

Children and adolescents with type 1 diabetes are at risk for disordered eating and unhealthy weight-control practices. This study describes (a) participants' weight perception and weight satisfaction, (b) participants' scores on the Diabetes Eating Problem Survey (DEPS), (c) prevalence of weight-control behaviors, and (d) association of DEPS and weight-control behaviors with race, gender, age, body mass index (BMI), hemoglobin A1c (HbA1c), weight satisfaction, and weight perception. TheAHEAD survey was completed by 295 participants to determine weight satisfaction, weight perception, and weight-control behaviors. Height, weight, and HbA1c were obtained from clinic charts. Older females with higher BMI and elevated HbA1c used significantly more weight-control behaviors. Weight dissatisfaction and heavy weight perception were associated with significantly more unhealthy weight-control practices. Prevention programs should be directed toward the preteen female. Older female teens presenting with higher BMI, elevated HbA1c, weight dissatisfaction, and heavy weight perception should be formally assessed for unhealthy weight-control behaviors. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the epidemiology of type 1 diabetes in children in Philadelphia, Pennsylvania, from 1995 through 1999 and compare these data with previous cohorts. RESEARCH DESIGN AND METHODS: This is a report of a retrospective population-based registry maintained since 1985. Hospital records meeting the following criteria were reviewed: newly diagnosed type 1 diabetes, age 0-14 years, residing in Philadelphia at the time of diagnosis, and diagnosed from 1 January 1995 to 31 December 1999. The secondary source of validation was the School District of Philadelphia. Incidence rates by race and age were compared with 1985-1989 and 1990-1994 cohorts. RESULTS: A total of 234 case subjects were identified, and the registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 14.8 per 100,000/year. Incidence rates in Hispanic children (15.5 per 100,000/year) and white children (12.8 per 100,000/year) have been relatively stable over 15 years. The incidence in black children (15.2 per 100,000/year), however, has increased dramatically, rising 64% in children 5-9 years of age (14.9 per 100,000/year) and 37% in the 10- to 14-year age-group (26.9 per 100,000/year). CONCLUSIONS: The overall incidence of type 1 diabetes in Philadelphia is increasing and is similar to other U.S. registries. These are the first data reporting a higher incidence in black children in a registry of children 0-14 years of age. The etiology of the marked increase in incidence in the black population is unknown and underscores the need to establish type 1 diabetes as a reportable disease, so that environmental risk factors may be thoroughly investigated. [ABSTRACT FROM AUTHOR]

Eating disorders are a significant health problem for many adolescents and are described as occurring along a spectrum of symptoms including disordered eating behaviors and clinical eating disorders. Poor self-esteem and body image, intense fear of gaining weight or refusal to maintain weight, and purging unwanted calories are clinical features of some eating disorders. Type 1 diabetes is a chronic illness with marked insulin deficiency. Chronic hyperglycemia creates a state of glucosuria with subsequent weight loss. Diabetes treatment focuses on intensive daily management of blood glucose by balancing insulin, food intake, and physical activity. Insulin omission offers an easy method for the purging of unwanted calories. The combination of these 2 illnesses is potentially deadly and also leads to an increased risk of poor diabetes outcomes. This includes poor metabolic control (measured by elevated hemoglobin A1C), increased risk of diabetic ketoacidosis, and microvascular complications such as retinopathy and nephropathy. Diabetes clinicians should be aware of the potential warning signs in an adolescent with diabetes as well as assessment and treatment options for eating disorders with concomitant type 1 diabetes. This article reviews the available data on the prevalence, screening tools, assessment guidelines, and treatment options for eating disorders in youth with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Objective: To determine the epidemiology of type 1 diabetes in children in Philadelphia from 1990 to 1994, and to identify whether an epidemic occurred during that time period.Research Design and Methods: This is a descriptive epidemiological study using a retrospective population-based registry in Philadelphia, PA, a city with large white, African-American, and Hispanic (Puerto Rican) populations. All hospitals in Philadelphia that admit children were identified. All charts meeting the following criteria were reviewed: 1) newly diagnosed type 1 diabetes, 2) children 0-14 years of age, 3) children residing in Philadelphia at the time of diagnosis, and 4) those diagnosed from 1 January 1990 to 31 December 1994. Standard type 1 diabetes registry data were abstracted from the charts. Ascertainment of the completeness of the hospital registry was validated by data from the Philadelphia School District. Communicable disease records were reviewed to identify epidemics from 1987 to 1995.Results: A total of 209 cases were identified, and the combined hospital and school registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 13.3/100,000/year. The highest rate by race continues to be in the Hispanic population (15.5). The incidence in African-American children has increased markedly (12.8), particularly in the 10- to 14-year age-group (22.9). An epidemic of type 1 diabetes occurred from January to June 1993, approximately 2 years after a measles epidemic in Philadelphia.Conclusions: The overall incidence of type 1 diabetes in Philadelphia is similar to other U.S. registries. The incidence in the Hispanic population continues to be among the highest of any U.S. ethnic group. The marked increase in incidence in the African-American population may be due in part to misclassification of cases actually having type 2 diabetes. The 1993 epidemic may have been due to beta-cell autoimmunity triggered by the measles virus. [ABSTRACT FROM AUTHOR]

Objective: The current study examines the prevalence of binge eating and its association with adiposity and psychosocial functioning in a large, diverse sample of youth with type 2 diabetes.Research Design and Methods: In the TODAY study, 678 (mean age 14.0 years; 64.9% girls) of the 704 youth randomized to the study completed a self-report measure of eating disorder symptoms and were categorized as nonovereaters, overeaters, subclinical binge eaters, or clinical binge eaters.Results: Youth with clinical (6%) and subclinical (20%) levels of binge eating had significantly higher levels and rates of extreme obesity, global eating disorder and depressive symptoms, and impaired quality of life.Conclusions: These findings highlight the importance of evaluating youth with type 2 diabetes for the presence of binge eating. Future research is needed to determine the cumulative effects of disordered eating, obesity, and psychosocial distress on adherence to lifestyle change recommendations and longitudinal response to treatment. [ABSTRACT FROM AUTHOR]